bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of lixisenatide in combination with basal insulin vs other insulin regimens for the treatment of patients with type 2 diabetes inadequately controlled by basal insulin: Systematic review, network meta‐analysis and cost‐effectiveness analysis
Authors: Men Peng , Qu Shuli , Luo Wenting , Li Chaoyun , Zhai Suodi
Published: August 2019

Aims

To evaluate the comparative efficacy and safety of lixisenatide combined with basal insulin (BI) vs intensive premix insulin (premix), BI plus prandial insulin with the main meal (basal‐plus) or progressively covering all meals (basal‐bolus) in patients with type 2 diabetes mellitus (T2DM) inadequately controlled by BI, and the long‐term cost‐effectiveness of lixisenatide from a Chinese healthcare system perspective.

Materials and methods

Randomized controlled trials (RCTs) published between 1998 and 2018 were systematically searched. The clinical efficacy and safety of each treatment were compared by network meta‐analysis (NMA). The IQVIA CORE Diabetes Model was used to estimate the lifetime quality‐adjusted life‐years (QALYs) and direct medical costs of patients treated with different strategies.

Results

Eight RCTs were finally included. Lixisenatide plus BI showed a similar reduction in HbA1c from baseline compared with premix, basal‐plus and basal‐bolus. There were significant differences in the change of body weight in favour of lixisenatide plus BI compared with the three insulin regimens. The risk of symptomatic hypoglycaemia of lixisenatide plus BI was significantly lower compared with premix and basal‐bolus. Lixisenatide plus BI was cost‐effective compared with premix, basal‐plus and basal‐bolus with incremental cost‐effectiveness ratios of Chinese yuan (CNY) 87 219, 48 173 and 48 670 per QALY gained, respectively, under the threshold of three times the gross domestic product (GDP) per capita in China.

Conclusions

Lixisenatide plus BI shows a similar HbA1c reduction compared with insulin regimens, accompanied by lower risk of hypoglycaemia and greater body weight reduction. It is a cost‐effective treatment alternative for patients with T2DM inadequately controlled by BI in China.
The attitudinal view and the integration of the particular object of emotions
Authors: Hernández Juan Pablo
Published: August 2019

In recent years, Julien Deonna and Fabrice Teroni have proposed to understand emotions as embodied evaluative attitudes we take towards objects that figure in nonevaluative representational states. Although their account nicely explains some of the key features that emotions are widely taken to have, it runs into a version of what I call the problem of integration. In the case of the attitudinal view, the integration problem takes the form of explaining how, from the point of view of the subject, the bodily responses that make up the attitude part of the emotion and the representational states that provide the particular object of the emotion come to form an intentionally structured unitary experience, that is, one in which the bodily responses are intentionally directed towards the object. I argue that what explains this integration is the way in which the experience of bodily responses and the experience of the representational states interact. This, I propose, produces what I call an experience of convergence. I also suggest that understanding emotional experience in this way not only solves the problem of the integration but also provides a more solid ground for the claim that emotionsquaembodied attitudes are evaluative.
Variable tree establishment in bauxite mine restoration in south‐west Australia linked to rainfall distribution, seasonal temperatures and seed rain
Authors: White‐Toney Tai , Korczynskyj Dylan , Grigg Andrew , Bulsara Max
Published: August 2019

Reasons for variable establishment of Jarrah (Eucalyptus marginata D. Don ex Sm.) and Marri (Corymbia calophylla (Lindl). K. D. Hill & L. A. S. Johnson) on restored forest sites after bauxite mining in south‐west Australia are not well understood. To refine restoration outcomes, we compiled tree seedling density establishment data from surveys of 654 previously mined sites restored between 1998 and 2017, and applied generalised linear models to discriminate the effects of 24 climatic and restoration practice variables. Final models explained 50% and 31% of the variation in Jarrah and Marri density, respectively. Broadcast seeding and fertiliser rates were positively related to seedling density. A more even rainfall distribution in the early wet season increased seedling density. However, persistent rain later in the wet season decreased density, possibly as a result of ripline soil saturation or ponding. Higher average daily maximum temperatures in the dry season decreased seedling density probably due to drought stress, but warmer daily temperature minima in both wet and dry seasons increased density. Seed rain from surrounding unmined forest was implicated as a significant, but highly variable, source of additional seed to restored sites. Restoration practices that influence soil moisture relations (tillage, depth and texture of returned soil), shallow burial of applied seed and timing of fertiliser application are likely to be important in refining restoration outcomes.
How to measure, report and verify soil carbon change to realize the potential of soil carbon sequestration for atmospheric greenhouse gas removal
Authors: Smith Pete , Soussana Jean‐Francois , Angers Denis , Schipper Louis , Chenu Claire , Rasse Daniel P. , Batjes Niels H. , van Egmond Fenny , McNeill Stephen , Kuhnert Matthias , Arias‐Navarro Cristina , Olesen Jorgen E. , Chirinda Ngonidzashe , Fornara Dario , Wollenberg Eva , Álvaro‐Fuentes Jorge , Sanz‐Cobena Alberto , Klumpp Katja
Published: August 2019

There is growing international interest in better managing soils to increase soil organic carbon (SOC) content to contribute to climate change mitigation, to enhance resilience to climate change and to underpin food security, through initiatives such as international ‘4p1000’ initiative and the FAO's Global assessment of SOC sequestration potential (GSOCseq) programme. Since SOC content of soils cannot be easily measured, a key barrier to implementing programmes to increase SOC at large scale, is the need for credible and reliable measurement/monitoring, reporting and verification (MRV) platforms, both for national reporting and for emissions trading. Without such platforms, investments could be considered risky. In this paper, we review methods and challenges of measuring SOC change directly in soils, before examining some recent novel developments that show promise for quantifying SOC. We describe how repeat soil surveys are used to estimate changes in SOC over time, and how long‐term experiments and space‐for‐time substitution sites can serve as sources of knowledge and can be used to test models, and as potential benchmark sites in global frameworks to estimate SOC change. We briefly consider models that can be used to simulate and project change in SOC and examine the MRV platforms for SOC change already in use in various countries/regions. In the final section, we bring together the various components described in this review, to describe a new vision for a global framework for MRV of SOC change, to support national and international initiatives seeking to effect change in the way we manage our soils.
An exploration of patient safety culture in Kuwait hospitals: a qualitative study of healthcare professionals' perspectives
Authors: Al Hamid Abdullah , Malik Aisha , Alyatama Shahad
Published: August 2019

Objective

Patient safety culture (PSC) represents a key component of the quality of care offered by healthcare professionals. Therefore, it is crucial to understand the factors that influence the implementation of a safe culture. This study explored the knowledge and attitudes of healthcare professionals in Kuwait towards the factors that might affect the PSC.

Methods

A qualitative study using semi-structured interviews with healthcare professionals was conducted between February and June 2018 at two major hospitals in Kuwait. Both hospitals had been accredited and have been applying the safety programmes recommended by the Kuwaiti Ministry of Health. Participants were purposively selected where 20 healthcare professionals were interviewed. The interviewees comprised of six physicians, six clinical pharmacists, six nurses and two members of the patient safety committee. Inclusion criteria involved healthcare professionals who had more than 1-year clinical experience, have interest in patient safety and had a good level of English. Interviews were audio-recorded and transcribed verbatim. Thematic analysis of the interview transcripts was conducted to identify the emergent themes.

Key findings

Thematic analysis of the interviews yielded three major themes related to ‘management', ‘regulations and policies' and ‘healthcare professionals'. Management issues included managerial support, resources, safety environment and staff training. Regulations and policies highlighted issues related to policies and procedures and incident reporting system. Healthcare professionals' theme covered factors related to knowledge, communication and teamwork among healthcare professionals.

Conclusions

This study gave insight into how healthcare professionals perceive the current PSC in Kuwait. Despite their positive attitudes and knowledge towards patient safety, various barriers were reported that hinder optimal PSC. These barriers were related to support, staffing, resources and response to error.
Impact of pharmacists' interventions on the pharmacotherapy of patients with complex needs monitored in multidisciplinary primary care teams
Authors: Samir Abdin Madjda , Grenier-Gosselin Lise , Guénette Line
Published: August 2019

Objectives

Recently, pharmacists have joined multidisciplinary healthcare teams within family medicine groups (FMG) in Quebec Province, Canada. This study assessed the impact of their interventions on the pharmacotherapy of patients with complex needs monitored in FMGs.

Methods

We performed a pre/post real-life intervention study among patients with complex needs referred to the FMG pharmacist in four FMGs in Quebec City. Pharmacists collected data at baseline, during follow-up and up to 6 months after the first encounter. They recorded all drug-related problems (DRPs) identified, interventions made and recommendations that were accepted by physicians. The researchers used the data collected to compare the medication regimen complexity index (MRCI) and medication adherence (using the proportion of days covered (PDC)) before and after the pharmacist’s interventions. Descriptive statistics and paired sample t-tests were computed.

Key findings

Sixty-four patients (median age: 74.5 years) were included; four patients were lost to follow-up. Pharmacists detected 300 DRPs (mean: 7.2 per patient) during the study period for which they made an intervention. The most common DRP was ‘drug use without indication’ (27%). The physicians accepted 263 (87.7%) of those interventions. The mean number of prescribed drugs per patient decreased from 13.8 (95% confidence interval (CI): 12.24 to 15.29) to 12.4 (95% CI: 10.92 to 13.90). The mean MRCI decreased from 47.18 to 41.74 (−5.44; 95% CI: 1.71 to 9.17), while the mean PDC increased from 84.4% to 90.0% (+5.6%; 95% CI: 2.7% to 8.4%).

Conclusion

Family medicine groups pharmacists can detect and resolve DRPs and can reduce medication regimen complexity and non-adherence to treatment in patients with complex needs monitored in FMGs.
A systematic review of outcome reporting in laser treatments for dermatological diseases
Authors: Fransen F. , Tio D.C.K.S. , Prinsen C.A.C. , Haedersdal M. , Hedelund L. , Laubach H.J. , Marini L. , Paasch U. , Passeron T. , Wolkerstorfer A.
Published: August 2019

The standardization of outcome reporting is crucial for interpretation and comparison of studies related to laser treatment of skin disorders. In collaboration with the Cochrane Skin‐Core Outcome Set Initiative (CS‐COUSIN), a procedure has been proposed to find consensus on the most important generic outcome domains (what to measure) for implementation in the international Laser TrEAtment in Dermatology (LEAD) registry. As the first step in the development of a generic outcome set for the LEAD registry, we undertook a systematic review to identify outcomes, outcome measurement instruments, methods and definitions reported in recently published literature of laser treatments for skin disorders. A systematic search was conducted and generated a total of 707 papers. We assessed 150 studies including all types of studies involving laser treatments for the skin. Two researchers independently extracted the type, definition and frequency of all outcomes and used outcome measurement instruments. We identified 105 verbatim outcomes that were categorized into eight domains recommended by the COMET framework: appearance, long‐term effects, physician and patient‐reported physical signs, satisfaction, health‐related quality of life, psychological functioning and adverse events. Heterogeneity in outcome reporting (e.g. categories and outcome measurement instruments) was high, and definitions were insufficiently reported. There was a clear under representation of life impact domains, including satisfaction (23%) quality of life (3%) and psychological functioning (1%). Outcome reporting concerning laser treatments for the skin is heterogeneous. Standardized outcomes are needed for improving evidence synthesis. Results of this review will be used in the next step to reach consensus between stakeholders on the outcome domains to be implemented in the LEAD registry.
Ecological and phylogenetic determinants of life‐history patterns among ten loricariid species
Authors: Borzone Mas Dalmiro , Alvarenga Patricio F. , Scarabotti Pablo A.
Published: August 2019

We analysed the influence of ecological factors, phylogenetic history and trade‐offs between traits on the life‐history variation among 10 loricariid species of the middle Paraná River. We measured eight life‐history variables and classified the life‐history strategies following the equilibrium–periodic–opportunistic (EPO) model. Principal‐component analysis of life‐history traits segregated species along a gradient from small opportunistic (low fecundity, low parental investment) to large equilibrium (low‐medium fecundity, high parental investment) species. A clear periodic strategist was absent in the analysed assemblage. Variation partitioning by canonical phylogenetic ordination analysis showed both a component of variation uniquely explained by phylogenetic history (PH; 32.2%) and a component shared between PH and ecological factors (EF; 37%). The EPO model is a useful tool for predicting correlations among life‐history traits and understanding potential demographic responses of species to environmental variation. Life‐history patterns observed throughout Loricariidae suggests that this family has diversified across all three endpoint strategies of the EPO model. Our study indicates that evolutionary lineage affiliation at the level of subfamily can be a strong predictor of the life‐history strategy used by each species.
Multiplex PCR for genotypingFlavobacterium columnare
Authors: LaFrentz Benjamin R. , García Julio C. , Shelley John P.
Published: August 2019

Recent research has identified four distinct genetic groups among isolates ofFlavobacterium columnarethrough multilocus phylogenetic analyses; however, there are no quick methods to determine the genotype of an isolate. The objective of this research was to develop a multiplex PCR to rapidly genotypeF. columnareto genetic group. Comparative bacterial genomics was used to identify regions in the genomes unique to each genetic group, and primers were designed to specifically amplify different sized amplicons for each genetic group. The optimized assay was demonstrated to be specific for each genetic group andF. columnare, and no specific amplicons were generated using gDNA from a panel of otherFlavobacteriumspp. and bacterial fish pathogens. The analytical sensitivity of the assay ranged from 209 to 883 genome equivalents depending on the genetic group. The multiplex PCR was evaluated by genotyping a panel of 22 unknownF. columnareisolates and performing DNA sequencing of thednaKgene in parallel. The results demonstrated 100% accordance between multiplex PCR results and assignment to genetic group via phylogenetic analysis. The multiplex PCR provides a useful tool for assigning an unknown isolate to genetic group and may be used to determine which genetic groups ofF. columnareare circulating and most predominant in different aquaculture industries.
Growth hormone secretagogue receptor signalling affects high‐fat intake independently of plasma levels of ghrelin andLEAP2, in a 4‐day binge eating model
Authors: Cornejo María Paula , Castrogiovanni Daniel , Schiöth Helgi B. , Reynaldo Mirta , Marie Jacky , Fehrentz Jean‐Alain , Perello Mario
Published: August 2019

The growth hormone secretagogue receptor (GHSR) is a G protein‐coupled receptor that is highly expressed in the central nervous system.GHSRacts as a receptor for ghrelin and for liver‐expressed antimicrobial peptide 2 (LEAP2), which blocks ghrelin‐evoked activity.GHSRalso displays ligand‐independent activity, including a high constitutive activity that signals in the absence of ghrelin and is reduced byLEAP2.GHSRactivity modulates a variety of food intake‐related behaviours, including binge eating. Previously, we reported thatGHSR‐deficient mice daily and time‐limited exposed to a high‐fat (HF) diet display an attenuated binge‐likeHFintake compared to wild‐type mice. In the present study, we aimed to determine whether ligand‐independentGHSRactivity affects binge‐likeHFintake in a 4‐day binge‐like eating protocol. We found that plasma levels of ghrelin andLEAP2 were not modified in mice exposed to this binge‐like eating protocol. Moreover, systemic administration of ghrelin orLEAP2 did not alterHFintake in our experimental conditions. Interestingly, we found that central administration ofLEAP2 or K‐(D‐1‐Nal)‐FwLL‐NH2, which are both blockers of constitutiveGHSRactivity, reduced binge‐likeHFintake, whereas central administration of ghrelin or the ghrelin‐evokedGHSRactivity blockers [D‐Lys3]‐GHRP‐6 andJMV2959 did not modify binge‐likeHFintake. Taken together, current data indicate thatGHSRactivity in the brain affects binge‐likeHFintake in mice independently of plasma levels of ghrelin andLEAP2.
Resisting “Politics as Usual”: Examining the Rise of Anti‐Establishment Politics by Comparing the Narratives of Opportunity Used Within the Single Payer Movement During Two Presidential Eras
Authors: Hern Lindy S.
Published: August 2019

The recent rise of “Medicare for All” in American political discourse was many years in the making. Behind this rise is a movement composed of grassroots activists and organizations focused on the goal of establishing a single‐payer health care system in the United States. I examine the ways in which activists used narrative to interpret opportunity within their historically specific environments to work towards this goal. I find that while the Single Payer Movement's narrative practice during the Clinton era was focused on opportunity within the political sphere, the focus in the Obama era shifted to mobilizing the public sphere, or grassroots opportunity. This was related to the critique that the Obama Administration was engaging in “politics as usual”, which was defined as the “enemy” of “real” health care reform. This narratively produced critique is tied to the anti‐establishment turn that factors into the current era of American politics.
Religious Social Support Protects against Social Risks for Adolescent Substance Use
Authors: Peviani Kristin M. , Brieant Alexis , Holmes Christopher J. , King‐Casas Brooks , Kim‐Spoon Jungmeen
Published: August 2019

We used a social developmental perspective to identify how prominent social contexts influence substance use during adolescence. Longitudinal data were collected annually from 167 parent–adolescent dyads over four years. We investigated whether parent substance use was related to adolescent substance use directly and indirectly via peer substance use and whether these associations were moderated by religious social support. Structural equation modeling (SEM) analysis indicated significant moderated mediation: Greater parent substance use predicted increases in adolescent substance use indirectly via increased peer substance use when adolescent religious social support was low or average, but not high. These results suggest religious social support may protect adolescents against prominent social risks for intergenerational substance use.
Effects of dietary crude protein and tannic acid on nitrogen excretion, urinary nitrogenous composition and urine nitrous oxide emissions in beef cattle
Authors: Zhou Ke , Bao Yu , Zhao Guangyong
Published: August 2019

Two consecutive trials were carried out to study the effects of dietary crude protein (CP) and tannic acid (TA) on nitrogen (N) metabolism of beef cattle and consequently, the N2O emissions from the urine of cattle. In Trial I, eight growing castrated cattle were used as the experimental animals. Two levels of dietary CP (110.6 and 135.7 g/kg dry matter [DM]) and two levels of TA (0 and 16.9 g/kg DM) were allocated in a replicated 2 × 2 crossover design. In Trial II, the N2O emissions from the urine of cattle collected from Trial I were determined using the static incubation technique. An interaction between dietary CP and TA on the urinary N excretion (p < .05) was found but not on the N2O‐N emission of cattle urine. Increasing dietary CP level from 110.6 g/kg DM to 135.7 g/kg DM increased the total N excretion (p < .001), the N retention (p < .05) and the ratio of urinary urea‐N/urinary N (p < .01), did not affect the N use efficiency (NUE; p > .05) and shifted the N excretion from faeces to urine. Increasing the dietary CP level increased the N2O‐N emission of cattle urine. Dietary addition of TA decreased the urinary excretions of urea (p < .001) and shifted the N excretion from urine to faeces, did not affect the NUE of beef cattle (p > .10), and decreased the N2O‐N emission of cattle urine. Pyrogallol and resorcinol of the TA metabolites were detected in urine with dietary addition of TA. Feeding beef cattle with relatively low CP level and adding TA in rations are effective approaches to mitigate the N2O‐N emissions from cattle urine.
Effects of a posttonsillectomy management program using a mobile instant messenger on parents’ knowledge and anxiety, and their children's compliance, bleeding, and pain
Authors: Yu Kyoung Eun , Kim Jin Sun
Published: August 2019

Purpose

Pediatric tonsillectomy is a highly common surgery for children. The inclusion of tonsillectomy in the diagnosis‐related group payment system in Korea has resulted in a shorter hospital stay for patients who undergo tonsillectomy. This, in turn, provides parents with additional caregiver roles in the home.

Objectives

This study aimed to investigate the effects of a postdischarge management program (PDMP) using Mobile Instant Messenger (MIM) on parents’ knowledge and state anxiety about postoperative care, and their children's compliance with care instructions at home, frequency of bleeding, and pain intensity after tonsillectomy.

Design and Methods

A nonequivalent control group nonsynchronized design.

Settings and Participants

Participants were 52 tonsillectomy children aged 3–7 years and their 52 parents (27 for the experimental group and 25 for the control group) from a hospital, in Korea. The control group received a routine written and oral predischarge education, while the experimental group received a predischarge education and a daily MIM for 7 days. For the experimental group, bidirectional communication between the nurse and parent when necessary using MIM are available during the intervention period.

Results

Parents in the experimental group reported a significantly higher knowledge about postdischarge management and lower state anxiety than the control group. Children in the experimental group showed a significantly greater improvement in compliance with the care instructions at home than the control group. However, bleeding frequency and pain intensity were not significantly lower in the experimental group than that in the control group.

Practical Implications

Nurses play a critical role in preventing and managing the complications of tonsillectomy. Providing proper parental education about pediatric posttonsillectomy care at home is critical for a successful recovery. With the explosion of smartphone technology, the MIM‐based PDMP is a useful and effective strategy in helping parents and children in posttonsillectomy care at home.
Local Government Fiscal Policy, Social Capital and Electoral Payoff: Evidence across Italian Municipalities
Authors: Batinti Alberto , Andriani Luca , Filippetti Andrea
Published: August 2019

Citizens' attitudes and reactions to policymakers' decisions depend on several factors, including informal institutions. The novelty of this paper is to use social capital as a moderator factor to shed light on the relationship between fiscal policies and electoral outcomes. We investigate this relationship using a sample of 6,000 Italian municipalities over the period 2003‐2012 and use a Conditional Logit Matching model comparing incumbents to challengers' characteristics within each election. We find that social capital increases the odds of the re‐election of incumbent mayors who adopted a local fiscal policy more oriented towards capital investment (versus current expenditure) and towards property tax (versus income surcharge). This suggests that social capital encourages governmental functions and public policies improving long‐term economic commitments, institutional transparency, and accountability. It also shows that decentralization works relatively better with social capital.
Productivity growth, Smith effects and Ricardo effects in Euro Area's manufacturing industries
Authors: Carnevali Emilio , Godin Antoine , Lucarelli Stefano , Veronese Passarella Marco
Published: August 2019

We analyse the determinants of labour productivity across (a sample of) EA member states. We focus on the divergent dynamics before and after the financial crisis, and of core countries relative to peripheral countries. We ground our empirical analysis in Paolo Sylos‐Labini's productivity equations. We test different models, including a Panel 2S‐LS model and a Panel vector autoregression model. Our preliminary findings confirm and strengthen Sylos‐Labini's main insights. Labour productivity in manufacturing industries is strongly and positively correlated with the market size (Smith effect), the relative cost of labour (Ricardo effect), the absolute cost of labour (organization effect) and past investment, whereas it is negatively correlated with current investment. Furthermore, we find evidence that the crisis has affected the size of these effects. Focusing on the core periphery dichotomy, the signs of the effects are the same for both groups of countries, although the Smith, Ricardo and long‐run investment effects are usually stronger for core countries compared to peripheral countries. The opposite holds for the organization effect, while investment effects are less clear.
Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy ‐ A Safe and Effective Low‐Dose Protocol
Authors: Poh Cheng Boon , Tan Poh Choo , Kam Jia Wen , Siau Chuin , Lim Noelle L , Yeon Wenxiang , Cui Hai Hua , Ding Hai Ting , Song Xiao Ying , Yan Peng , Chea Kai Li , Liu Jin Shu , Chionh Chang Yin
Published: August 2019

Aims

Regional citrate anticoagulation (RCA) is the preferred mode of anticoagulation for continuous renal replacement therapy (CRRT). Conventional RCA‐CRRT citrate dose ranges from 3 to 5 mmol/L of blood. This study explored the effectiveness of an RCA protocol with lower citrate dose and its impact on citrate‐related complications.

Methods

This prospective observational study compared two RCA‐CRRT protocols in the intensive care unit. RCA Protocol 1 used an initial citrate dose of 3.0 mmol/L while Protocol 2 started with 2.5 mmol/L. The citrate dose was titrated by sliding scale to target circuit‐iCa 0.26–0.40 mmol/L. Calcium was re‐infused post‐dialyzer and titrated by protocol to target systemic‐iCa 1.01–1.20 mmol/L.

Results

Two hundred RCA‐CRRT sessions were performed (81 Protocol 1; 119 Protocol 2). The median age was 65.4 years and median APACHE‐II score was 23. Citrate dose for Protocol 1 was significantly higher than Protocol 2 in the first 12 h. The circuit clotting rate was similar in both arms (Protocol 1: 9.9%; Protocol 2: 9.2%; P = 0.881). With Protocol 2, circuit‐iCa levels were 2.42 times more likely to be on target (P = 0.003) while the odds of hypocalcaemia was 4.67 times higher with Protocol 1 (P < 0.001). There was a wider anion gap was noted with Protocol 1, which suggests a propensity for citrate accumulation with higher citrate exposure.

Conclusion

The RCA protocol with a lower initial citrate dose of 2.5 mmol/L blood had less citrate‐related complications with no loss of efficacy. A more precise RCA prescription at the start of treatment avoids unnecessary citrate exposure and improves safety.
Divergence of duplicated genes by repeated partitioning of splice forms and subcellular localization
Authors: Qiu Yichun , Tay Yii Van , Ruan Yuan , Adams Keith L.
Published: August 2019

Gene duplication is a prominent and recurrent process in plant genomes. Among the possible fates of duplicated genes, subfunctionalization refers to duplicates taking on different parts of the function or expression pattern of the ancestral gene. This partitioning could be accompanied by changes in subcellular localization of the protein products. When alternative splicing of gene products leads to protein products with different subcellular localizations, we propose that after gene duplication there will be partitioning of the alternatively spliced forms such that the products of each duplicate are localized to only one of the original locations, which we refer to as sublocalization.

We identified the plastid ascorbate peroxidase (cpAPX) genes across angiosperms and analyzed their duplication history, alternative splicing, and subcellular targeting patterns to identify cases of sublocalization.

We found angiosperms typically have one cpAPX gene that generates both thylakoidal APX (tAPX) and stromal APX (sAPX) through alternative splicing. We identified several independent lineage‐specific sublocalization cases with specialized paralogues of tAPX and sAPX. We determined that the sublocalization happened through two types of sequence evolution patterns.

Our findings suggest that the divergence through sublocalization is key to the retention of paralogous cpAPX genes in angiosperms.
Dermoscopic findings in neonatal leukemia cutis
Authors: Calderón‐Castrat Ximena , Pomar Reynaldo , Lipa‐Chancolla Roxana Maybor , Apagüeño Consuelo , Castro Rosa , Ballona Rosalía
Published: August 2019

Leukemia cutis is the direct infiltration of cutaneous tissues by leukemic cells and can present as a blueberry muffin baby. We present a case of neonatal leukemia cutis highlighting its dermoscopic features, the presence of fine telangiectatic arborizing vessels distributed within a pink background within all lesions.
Perianal abscess in infants: Amenable to conservative treatment in selected cases
Authors: Samuk Inbal , Avinadav Efrat , Barak Uri , Seguier Emmanuelle , Steiner Zvika , Freud Enrique
Published: August 2019

Background

Perianal abscess is a common surgical condition in daily pediatric practice. Management is a subject of controversy and a variety of approaches are practiced. While the most frequent approach is drainage with/without fistulotomy, the superiority of this approach and the place of conservative approach has not been established. The aim of this study was to evaluate the outcomes of conservative approach in selected cases of perianal abscesses in infants.

Methods

Data of 19 patients aged <24 months treated conservatively for perianal abscess at a tertiary hospital in 2014–2018 were retrospectively reviewed.

Results

Criteria for a conservative approach were: spontaneous drainage into the anal canal (n = 8) or perianal skin (n = 4), and phlegmonous infiltrate with fluid collection detected on ultrasound (n = 7). Mean age at symptom onset was 8.4 months. Twelve patients were managed for the first time. Previous care in seven patients included 1–4 drainage procedures (n = 4), spontaneous drainage (n = 1) and antibiotics (n = 2). Five patients were on oral antibiotics at presentation. After diagnosis, 18 patients received i.v. antibiotics and one, oral antibiotics. Three patients (15.7%) ultimately required surgical drainage; two were lost to follow up. During follow up (mean, 22.4 months) four patients (28.5%) had a single recurrent episode; abscess in three (managed conservatively in two and surgically in one) and fistula‐in‐ano in one patient that healed spontaneously. Thus, surgical intervention was prevented in 13/17 patients (76.4%) available for follow up.

Conclusions

Perianal abscess in infants is amenable to conservative management in selected cases. Avoiding surgical intervention is advantageous, especially given the high recurrence rate.
Understanding the impact of an evidence-based practice curriculum on oral health graduates
Authors: Wong Grace Wai-Lin , Print Murray , Gerzina Tania
Published: August 2019

Background: The explosion of health information accessible to consumers through multimedia has supported the merit and value of evidence-based practice (EBP). Both informed interest from patients and medico-legal considerations of patient care and safety have also contributed to the increased importance of EBP for health practitioners. An EBP curriculum was implemented at the [blinded]. The evaluation of the student perspectives was previously completed by using questionnaires and focus group interviews. Objectives: To further explore and analyse the potential impact of the EBP curriculum on [blinded] graduates’ clinical practice. Methods: Semi-structure interviews were conducted to allow for elaboration and clarification to assess understanding of oral health graduates’ perception of EBP. Graduates (n=12) from both the private and public sectors were invited to participate. Qualitative responses were transcribed and analysed using thematic analysis. Triangulation was used to cross-validate and confirm findings with previous quantitative data and focus group responses on providing a broader understanding of the subject. Results: Graduates reported they felt confident and were empowered by EBP in making clinical decisions. Challenges included limited online resources for literature search, lack of evidence in some aspects of dentistry, and gaining full-text access. Conclusion: The triangulation approach has enhanced the analysis and interpretation of the impact of the EBP curriculum on oral health graduates’ clinical practice. This study can serve as a pathfinder to introduce and implement EBP in other healthcare educational institutions and support translational science by bridging the gap between research and clinical practice.
Auditory enhancement and spectral contrast effects in speech perception
Authors: Stilp Christian E.
Published: August 2019

The auditory system is remarkably sensitive to changes in the acoustic environment. This is exemplified by two classic effects of preceding spectral context on perception. In auditory enhancement effects (EEs), the absence and subsequent insertion of a frequency component increases its salience. In spectral contrast effects (SCEs), spectral differences between earlier and later (target) sounds are perceptually magnified, biasing target sound categorization. These effects have been suggested to be related, but have largely been studied separately. Here, EEs and SCEs are demonstrated using the same speech materials. In Experiment 1, listeners categorized vowels (/ɪ/-/ɛ/) or consonants (/d/-/g/) following a sentence processed by a bandpass or bandstop filter (vowel tasks: 100–400 or 550–850 Hz; consonant tasks: 1700–2700 or 2700–3700 Hz). Bandpass filtering produced SCEs and bandstop filtering produced EEs, with effect magnitudes significantly correlated at the individual differences level. In Experiment 2, context sentences were processed by variable-depth notch filters in these frequency regions (−5 to −20 dB). EE magnitudes increased at larger notch depths, growing linearly in consonant categorization. This parallels previous research where SCEs increased linearly for larger spectral peaks in the context sentence. These results link EEs and SCEs, as both shape speech categorization in orderly ways.
Critical Review of Measurement Practices in the Study of Automatic Associations of Sedentary Behavior, Physical Activity, and Exercise
Authors: Zenko Zachary , Ekkekakis Panteleimon
Published: August 2019

Studies of automatic associations of sedentary behavior, physical activity, and exercise are proliferating, but the lack of information on the psychometric properties of relevant measures is a potential impediment to progress. The purpose of this review was to critically summarize measurement practices in studies examining automatic associations related to sedentary behavior, physical activity, and exercise. Of 37 studies, 27 (73%) did not include a justification for the measure chosen to assess automatic associations. Additional problems have been noted, including the nonreporting of psychometric information (validity, internal consistency, test–retest reliability) and the lack of standardization of procedures (e.g., number, type of stimuli). The authors emphasize the need to select measures based on conceptual arguments and psychometric evidence and to standardize measurement procedures. To facilitate progress, the review concludes with a proposal for conceptually appropriate validation criteria to be used in future studies.
Carbon speciation in organic fossils using 2D to 3D x-ray Raman multispectral imaging
Authors: Georgiou Rafaella , Gueriau Pierre , Sahle Christoph J. , Bernard Sylvain , Mirone Alessandro , Garrouste Romain , Bergmann Uwe , Rueff Jean-Pascal , Bertrand Loïc
Published: August 2019

X-ray Raman multispectral imaging identifies the 3D chemistry of carbon in entire organic paleontological specimens.
Binding energy of solvated electrons and retrieval of true UV photoelectron spectra of liquids
Authors: Nishitani Junichi , Yamamoto Yo-ichi , West Christopher W. , Karashima Shutaro , Suzuki Toshinori
Published: August 2019

Accurate binding energies of solvated electrons are determined, and retrieval of sharp UV photoelectron spectra is demonstrated.
Role of indentation depth and contact area on human perception of softness for haptic interfaces
Authors: Dhong Charles , Miller Rachel , Root Nicholas B. , Gupta Sumit , Kayser Laure V. , Carpenter Cody W. , Loh Kenneth J. , Ramachandran Vilayanur S. , Lipomi Darren J.
Published: August 2019

This work provides a model for designing materials that humans perceive as soft based on material and geometric properties.
Macroscopic x-ray powder diffraction imaging reveals Vermeer’s discriminating use of lead white pigments in
Girl with a Pearl Earring
Authors: De Meyer S. , Vanmeert F. , Vertongen R. , Van Loon A. , Gonzalez V. , Delaney J. , Dooley K. , Dik J. , Van der Snickt G. , Vandivere A. , Janssens K.
Published: August 2019

Different types of lead white used by Vermeer in
Girl with a Pearl Earring
are quantified by macroscopic x-ray powder diffraction.
Position β57 of I-A
g7
controls early anti-insulin responses in NOD mice, linking an MHC susceptibility allele to type 1 diabetes onset
Authors: Gioia Louis , Holt Marie , Costanzo Anne , Sharma Siddhartha , Abe Brian , Kain Lisa , Nakayama Maki , Wan Xiaoxiao , Su Andrew , Mathews Clayton , Chen Yi-Guang , Unanue Emil , Teyton Luc
Published: August 2019

Onset of type 1 diabetes in NOD mice is triggered by the recognition of I-A
g7
insulin peptide complexes by islet CD4
+
T cells.
Inclusion of the Viral Pentamer Complex in a Vaccine Design Greatly Improves Protection against Congenital Cytomegalovirus in the Guinea Pig Model
Authors: Choi K. Yeon , El-Hamdi Nadia S. , McGregor Alistair
Published: August 2019

Cytomegalovirus (CMV) is a leading cause of congenital disease in newborns, and an effective vaccine remains an elusive goal. The guinea pig is the only small-animal model for cCMV. Guinea pig cytomegalovirus (GPCMV) encodes a glycoprotein pentamer complex (PC) for entry into non-fibroblast cells, including placental trophoblasts, to enable cCMV. As with human cytomegalovirus (HCMV), GPCMV uses a specific cell receptor (PDGFRA) for fibroblast entry, but other receptors are required for non-fibroblast cells. A disabled infectious single-cycle (DISC) GPCMV vaccine strain induced an antibody immune response to the viral pentamer to enhance virus neutralization on non-fibroblast cells, and vaccinated animals were fully protected against cCMV. Inclusion of the PC as part of a vaccine design dramatically improved vaccine efficacy, and this finding underlines the importance of the immune response to the PC in contributing toward protection against cCMV. This vaccine represents an important milestone in the development of a vaccine against cCMV.
The Capitanian (Guadalupian, Middle Permian) mass extinction in NW Pangea (Borup Fiord, Arctic Canada): A global crisis driven by volcanism and anoxia
Authors: Bond David P.G. , Wignall Paul B. , Grasby Stephen E.
Published: August 2019

Until recently, the biotic crisis that occurred within the Capitanian Stage (Middle Permian, ca. 262 Ma) was known only from equatorial (Tethyan) latitudes, and its global extent was poorly resolved. The discovery of a Boreal Capitanian crisis in Spitsbergen, with losses of similar magnitude to those in low latitudes, indicated that the event was geographically widespread, but further non-Tethyan records are needed to confirm this as a true mass extinction. The cause of this crisis is similarly controversial: While the temporal coincidence of the extinction and the onset of volcanism in the Emeishan large igneous province in China provides a clear link between those phenomena, the proximal kill mechanism is unclear. Here, we present an integrated fossil, pyrite framboid, and geochemical study of the Middle to Late Permian section of the Sverdrup Basin at Borup Fiord, Ellesmere Island, Arctic Canada. As in Spitsbergen, the Capitanian extinction is recorded by brachiopods in a chert/limestone succession 30–40 m below the Permian-Triassic boundary. The extinction level shows elevated concentrations of redox-sensitive trace metals (Mo, V, U, Mn), and contemporary pyrite framboid populations are dominated by small individuals, suggestive of a causal role for anoxia in the wider Boreal crisis. Mercury concentrations—a proxy for volcanism—are generally low throughout the succession but are elevated at the extinction level, and this spike withstands normalization to total organic carbon, total sulfur, and aluminum. We suggest this is the smoking gun of eruptions in the distant Emeishan large igneous province, which drove high-latitude anoxia via global warming. Although the global Capitanian extinction might have had different regional mechanisms, like the more famous extinction at the end of the Permian, each had its roots in large igneous province volcanism.
Preservation of organic carbon during active fluvial transport and particle abrasion
Authors: Scheingross Joel S. , Hovius N. , Dellinger M. , Hilton R.G. , Repasch M. , Sachse D. , Gröcke D.R. , Vieth-Hillebrand A. , Turowski J.M.
Published: August 2019

Oxidation of particulate organic carbon (POC) during fluvial transit releases CO2 to the atmosphere and can influence global climate. Field data show large POC oxidation fluxes in lowland rivers; however, it is unclear if POC losses occur predominantly during in-river transport, where POC is in continual motion within an aerated environment, or during transient storage in floodplains, which may be anoxic. Determination of the locus of POC oxidation in lowland rivers is needed to develop process-based models to predict POC losses, constrain carbon budgets, and unravel links between climate and erosion. However, sediment exchange between rivers and floodplains makes differentiating POC oxidation during in-river transport from oxidation during floodplain storage difficult. Here, we isolated in-river POC oxidation using flume experiments transporting petrogenic and biospheric POC without floodplain storage. Our experiments showed solid phase POC losses of 0%–10% over ∼103 km of fluvial transport, compared to ∼7% to >50% losses observed in rivers over similar distances. The production of dissolved organic carbon (DOC) and dissolved rhenium (a proxy for petrogenic POC oxidation) was consistent with small POC losses, and replicate experiments in static water tanks gave similar results. Our results show that fluvial sediment transport, particle abrasion, and turbulent mixing have a minimal role on POC oxidation, and they suggest that POC losses may accrue primarily in floodplain storage.
Plume-modified collision orogeny: The Tarim–western Tianshan example in Central Asia
Authors: Han Yigui , Zhao Guochun , Cawood Peter A. , Sun Min , Liu Qian , Yao Jinlong
Published: August 2019

Plume-modified orogeny involves the interaction between a mantle plume and subducting oceanic lithosphere at accretionary margins. We propose that a plume can also be involved in collisional orogeny and accounts for the late Paleozoic geological relations in Central Asia. Continental collision between the Tarim and Central Tianshan–Yili blocks at the end Carboniferous resulted in an orogeny lacking continental-type (ultra)high-pressure [(U)HP] rocks and significant syncollision surface erosion and uplift, features normally characteristic of continent-continent interactions. Their absence from the Tianshan region corresponded with the arrival of a mantle plume beneath the northern Tarim. Elemental and isotopic data reveal an increasing influence of the mantle plume on magmatic petrogenesis from ca. 300 to 280 Ma, immediately after collision at 310–300 Ma. The rising mantle plume interrupted the normal succession of collisional orogenic events, destroying the deeply subducted continental crust and hence preventing slab break-off–induced continental rebound. Plume-modified continental collision thus limited continental (U)HP rock exhumation and associated surface uplift.
Leucocyte adhesion defect presenting as fulminant sepsis in a new born
Authors: Gupta Vishal , Pandita Aakash , Panghal Astha , Pillai Anish
Published: August 2019

We present a term neonate with severe sepsis, presenting on day 10 of life. The neonate presented with bilateral purulent eye discharge and hepatosplenomegaly. On investigation, persistent leucocytosis was observed and thus the possibility of leucocyte adhesion defect was considered. Flow cytometry confirmed the diagnosis.
Clozapine-induced stercoral colitis: a surgical perspective
Authors: George Jayan , Hotham Richard , Melton William , Chapple Keith
Published: August 2019

We describe a case of a 46-year-old man with schizophrenia treated with clozapine who presented as an emergency with abdominal pain on the background of a 1 month history of constipation. The initial presenting symptoms were vague and a diagnosis was difficult to establish. Initial CT of the abdomen and pelvis demonstrated only minor abnormalities. He continued to deteriorate until a further CT scan revealed worsening stercoral colitis. He subsequently underwent an emergency total colectomy and ileostomy formation and had a complicated prolonged postoperative recovery. This case highlights the risks that clozapine can have on slowing bowel transit and the dangerous consequences that can occur if not identified early.