bluuebunny/crossref_metadata_2025 huggingface dataset:
Which Factors Are the Most Important for Predicting Sleep Quality in Obstructive Sleep Apnea Patients with Obesity?
Authors: Kim Byung Joon , Park Kang Min
Published: July 2019

Background: Both obstructive sleep apnea (OSA) and obesity are associated with poor sleep quality. However, there have been no studies investigating sleep quality in OSA patients with obesity. The aims of this study were to (1) evaluate the sleep quality in OSA patients with obesity and (2) identify the parameters most related to sleep quality in OSA patients with obesity. Methods: Of the patients with polysomnography (PSG), OSA patients with obesity (body mass index [BMI] ≥25) were enrolled and then divided into 2 groups based on the Pittsburg Sleep Questionnaire Index (PSQI): patients with good sleep quality (PSQI ≤5, good sleepers) and those with poor sleep quality (PSQI >5, poor sleepers). In addition, we enrolled OSA patients without obesity as a disease control group. Results: Eighty-two OSA patients with obesity met the inclusion criteria (28 were good sleepers, whereas 54 were poor sleepers). We found that the BMI of the poor sleepers was significantly higher than that of the good sleepers, whereas the N-stage sleep ratio of good sleepers was higher than that of poor sleepers. Logistic ­regression analysis also showed that a high BMI and low ­N-stage sleep ratio were independently associated with poor sleep quality. In addition, BMI and N-stage sleep ratio were significantly correlated with PSQI. However, in 56 OSA patients (n = 56) without obesity, there were no differences of demographic/clinical characteristics and PSG parameters between the good (n = 18) and poor sleepers (n = 38). Discussions: About two-thirds of OSA patients with obesity show poor sleep quality. The sleep quality of these patients was more affected by the severity of obesity, but not the severity of OSA. Thus, we recommend weight loss in OSA patients with obesity to improve sleep quality as well as the severity of OSA.
Therapeutic Potential of Wnt-3a in Neurological Recovery after Spinal Cord Injury
Authors: Gao Kai , Zhang Tao , Wang Fang , Lv Chaoliang
Published: July 2019

Background: Spinal cord injury (SCI) is a constant challenge in medical research and a global therapeutic problem. Treatment of this condition remains difficult in clinical practice. Hence, prevention, treatment, and rehabilitation of SCI have become imminent tasks in the medical field. Summary: Recent evidence suggest the important role of Wnt/β-catenin signaling pathway, a canonical Wnt signaling pathway, in neural development, axon guidance, neuropathic pain relief, and neuronal survival. Wnt-3a is regarded as an activator of the canonical Wnt signaling pathway. This activator is expressed in the dorsal midline region and is responsible for spinal cord development. In addition, Wnt-3a plays a regulatory role in autophagy, apoptosis, and regeneration of neurons; neurogenic inflammation; and axon regeneration. Herein, we demonstrated that neuronal autophagy was regulated by Wnt-3a via β-catenin and mammalian target of rapamycin signaling pathways after SCI. Our study also discovered that the Wnt-3a provided a favorable microenvironment for the recovery of nerve function after SCI. Key Messages: This study systematically elaborates the neuroprotective effect of Wnt-3a and its neuroprotection molecular mechanism after SCI. This study provides a new molecular mechanism and research basis for clinical treatment of SCI.
RIKADA Study Reveals Risk Factors in Pediatric Primary Cardiomyopathy
Authors: Al‐Wakeel‐Marquard Nadya , Degener Franziska , Herbst Christopher , Kühnisch Jirko , Dartsch Josephine , Schmitt Boris , Kuehne Titus , Messroghli Daniel , Berger Felix , Klaassen Sabine
Published: July 2019

Background

Cardiomyopathies are heterogeneous diseases with clinical presentations varying from asymptomatic to life‐threatening events, including severe heart failure and sudden cardiac death. The role of underlying genetic and disease‐modulating factors in children and adolescents is relatively unknown. In this prospective study, in‐depth phenotypic and genetic characterization of pediatric patients with primary cardiomyopathy and their first‐degree family members (FMs) was performed. Outcome was assessed to identify clinical risk factors.

Methods and Results

Sixty index patients with primary cardiomyopathy (median age: 7.8 years) and 124 FMs were enrolled in the RIKADA (Risk Stratification in Children and Adolescents with Primary Cardiomyopathy) study. Family screening included cardiac workup and genetic testing. Using cardiologic screening, we identified 17 FMs with cardiomyopathies and 30 FMs with suspected cardiomyopathies. Adverse events appeared in 32% of index patients and were more common in those with lower body surface area (
P
=0.019), increased NT‐proBNP (N‐terminal pro–brain natriuretic peptide;
P
<0.001), and left ventricular dysfunction (
P
<0.001) and dilatation (
P
=0.005). The worst prognosis was observed in dilated and restrictive cardiomyopathies. Genetic variants of interest were detected in patients (79%) and FMs (67%). In all 15 families with at least 1 FM with cardiomyopathy, we found a variant of interest in the index patient. Increased number of variants of interest per patient was associated with adverse events (
P
=0.021). Late gadolinium enhancement was related to positive genotypes in patients (
P
=0.041).

Conclusions

Lower body surface area, increased NT‐proBNP, left ventricular dysfunction or dilatation, late gadolinium enhancement, and increased number of variants of interest were associated with adverse outcome and should be considered for risk assessment in pediatric primary cardiomyopathies.

Clinical Trial Registration

URL:
https://www.clinicaltrials.gov/
. Unique identifier: NCT03572569.
Treatment With Tetrahydrobiopterin Improves White Matter Maturation in a Mouse Model for Prenatal Hypoxia in Congenital Heart Disease
Authors: Romanowicz Jennifer , Leonetti Camille , Dhari Zaenab , Korotcova Ludmila , Ramachandra Shruti D. , Saric Nemanja , Morton Paul D. , Bansal Shivani , Cheema Amrita , Gallo Vittorio , Jonas Richard A. , Ishibashi Nobuyuki
Published: July 2019

Background

Reduced oxygen delivery in congenital heart disease causes delayed brain maturation and white matter abnormalities in utero. No treatment currently exists. Tetrahydrobiopterin (
BH
4) is a cofactor for neuronal nitric oxide synthase.
BH
4 availability is reduced upon
NOS
activation, such as during hypoxic conditions, and leads to toxin production. We hypothesize that
BH
4 levels are depleted in the hypoxic brain and that BH4 replacement therapy mitigates the toxic effects of hypoxia on white matter.

Methods and Results

Transgenic mice were used to visualize oligodendrocytes. Hypoxia was introduced during a period of white matter development equivalent to the human third trimester.
BH
4 was administered during hypoxia.
BH
4 levels were depleted in the hypoxic brain by direct quantification (n=7–12). The proliferation (n=3–6), apoptosis (n=3–6), and developmental stage (n=5–8) of oligodendrocytes were determined immunohistologically. Total oligodendrocytes increased after hypoxia, consistent with hypoxia‐induced proliferation seen previously; however, mature oligodendrocytes were less prevalent in hypoxia, and there was accumulation of immature oligodendrocytes.
BH
4 treatment improved the mature oligodendrocyte number such that it did not differ from normoxia, and accumulation of immature oligodendrocytes was not observed. These results persisted beyond the initial period of hypoxia (n=3–4). Apoptosis increased with hypoxia but decreased with
BH
4 treatment to normoxic levels. White matter myelin levels decreased following hypoxia by western blot.
BH
4 treatment normalized myelination (n=6–10). Hypoxia worsened sensory‐motor coordination on balance beam tasks, and
BH
4 therapy normalized performance (n=5–9).

Conclusions

Suboptimal
BH
4 levels influence hypoxic white matter abnormalities. Repurposing
BH
4 for use during fetal brain development may limit white matter dysmaturation in congenital heart disease.
Prospective Randomized Comparison of Fractional Flow Reserve Versus Optical Coherence Tomography to Guide Revascularization of Intermediate Coronary Stenoses: One‐Month Results
Authors: Leone Antonio Maria , Burzotta Francesco , Aurigemma Cristina , De Maria Giovanni Luigi , Zambrano Aniello , Zimbardo Giuseppe , Arioti Manfredi , Cerracchio Emma , Vergallo Rocco , Trani Carlo , Crea Filippo
Published: July 2019

Background

Fractional flow reserve (
FFR
) and optical coherence tomography (
OCT
) may help both in assessment and in percutaneous coronary intervention optimization of angiographically intermediate coronary lesions. We designed a prospective trial comparing the clinical and economic outcomes associated with
FFR
or
OCT
in angiographically intermediate coronary lesions.

Methods and Results

Three hundred fifty patients with angiographically intermediate coronary lesions (n=446) were randomized to
FFR
or
OCT
guidance. In the
FFR
arm, percutaneous coronary intervention was performed if
FFR
was ≤0.80 aiming for a postprocedure
FFR
>0.90. In the
OCT
arm, percutaneous coronary intervention was performed if percentage of area stenosis was ≥75% or 50% to 75% with minimal lumen area <2.5 mm
2
or plaque ulceration. Costs, angina frequency, and major adverse cardiac events were assessed at 1 month and at 13 months. We present early data at 1 month consistent with a prespecified analysis of secondary end points. Patients randomized to
FFR
, as compared with
OCT
, were significantly more commonly managed with medical therapy alone (67.7% versus 41.1%;
P
<0.001), required less contrast media (245±137 versus 280±129 mL;
P
=0.004), and exhibited a lower occurrence of contrast‐induced acute kidney injury (1.7% versus 8.6%;
P
=0.034). At 1 month, in comparison to
FFR
,
OCT
was associated with increased total costs (2831±1288 versus 4292±3844 euros/patient;
P
<0.001) whereas occurrence of major adverse cardiac events or significant angina was similar.

Conclusions

In patients with angiographically intermediate coronary lesions, a functional guidance by
FFR
, as compared with
OCT
, increased the rate of patients treated with medical therapy alone. This translated into a significant reduction in administered contrast, contrast‐induced acute kidney injury, and total costs at 1 month with
FFR
.

Clinical Trial Registration

URL
:
http://www.clinicaltrialsgov
. Unique identifier:
NCT
01824030.
Decoding Hidden Cognitive States From Behavior and Physiology Using a Bayesian Approach
Authors: Yousefi Ali , Basu Ishita , Paulk Angelique C. , Peled Noam , Eskandar Emad N. , Dougherty Darin D. , Cash Sydney S. , Widge Alik S. , Eden Uri T.
Published: July 2019

Cognitive processes, such as learning and cognitive flexibility, are both difficult to measure and to sample continuously using objective tools because cognitive processes arise from distributed, high-dimensional neural activity. For both research and clinical applications, that dimensionality must be reduced. To reduce dimensionality and measure underlying cognitive processes, we propose a modeling framework in which a cognitive process is defined as a low-dimensional dynamical latent variable—called a cognitive state, which links high-dimensional neural recordings and multidimensional behavioral readouts. This framework allows us to decompose the hard problem of modeling the relationship between neural and behavioral data into separable encoding-decoding approaches. We first use a state-space modeling framework, the behavioral decoder, to articulate the relationship between an objective behavioral readout (e.g., response times) and cognitive state. The second step, the neural encoder, involves using a generalized linear model (GLM) to identify the relationship between the cognitive state and neural signals, such as local field potential (LFP). We then use the neural encoder model and a Bayesian filter to estimate cognitive state using neural data (LFP power) to generate the neural decoder. We provide goodness-of-fit analysis and model selection criteria in support of the encoding-decoding result. We apply this framework to estimate an underlying cognitive state from neural data in human participants ([Formula: see text]) performing a cognitive conflict task. We successfully estimated the cognitive state within the 95% confidence intervals of that estimated using behavior readout for an average of 90% of task trials across participants. In contrast to previous encoder-decoder models, our proposed modeling framework incorporates LFP spectral power to encode and decode a cognitive state. The framework allowed us to capture the temporal evolution of the underlying cognitive processes, which could be key to the development of closed-loop experiments and treatments.
Supervised Determined Source Separation with Multichannel Variational Autoencoder
Authors: Kameoka Hirokazu , Li Li , Inoue Shota , Makino Shoji
Published: July 2019

This letter proposes a multichannel source separation technique, the multichannel variational autoencoder (MVAE) method, which uses a conditional VAE (CVAE) to model and estimate the power spectrograms of the sources in a mixture. By training the CVAE using the spectrograms of training examples with source-class labels, we can use the trained decoder distribution as a universal generative model capable of generating spectrograms conditioned on a specified class index. By treating the latent space variables and the class index as the unknown parameters of this generative model, we can develop a convergence-guaranteed algorithm for supervised determined source separation that consists of iteratively estimating the power spectrograms of the underlying sources, as well as the separation matrices. In experimental evaluations, our MVAE produced better separation performance than a baseline method.
The Religious Gender Gap within Dutch Relationships: Explaining the Persistent Religious Gender Gap in the Netherlands Using a Multifactorial Approach
Authors: Kregting Joris , Scheepers Peer , Vermeer Paul , Hermans Chris
Published: July 2019

Like other Western countries, in the Netherlands women continue to demonstrate higher levels of religiosity than men. In this article, we set out to explain this Dutch religious gender gap regarding belief in God, prayer and church attendance. Using high quality survey data (LISS 2015), a comprehensive model is built combining social and psychological differences between Dutch men and women. These gender differences are operationalized where they are most strongly experienced, i.e. within personal relationships. We find that the gender gaps within Dutch relationships regarding belief in God and prayer can be explained by gendered religious socialization and gendered mental health dependency—and for belief in God additionally by the gendered level of agreeableness. For the gender gap regarding church attendance, gendered religious socialization explains the religious gender gap.
Religion and Inclusive Society: Attitudes towards the Poor among Muslim and Christian Students in Surabaya
Authors: Sterkens Carl , Isharianto Rafael , Vermeer Paul
Published: July 2019

This study explores attitudes towards the poor among Christian and Muslim secondary school students in Indonesia. Are there significant differences between Muslims and Christians with regard to these attitudes and, if any, how could they be explained? The authors argue that there is little reason to expect differences based on religious affiliation alone, because both Christianity and Islam pay special attention to poverty alleviation and economic justice in teachings and moral guidelines. However, specific religious beliefs and practices could still result in different attitudes towards the poor among Muslims and Christians. This study investigates to what extent beliefs such as attitudes towards religious plurality, fundamentalism, religious salience and religious practices are related with attitudes towards the poor. The potential differential effects of non-religious factors like socio-economic status, social dominance orientation, bonding and bridging social capital, compassion and school activities are also taken into account.
A Glass Half Full?
Authors: Bordin Fernando Lusa
Published: July 2019

Much has been said about the shortcomings of the two-element test for customary international law, the traditional methodology on which the ILC has focused in its recently completed study on the identification of custom. But custom as a source of law is notoriously elusive and slippery, and the deficiencies of the traditional methodology, for which there is no easy fix, are a reflection of a decentralised international legal system lacking a legislature and a system of courts with compulsory jurisdiction. The article offers some thoughts on the character of the two-element approach as an evaluative test, and the functions that it performs in structuring and constraining international legal reasoning in a way that safeguards the equality of States. By reflecting on the methodology’s constructive role, the article cautions against overly alarmist predictions that customary international law is a dancefloor.
Disentangling the identity of the genus Biatorellina (Leotiomycetes, Ascomycota)
Authors: QUIJADA LUIS , POLHORSKÝ ADAM , MITCHELL JAMES K. , Pfister Donald H.
Published: July 2019

The monotypic genus Biatorellina is currently considered a taxonomic synonym of Tryblidiopsis but has an obscure and complicated history. During the revision of the genus Tympanis a syntype of Biatorellina buchsii was fortuitously found and reviewed. Initially our revision led to the hypothesis that B. buchsii could be conspecific with Tympanis confusa. A bibliographic and morphological revision, together with a biometric study, was done using the syntype of B. buchsii and specimens of Tympanis confusa to verify the identity of the genus Biatorellina. Our results show an overlap in the morphology, biometry, distribution and ecology of B. buchsii (≡ Tympanis buchsii) and Tympanis confusa. The identity and the placement of Biatorellina is resolved and B. buchsii is proposed as a synonym of Tympanis confusa.
Synalpheus amintae sp. nov., a new species of sponge–dwelling snapping shrimp (Crustacea: Decapoda: Alpheidae) from Parque Nacional Natural Isla Gorgona, Pacific Coast of Colombia
Authors: RAMOS-TAFUR GABRIEL E. , FRANKE-ANTE REBECA
Published: July 2019

A new species of sponge–dwelling snapping shrimp, Synalpheus amintae sp. nov. from the Parque Nacional Natural Isla Gorgona, Pacific coast of Colombia, is described. This new species pertains to the denominated Synalpheus “Gambarelloides” species group sensu Coutière (1909)—previously known as “Laevimanus” group. It was collected in the southern part of the Island, during episodes of extreme low tides, known locally as “puja”. Synalpheus amintae sp. nov. is closely related to the only two other known species of the S. “Gambarelloides” species group from the eastern Pacific: Synalpheus occidentalis Coutière, 1909, from Gulf of San José, Lower California, and Synalpheus mulegensis Ríos, 1992, from Bahía Concepción, Gulf of California, and can be differentiated from them by the poorly developed distal portion of pollex of the major cheliped, the armature of the distal segment of third maxilliped, and the number of acute teeth of exopodal uropod. A discriminative analysis dealing with other three species of Synalpheus from the western Atlantic, with distinctive pollex of major chela reduced, is presented. A dichotomous key was elaborated to identify the species of Synalpheus “Gambarelloides” species group from the eastern Pacific. The number of valid species described of Synalpheus from the eastern Pacific is increased to 23.
Revision of the spider genus Epiceraticelus (Araneae, Linyphiidae) with a description of a new species
Authors: DRANEY MICHAEL L. , MILNE MARC A. , ULYSHEN MICHAEL , MADRIZ GABRIELLE
Published: July 2019

The type species of the genus, Epiceraticelus fluvialis Crosby & Bishop, 1931, is herein redescribed since the types are presumed lost. In addition, a new species, Epiceraticelus mandyae n. sp., from the Southeastern United States is described.
Four new free-living marine nematode species (Sabatieria) from the Chukchi Sea
Authors: YANG PEIPEI , GUO YUQING , CHEN YUZHEN , LIN RONGCHENG
Published: July 2019

Four new free-living marine nematode species of the genus Sabatieria are described from the Chukchi Sea. Sabatieria chukchensis sp. n. is characterized by a long body (2052–2326 μm), two pairs of short cervical setae present, amphideal fovea spiral with 2.75–3.25 turns, and seven papilliform pre-cloacal supplements. Sabatieria parvamphis sp. n. is characterized by small amphideal fovea (equal to 55–72% corresponding body diameter), amphideal fovea spiral with 3.25 turns, short cephalic setae (6–7 μm, equal to 31–38% of head diameter), curved gubernacular apophyses, thirteen to fifteen prominent tubular pre-cloacal supplements with distance between adjacent supplements increasing towards the anterior. Sabatieria major sp. n. is characterized by a long body (3879–4255 μm), amphideal fovea spiral with 2.5–3.25 turns, and seventeen to thirty-two small tubular pre-cloacal supplements. Sabatieria multisupplementia sp. n. is characterized by a long body (3967–4294 μm), amphideal fovea spiral with 2.75–3 turns, and forty-one to forty-seven tubular pre-cloacal supplements.
The Coccinellidae (Coleoptera) from Fuerteventura, Canary Islands
Authors: ROMANOWSKI JERZY , CERYNGIER PIOTR , VĚTROVEC JAROSLAV , SZAWARYN KAROL
Published: July 2019

During this study, Coccinellidae were collected and observed at 25 sites located along the coast and inland of the island of Fuerteventura during 2016 and 2017. A total of 2825 Coccinellidae specimens belonging to 22 species was recorded, of which 11 species are newly recorded from Fuerteventura. In the case of three species taxonomical decisions are proposed. Scymnus incisus (Har. Lindberg, 1950) is transferred to the genus Nephus Mulsant and placed in the nominate subgenus as Nephus (Nephus) incisus (Har. Lindberg, 1950), comb. nov. Scymnus medanensis Eizaguirre, 2007, is redescribed and placed in the subgenus Pullus Mulsant. Coccinella algerica Kovář, 1977, is synonymized with Coccinella septempunctata Linnaeus, 1758, syn. nov. We propose retaining the taxonomic distinction of the North African and Canarian populations of this species as the subspecies Coccinella septempunctata algerica Kovář, stat. nov. Nephus peyerimhoffi (Sicard, 1923) is deleted from the list of ladybird beetles inhabiting the Canary Islands.
Taxonomic revision of the genus Anostomoides (Characiformes: Anostomidae)
Authors: ASSEGA FERNANDO MASSAYUKI , BIRINDELLI JOSÉ LUÍS OLIVAN
Published: July 2019

A taxonomic revision of Anostomoides is herein presented based on a comprehensive revision of specimens deposited in fish collections and the literature. The present revision proposes that A. laticeps is a junior synonym of A. atrianalis, while A. passionis is a junior synonym of Leporinus nattereri, and the latter is thus transferred to Anostomoides, forming the new combination Anostomoides nattereri. Principal Components Analysis (PCA) showed that examined specimens form two distinct morphotypes, corroborating the validity of both A. atrianalis and A. nattereri. Anostomoides nattereri is distinguished from A. atrianalis by having four branchiostegal rays (vs. three), three pores in infraorbital one (vs. four), 37–39 pored lateral-line scales (vs. 41–44), lower lip with rounded dermal papillae (vs. forming ridges), three dark  rounded midlateral blotches (vs. three or four vertically elongated blotches and/or a faded dark longitudinal stripe), dark lines between scale series on posterior half of body on specimens smaller than 150 mm SL (vs. dark lines absent), a greater body depth (27.6–36.2 % vs. 24.5–38.7% of SL) and smaller interorbital distance (34.4–53.8 % vs. 42.6–67.3 % of HL). Anostomoides nattereri is distributed across several tributaries of the Amazon and Orinoco rivers, whereas A. atrianalis is widespread throughout the Amazon, Orinoco, and Essequibo basins. The genus Anostomoides is currently diagnosed based on a combination of non-exclusive characters: upturned or slightly upturned mouth with four premaxillary teeth including symphyseal tooth bicuspid or with blunt cutting edge, remaining teeth slightly tricuspid (with medial cuspid distinctly larger); four dentary teeth, symphyseal tooth with truncate cutting edge (without cusps); second tooth with a single large cusp, and two lateral teeth with three or slightly more small cusps.
Mechanisms for Global Warming Impacts on Madden–Julian Oscillation Precipitation Amplitude
Authors: Bui Hien X. , Maloney Eric D.
Published: July 2019

Mechanisms that cause changes in Madden–Julian oscillation (MJO) precipitation amplitude under global warming are examined in models from phase 5 of the Coupled Model Intercomparison Project. Under global warming in representative concentration pathway 8.5, MJO precipitation intensifies in most models relative to current climate while MJO wind circulations increase at a slower rate or weaken. Changes in MJO precipitation intensity are partially controlled by changes in moisture profiles and static stability. The vertical moisture gradient increases in the lower half of the troposphere in response to the surface warming, while the vertical static stability gradient increases due to preferential warming in the upper troposphere. A nondimensional quantity called α has been defined that gives the efficiency of vertical advective moistening associated with diabatic processes in the free troposphere, and has been hypothesized by previous studies to regulate MJO amplitude. The term α is proportional to the vertical moisture gradient and inversely proportional to static stability. Under global warming, the increased vertical moisture gradient makes α larger in models, despite increased static stability. Although α increases in all models, MJO precipitation amplitude decreases in some models, contrary to expectations. It is demonstrated that in these models more top-heavy MJO diabatic heating with warming overwhelms the effect of increased α to make vertical moisture advection less efficient.
Study on the fracture toughness and deformation micro-mechanisms of PP/EPDM/SiO2 ternary blend-nanocomposites
Authors: Hajibabazadeh S , Razavi Aghjeh MK , Palahang M
Published: July 2019

A detailed fracture analysis of polypropylene/ethylene–propylene–diene monomer rubber/nano-silica (PP/EPDM/SiO2) ternary blend-nanocomposites was conducted through using both Izod impact and quasi-static fracture tests. The phase morphology and the fractured surfaces were evaluated using scanning electron microscopy. Morphological observations revealed that the SiO2 nanoparticles were mainly located either around the EPDM particles or at the PP/EPDM interface. A synergistic effect was observed between the soft EPDM rubber particles and rigid SiO2 filler on activation of different toughening micro-mechanisms, so that the impact strength of the ternary systems was significantly higher than that of corresponding binary blends. This effect was much more significant for percolated morphologies. The concept of the essential work of fracture (EWF) was used to analyze the fracture behavior and toughening/deformation mechanisms of the samples. The percolated structure of the EPDM particles and the SiO2 nanoparticles exhibited superior fracture resistance under EWF fracture tests. Formation of multiple void-fibrillar structures dissipated further energy and significantly improved fracture resistance under EWF tests. It was demonstrated that the toughness and stiffness could successfully be balanced via controlling the microstructure of the ternary systems.
Effects of material and process parameters on void evolution in unidirectional prepreg during vacuum bag-only cure
Authors: Hu Wei , Centea Timotei , Nutt Steven
Published: July 2019

Void reduction during composites manufacturing is critical for successful processing. In this study, we perform a parametric study to determine the mechanisms of interply void evolution in unidirectional prepregs during vacuum bag-only cure and to identify the key factors that affect interply air removal. We employ an in situ visualization setup for direct, real-time observation of air removal for prepregs during cure. Results showed that super-ambient dwell at 50℃ effectively promoted interply air removal in unidirectional prepregs, reduced vacuum quality (80% vacuum) had negligible effects on part quality, and that an increase in moisture content of the laminate notably increased void content. Prepreg moisture content was tracked by the inspection of laminate water content at different times during the cure cycle, and the data was combined with a diffusion-based analytical model to predict void size and to improve the understanding of void evolution mechanisms. Results indicated that moisture content of the laminate decreased markedly as cure progressed, providing insights into bubble behavior (expansion and shrinkage) observed during cure. The modified model predictions aligned with experimental data, especially during the second stage, confirming that the observed void growth results from moisture diffusion.
Polygynous Neighbors, Excess Men, and Intergroup Conflict in Rural Africa
Authors: Koos Carlo , Neupert-Wentz Clara
Published: July 2019

We argue that polygyny creates a social imbalance where few, economically well-off men marry many wives and many poor men marry late or never. By definition, polygyny produces what we refer to as “excess men.” In order to gain material wealth, excess men are likely to raid, plunder, and rob neighboring ethnic groups. We test this hypothesis with georeferenced data on polygyny and intergroup conflict in rural Africa and find strong support. Drawing on Afrobarometer survey data, we explore the underlying mechanisms and find that young men who belong to polygynous groups feel that they are treated more unequally and are readier to use violence in comparison to those belonging to monogamous groups. Our article makes an important contribution to the peace, conflict, and development literature by emphasizing a fundamental aspect of human life: marriage and family.
Epithelial Cell Lineage and Signaling in Murine Salivary Glands
Authors: Aure M.H. , Symonds J.M. , Mays J.W. , Hoffman M.P.
Published: July 2019

Maintaining salivary gland function is critical for oral health. Loss of saliva is a common side effect of therapeutic irradiation for head and neck cancer or autoimmune diseases such as Sjögren’s syndrome. There is no curative treatment, and current strategies proposed for functional regeneration include gene therapy to reengineer surviving salivary gland tissue, cell-based transplant therapy, use of bioengineered glands, and development of drugs/biologics to stimulate in vivo regeneration or increase secretion. Understanding the genetic and cellular mechanisms required for development and homeostasis of adult glands is essential to the success of these proposed treatments. Recent advances in genetic lineage tracing provide insight into epithelial lineage relationships during murine salivary gland development. During early fetal gland development, epithelial cells expressing keratin 14 (K14) Sox2, Sox9, Sox10, and Trp63 give rise to all adult epithelium, but as development proceeds, lineage restriction occurs, resulting in separate lineages of myoepithelial, ductal, and acinar cells in postnatal glands. Several niche signals have been identified that regulate epithelial development and lineage restriction. Fibroblast growth factor signaling is essential for gland development, and other important factors that influence epithelial patterning and maturation include the Wnt, Hedgehog, retinoic acid, and Hippo signaling pathways. In addition, other cell types in the local microenvironment, such as endothelial and neuronal cells, can influence epithelial development. Emerging evidence also suggests that specific epithelial cells will respond to different types of salivary gland damage, depending on the cause and severity of damage and the resulting damaged microenvironment. Understanding how regeneration occurs and which cell types are affected, as well as which signaling factors drive cell lineage decisions, provides specific targets to manipulate cell fate and improve regeneration. Taken together, these recent advances in understanding cell lineages and the signaling factors that drive cell fate changes provide a guide to develop novel regenerative treatments.
Exploring the Link Between Economic Complexity and Emergent Economic Activities
Authors: Bishop Alex , Mateos-Garcia Juan
Published: July 2019

Recent studies have shown a strong link between the complexity of economies and their economic development. There remain gaps in our understanding of the mechanisms underpinning these links, in part because they are difficult to analyse with highly aggregated, official data sources that do not capture the emergence of new industrial activities, a potential benefit from complexity. We seek to address some of these gaps by calculating two indices of economic complexity for functional local economies (Travel to Work Areas) in Great Britain, and explore their link with these locations’ economic performance. Seeking to gain a better understanding of the mechanism connecting economic complexity with economic performance, we create a measure of emergent technological activity in a location based on a combination of novel data sources including text from UK business websites and CrunchBase, a technology company directory, and study its link with economic complexity. Our results highlight the potential value of novel, unstructured data sources for the analysis of the links between economic complexity and regional economic development.
Distinguishing Between Imports for Domestic Use and for Re-Exports: A Novel Method Illustrated for the Netherlands
Authors: Lemmers Oscar , Wong Khee Fung
Published: July 2019

Global trade in the 21st century is characterised by complex value chains. Successful exporters usually rely on quality imports, and exported goods cross borders many times before reaching their final consumer. This poses challenges to economic measurement as well as policymaking because it becomes difficult to characterise the true interdependencies between countries. Currently, estimates of the share of imports from a trade partner destined for re-exports, and the share used in the domestic economy, are crude at best. We develop a novel approach to estimate these shares. Instead of assigning imports for re-exports proportionally across all source countries, we consider the origin of imports for each trader who re-exports goods. The method is illustrated for the Netherlands, a major re-exporter. We find that non-European member states export 10 billion euros of commodities to the Netherlands that are destined for re-export to the United Kingdom. We also find that the goods trade deficit between the Netherlands and the United States is drastically reduced when taking re-export flows into account.
Rethinking technological change in smallholder agriculture
Authors: Glover Dominic , Sumberg James , Ton Giel , Andersson Jens , Badstue Lone
Published: July 2019

The concept of technology adoption (along with its companions, diffusion and scaling) is commonly used to design development interventions, to frame impact evaluations and to inform decision-making about new investments in development-oriented agricultural research. However, adoption simplifies and mischaracterises what happens during processes of technological change. In all but the very simplest cases, it is likely to be inadequate to capture the complex reconfiguration of social and technical components of a technological practice or system. We review the insights of a large and expanding literature, from various disciplines, which has deepened understanding of technological change as an intricate and complex sociotechnical reconfiguration, situated in time and space. We explain the problems arising from the inappropriate use of adoption as a framing concept and propose an alternative conceptual framework for understanding and evaluating technological change. The new approach breaks down technology change programmes into four aspects: propositions, encounters, dispositions and responses. We begin to sketch out how this new framework could be operationalised.
Effect of Parent–Child Attachment on College Students’ Social Anxiety: A Moderated Mediation Model
Authors: Yu Yi , Liu Shen , Song Minghua , Fan Hang , Zhang Lin
Published: July 2019

This study investigated the relationship between parent–child attachment and social anxiety in college students, as well as the mediating role of psychological resilience and the moderating role of online social support. In total, 614 college students were recruited by the cluster sampling method. The results showed that (1) parent–child attachment was negatively correlated with college students’ social anxiety and positively correlated with their psychological resilience, (2) psychological resilience played a mediating role between parent–child attachment and college students’ social anxiety, and (3) online social support regulated the first half and second half of the mediation process in which parent–child attachment affected college students’ social anxiety through psychological resilience. These findings revealed the mechanism of parent–child attachment affecting social anxiety, which had important theoretical and empirical value for enhancing the strength of college students’ psychological resilience and alleviating social anxiety.
Dimensional Structure of the Arabic Positive Affect and Negative Affect Scale Adapted From its English Form
Authors: Narayanan Lakshmi , Abdelrasheed Nasser Said Gomaa , Nasser Ramzi Naim , Menon Shanker
Published: July 2019

The purpose of this study was to examine the dimensional structure of the Arabic version of the Positive Affect and Negative Affect Schedule using a sample of undergraduate students from a private university in the Sultanate of Oman. Confirmatory factor analysis was conducted to test four preconceptualized item-fit models: a one-factor structure model, a two-factor model using a factor structure of items converging on Positive Affect and Negative Affect, a correlated two-factor model, and finally the correlated three-factor model. Strongest support was found for the correlated two-factor model. A recent study provided further evidence of the robust structure of the Positive Affect and Negative Affect Schedule using the two-factor model. This study tested the model in a non-Western culture and a population that was very different from that in previous studies. The implications of these findings and recommendations are discussed herein.
A Quantitative Measurement of Physical Therapists’ Empathy and Exploration of the Relationship With Practice Setting and Work Engagement
Authors: Starr Julie Ann , Holmes Mary Beth , Riley Erin , McDonnell Brian , Driscoll Laura , Camarinos James , Grabowska Weronika , Harbaugh Allen G.
Published: July 2019

Clinical empathy has been studied in a number of health-care disciplines suggesting that higher practitioner empathy leads to improved patient health and wellness and improved patient outcomes. While some aspects of the physical therapist–patient relationship have been described, evidence of quantitative assessment of clinical empathy in physical therapists is scarce. To investigate the level of self-reported clinical empathy in physical therapists and its relationship to practice environment and workplace engagement, the Jefferson Scale of Empathy-Health Provider version (JSE-HP) and the Oldenburg Burnout Inventory (OLBI) were used. Study participants were 123 physical therapists working full time at either an acute care setting, a rehabilitation hospital, or an outpatient clinic. These physical therapists demonstrated a mean JSE-HP score of 118.5 (9.1) and a mean OLBI score of 15.63 (3.5). This mean empathy score was found to be higher than reported empathy level of some health disciplines such as nursing and pharmacy yet lower than others such as mental health workers, psychiatrists, and pediatricians. Practice setting was not found to be a significant factor regarding empathy levels in physical therapists. As reported in previous studies, there was a positive correlation between being female and having higher empathy levels. A positive correlation was found between age and work disengagement. Finally, our hypothesis regarding a negative correlation between empathy and work disengagement was confirmed, suggesting that workplace disengagement may diminish a physical therapist’s empathy, which may then negatively affect patient clinical outcomes.
Religious Attendance, Religious Importance, and the Pathways to Depressive Symptoms in Men and Women Aged 50 and Over Living in Ireland
Authors: Orr Joanna , Tobin Katy , Carey Daniel , Kenny Rose Anne , McGarrigle Christine
Published: July 2019

Objectives:

We aimed to explore the relationship between religiosity and depressive symptoms longitudinally.

Method:

We used four waves (2009–2016) of the Irish Longitudinal Study on Ageing (TILDA) to create growth curve models (GCM) of depressive symptoms and religious attendance/importance in a sample aged 50+ in Ireland and structural models to assess the longitudinal associations between religious attendance/importance and depressive symptoms. We tested whether this relationship was mediated by social connectedness.

Results:

GCM showed that higher religious attendance at baseline was associated with lower baseline depressive symptoms, while higher religious importance was associated with higher baseline depressive symptoms. Social connectedness partially mediated the baseline associations between religious attendance and lower depressive symptoms. There were no associations between religious factors and the development of depressive symptoms over time.

Discussion:

This study found that the relationship between religion and depressive symptoms is complex, and any protective effect was driven by religious attendance.
Relationship between Drug‐Induced Sleep Endoscopy Findings, Tonsil Size, and Polysomnographic Outcomes of Adenotonsillectomy in Children
Authors: Lam Derek J. , Krane Natalie A. , Mitchell Ron B.
Published: July 2019

Objective

(1) Determine the correlation of awake tonsil scores and preadenotonsillectomy (pre‐AT) sleep endoscopy findings. (2) Assess the relationship between polysomnographic AT outcomes with awake tonsil scores and sleep endoscopy ratings of tonsil and adenoid obstruction.

Study Design

Retrospective case series with chart review.

Setting

Tertiary care children’s hospital.

Subjects and Methods

Children aged 1 to 18 years who underwent sleep endoscopy and AT from January 1, 2013, to August 30, 2016, were included. Pre‐AT sleep endoscopy findings were scored with the Sleep Endoscopy Rating Scale. Awake tonsil scores and sleep endoscopy ratings were compared with Spearman correlation. Associations between changes in pre‐ and post‐AT polysomnography parameters and (1) awake tonsil scoring and (2) sleep endoscopy scoring were assessed with 1‐way analysis of variance and linear regression.

Results

Participants included 36 children (mean ± SD age, 6.8 ± 4.3 years; 68% male, 44% obese). Awake tonsil scores and sleep endoscopy ratings were strongly correlated (R = 0.58, P =. 003). Awake tonsil scores were not associated with changes in any polysomnography parameters after AT (all P >. 05), while sleep endoscopy ratings of adenotonsillar obstruction were significantly associated (all P <. 05, R2 = 0.16‐0.35). Patients with minimal adenotonsillar obstruction during sleep endoscopy had less improvement than those with partial or complete obstruction (mean obstructive apnea‐hypopnea index change: −8.2 ± 11.5 vs −15.9 ± 14.3, and −46.8 ± 31.3, respectively; P <. 001).

Conclusions

In children at risk for AT failure, assessment of dynamic collapse with sleep endoscopy may better predict the outcome of AT than awake tonsil size assessment, thus helping to inform surgical expectations.
Risk Factors and Incidence of Postoperative Delirium in Patients Undergoing Laryngectomy
Authors: Wang Yiru , Yu Huiqian , Qiao Hui , Li Chan , Chen Kaizheng , Shen Xia
Published: July 2019

Objective

To explore the risk factors and incidence of postoperative delirium (POD) in patients undergoing laryngectomy for laryngeal cancer.

Study Design

Prospective cohort study.

Setting

Shanghai Eye, Ear, Nose, and Throat Hospital, Fudan University.

Subjects and Methods

A total of 323 patients underwent laryngectomy from April 4, 2018, to December 28, 2018. Perioperative data were collected. The primary outcome was the presence of POD as defined by the Confusion Assessment Method diagnostic algorithm. Univariate and multivariable logistic regression analyses were used to identify risk factors associated with POD.

Results

Of the patients who underwent laryngectomy during the study period, 99.1% were male, with a mean age of 60.0 years. Of these patients, 28 developed POD, with most episodes (88.1%) occurring during the first 3 postoperative days. The type of POD was hyperactive in 7 cases and hypoactive in 21 cases. The mean duration of POD was 1 day. The mean Delirium Rating Scale‐Revised‐98 score (a measure of POD severity) was 11.5. For the multivariable analysis, risk factors associated with POD included advanced cancer stage, lower educational level, higher American Society of Anesthesiologists classification, and intraoperative hypotension lasting at least 30 minutes. Intraoperative dexmedetomidine use was protective against POD.

Conclusion

This study identified risk factors associated with POD, providing a target population for quality improvement initiatives. Furthermore, intraoperative dexmedetomidine use can reduce POD.
Predictive Value of First Posttreatment Imaging Using Standardized Reporting in Head and Neck Cancer
Authors: Hsu Derek , Chokshi Falgun H. , Hudgins Patricia A. , Kundu Suprateek , Beitler Jonathan J. , Patel Mihir R. , Aiken Ashley H.
Published: July 2019

Objective

The Neck Imaging Reporting and Data System (NI‐RADS) is a standardized numerical reporting template for surveillance of head and neck squamous cell carcinoma (HNSCC). Our aim was to analyze the accuracy of NI‐RADS on the first posttreatment fluorodeoxyglucose positron emission tomography/contrast‐enhanced computed tomography (PET/CECT).

Study Design

Retrospective cohort study.

Setting

Academic tertiary hospital.

Subject and Methods

Patients with HNSCC with a 12‐week posttreatment PET/CECT interpreted using the NI‐RADS template and 9 months of clinical and radiologic follow‐up starting from treatment completion between June 2014 and July 2016 were included. Treatment failure was defined as positive tumor confirmed by biopsy or Response Evaluation Criteria in Solid Tumors criteria. Cox proportional hazards models were performed.

Results

This study comprised 199 patients followed for a median of 15.5 months after treatment completion (25% quartile, 11.8 months; 75% quartile, 20.2 months). The rates of treatment failure increased with each incremental increase in NI‐RADS category from 1 to 3 (4.3%, 9.1%, and 42.1%, respectively). A Cox proportional hazards model demonstrated a strong association between NI‐RADS categories and treatment failure at both primary and neck sites (hazard ratio [HR], 2.60 and 5.22, respectively; P <. 001). In the smaller treatment subgroup analysis, increasing NI‐RADS category at the primary site in surgically treated patients and treatment failure did not achieve statistically significant association (HR, 0.88; P =. 82).

Conclusion

Increasing NI‐RADS category at the baseline posttreatment PET/CECT is strongly associated with increased risk of treatment failure in patients with HNSCC.