bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of sodium‐glucose co‐transporter‐2 inhibitors in Asian patients with type 2 diabetes and kidney disease: An Asian perspective and expert recommendations
Authors: Khoo Chin Meng , Deerochanawong Chaicharn , Chan Siew Pheng , Matawaran Bien , Sheu Wayne Huey‐Herng , Chan Juliana , Mithal Ambrish , Luk Andrea , Suastika Ketut , Yoon Kun‐Ho , Ji Linong , Man Nguyen Huu , Pollock Carol
Published: November 2020

Early onset of type 2 diabetes and a high prevalence of co‐morbidities predispose the Asian population to a high risk for, and rapid progression of, diabetic kidney disease (DKD). Apart from renin‐angiotensin system inhibitors, sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors have been shown to delay renal disease progression in patients with DKD. In this review article, we consolidate the existing literature on SGLT‐2 inhibitor use in Asian patients with DKD to establish contemporary guidance for clinicians. We extensively reviewed recommendations from international and regional guidelines, data from studies on Asian patients with DKD, global trials (DAPA‐CKD, CREDENCE and DELIGHT) and cardiovascular outcomes trials. In patients with DKD, SGLT‐2 inhibitor therapy significantly reduced albuminuria and the risk of hard renal outcomes (defined as the onset of end‐stage kidney disease, substantial decline in renal function from baseline and renal death), cardiovascular outcomes and hospitalization for heart failure. In all the cardiovascular and renal outcomes trials, there was an initial decline in the estimated glomerular filtration rate (eGFR), which was followed by a slowing in the decline of renal function compared with that seen with placebo. Despite an attenuation in glucose‐lowering efficacy in patients with low eGFR, there were sustained reductions in body weight and blood pressure, and an increase in haematocrit. Based on the available evidence, we conclude that SGLT‐2 inhibitors represent an evidence‐based therapeutic option for delaying the progression of renal disease in Asian patients with DKD and preserving renal function in patients at high risk of kidney disease.
Clinical outcomes following bone marrow transplantation in patients with sickle cell disease: A cohort study of US Medicaid enrollees
Authors: Mahesri Mufaddal , Schneeweiss Sebastian , Globe Denise , Mutebi Alex , Bohn Rhonda , Achebe Maureen , Levin Raisa , Desai Rishi J.
Published: November 2020

Objectives

Bone marrow transplantation (BMT) is currently the only curative therapy available for patients with sickle cell disease (SCD), but clinical outcomes in routine care are not well understood. We describe the rates of vaso‐occlusive crises (VOCs), transplant complications, and mortality in SCD patients after BMT.

Methods

A cohort study of SCD patients who underwent BMT was designed using US Medicaid claims data (2000‐2013).

Results

A total of 204 SCD patients undergoing BMT were identified with a mean (SD) age of 10.6 (7.3) years, with 52.9% male and 67.6% African American. The overall VOC rate was 0.99 per person‐year (95% CI: 0.91‐1.07) over a median follow‐up time of 2.1 years (IQR: 0.8‐4.3 years). A total of 138 (67.6%) remained free of VOCs. The mortality rate was 1.7 (95% CI: 0.9‐3.1) per 100 person‐years, transplant‐related complications occurred among 113 (55.4%) patients with an incidence rate of 38.2 (95% CI: 31.7‐45.9) per 100 person‐years, while 47 (23%) patients had GvHD with an incidence rate of 8.0 (95% CI: 6.0‐10.7) per 100 person‐years.

Conclusion

Two thirds of the BMT recipients remained VOC‐free over 2 years of follow‐up, but transplant‐related complications, including GvHD occurred with high frequency. This highlights a continuing unmet need for alternative curative interventions in SCD.
Anisotropic mechanical and fatigue behaviour of Inconel718 produced by SLM in LCF and high‐temperature conditions
Authors: Sausto F. , Marchese G. , Bassini E. , Calandri M. , Biamino S. , Ugues D. , Foletti S. , Beretta S.
Published: November 2020

Additive manufacturing (AM) is one of the processes with the most potential for producing components used in internal combustion engines and features high efficiency due to the possibility of building very complex shapes. Several drawbacks of parts produced using AM are still unresolved, like poor surface quality, the presence of internal defects and anisotropic mechanical behaviour, which all contribute to decreasing the fatigue strength compared with the material produced using conventional processes. The effect of building direction on both the macroscopic mechanical behaviour and the crack propagation mechanism of Ni‐base superalloy Inconel718 produced using AM was investigated under the combined effect of low cycle fatigue (LCF) and high temperature. The different crack growth mechanisms investigated using compact tension (CT) specimens, tested at high temperature, showed a significant difference between the two building directions. The LCF fatigue experiments also showed a significant difference in the ε‐N curves from the two directions together with a high level of scatter due to the dispersion of the defect size at the fracture origin. The dimensions of the defects (as measured using the
parameter) were analysed by means of extreme value statistics and showed a significant difference between the two orientations investigated. The aim of this work is to propose a simplified approach (based on ΔJeff concepts) to estimate the fatigue life of a component produced using AM that takes into account the material variability due to the combined effect of mechanical anisotropic behaviour and the presence of defects at high‐temperature conditions.
Seed production of semi‐natural grasslands: Amount and variability in an unfertilized upright brome and a fertilized tall oat‐grass meadow
Authors: Scotton Michele
Published: November 2020

Seed production is an important grassland feature, as it affects its persistence and botanical composition, and plays an essential role in complex plant–animal interactions. Species‐rich seed mixtures from grasslands can be utilized for ecological restoration. Previous studies used different methods to characterize seed production and did not consider all the main aspects involved; hence, they did not allow the complete understanding of the seed production. In this study the seed yield of an unfertilized Mesobromion and a fertilized Arrhenatherion meadow were investigated by considering all main reproductive traits and grassland species. In Arrhenatherion, the viable seed production was 24,000 seeds m−2 year−1, with a viable seed set of 21% (ovule number 115,000 m−2). These values were three times higher than those in Mesobromion. This difference was mainly attributed to different fertile shoot densities (758 vs. 358 m−2 for Arrhenatherion and Mesobromion respectively). Grasses transformed ovules to seeds (38%) more efficiently than forbs (11%). The standing seed yield at the first mowing was 35% and 45% of the produced seeds for Mesobromion and Arrhenatherion respectively. Because of late mowing, which is typical for Mesobromion meadows, the proportion of species found as seed at the first mowing was higher than that in Arrhenatherion. However, because many Mesobromion species were found to be poorly seed‐producing forbs with high spatial and temporal variabilities of seed yield, harvesting of seeds of all species would be more difficult, and a greater effort would be necessary if the collected seeds are to be used in ecological restoration.
Assessing the effectiveness of colloidal microcrystalline cellulose as a suspending agent for black and white liquid dyes
Authors: Domian Ewa , Marzec Agata , Kowalska Hanna
Published: November 2020

This study aimed to determine the effect of the concentration (1, 5, or 8 wt%) of colloidal microcrystalline cellulose (MCCS) as suspending agent on the long‐term stability and rheology of the vegetable carbon (C) and calcium carbonate (CC) suspended in water–glycerine mixture. These suspensions as ready‐to‐use black and white liquid dyes containing 10 wt% C or CC were assessed for particle size, Turbiscan stability index (TSI), steady shear, thixotropy and dynamic viscoelasticity. After 370 days, the black dyes showed excellent stability (TSI ≪ 0.5) at 4 °C and 25 °C already at 1 wt% MCCS, while the white dyes showed reasonable stability (TSI 1–3) only at 5 and 8 wt% MCCS. Dye formulations exhibited a relatively liquid‐like viscoelastic behaviour, while they showed extremely shear‐thinning behaviour with a network structure dependent on the concentration of the MCCS as exhibited by the increase in thixotropy and the existence of the measurable yield stress.
Production of angiotensin‐converting enzyme inhibitory peptides in Iranian ultrafiltered white cheese prepared with Lactobacillus brevis KX572382
Authors: Yousefi Leila , Habibi Najafi Mohammad Bagher , Edalatian Dovom Mohammad Reza , Mortazavian Amir Mohammad
Published: November 2020

In this study, ultrafiltered (UF) Iranian white cheese made with adjunct cultures including six Lactobacillus isolates (Lactobacillus brevis, L. casei and L. plantarum) from traditional Iranian Motal cheese. The peptide extract (<5 kDa) of cheese samples were assessed for angiotensin‐converting enzyme (ACE)‐inhibitory activity during ripening (5 °C). Among the strains used, L. brevis KX572382 (M8) was selected because of the greater increase in (ACE)‐inhibitory activity in the cheese (P < 0.05). The highest activity of M8 extract was observed on the 28th (71.72%) day of ripening (P < 0.05). Proteolytic activity assessment and RP‐HPLC peptide profile of M8 water‐soluble extracts (WSEs) indicated the effect of M8 on further protein degradation due to secondary proteolysis. A total of 7 different peptide sequences, previously known in the literature for their ACE‐inhibitory activity, were tentatively identified by LC/ESI‐MS in 28‐day M8 peptide extract. Although the effect of M8 on pH and the proteolysis development in cheese was significant, no adverse effect was observed on the sensory properties. In conclusion, M8 strain can enhance the functional properties of Iranian UF white cheese.
A heuristic for the convex recoloring problem in graphs
Authors: Dantas Ana Paula S. , de Souza Cid C. , Dias Zanoni
Published: November 2020

We consider a coloring as a function that assigns a color to a vertex, regardless of the color of its neighbors. In this sense, a coloring is said to be convex if every set of all same colored vertices induces a connected subgraph. The Convex Recoloring Problem finds the minimum number of recolored vertices needed to turn a coloring convex. This problem is most commonly studied considering trees due to its origins in Computational Biology, but in this paper, we focus on general graphs. We propose a heuristic based on the Greedy Randomized Adaptive Search Procedure to solve the problem. We present computational experiments for our heuristic and compare it to an Integer Linear Programming (ILP) model from the literature. In these experiments, our heuristic recolored at most one vertex more than the ILP model, and it was also able to give better solutions when the ILP model was unable to find the optimal solution within the time limit. We also introduce a set of benchmark instances for the problem.
Sequential ultrahigh‐density contact mapping of persistent atrial fibrillation: An efficient technique for driver identification
Authors: Lațcu Decebal G. , Enache Bogdan , Hasni Karim , Wedn Ahmed M. , Zarqane Naïma , Pathak Atul , Saoudi Nadir
Published: November 2020

Introduction

Literature supports the existence of drivers as maintainers of atrial fibrillation (AF). Whether ultrahigh density (UHD) contact mapping may detect them is unknown.

Methods

We sequentially mapped the left atrial (LA) activation during spontaneous persistent AF and performed circumferential pulmonary vein isolation (CPVI), followed by remapping and ablation of potential drivers (rotational and focal propagation sites) with Rhythmia™ in 90 patients. The time reference was an LA appendage (LAA) electrogram (EGM). Regions with uniform color were defined as “organized.” Only patients (51) with no previous ablation were considered for acute results and follow‐up reporting.

Results

LA maps (175 ± 28 ml, 43578 ± 18013 EGM) were acquired in 23 ± 7 min. In all post‐CPVI maps potential drivers (7.3 ± 3.2/patient) were visualized: 85% with rotational propagation and continuous low voltage in the center; the remaining with focal propagation and an organized EGM at the site of earliest activation. The RF delivery time for extra‐PV driver ablation was 12.2 ± 7.9 min. There was a progressive increase of AF organization: the LAA cycle length prolonged, the number of potential drivers decreased, and the organized LA surface in AF increased from 14 ± 6% to 28 ± 16% (p = .0007). Termination of AF without cardioversion was obtained in 67%. AF recurrence rate at 15 ± 7.3 months was 17.6% after the first procedure.

Conclusions

Sequential UHD contact activation mapping of persistent AF allows visualization of potential drivers. A sequential strategy of CPVI followed by ablation of potential drivers with limited RF time resulted in an increasing organization of AF and good acute and long‐term results.
High‐power short duration and low‐power long duration in atrial fibrillation ablation: A meta‐analysis
Authors: Kewcharoen Jakrin , Techorueangwiwat Chol , Kanitsoraphan Chanavuth , Leesutipornchai Thiratest , Akoum Nazem , Bunch Thomas J. , Navaravong Leenhapong
Published: November 2020

Background

Multiple strategies have advocation for power titration and catheter movement during atrial fibrillation (AF) ablation. Comparative favoring evidence regarding the efficacy, logistics, and safety of a higher‐power, shorter duration (HPSD) ablation strategy compared to a lower‐power, longer duration (LPLD) ablation strategy is insubstantial. We performed a meta‐analysis to compare arrhythmia‐free survival, procedure times, and complication rates between the two strategies.

Methods

We searched MEDLINE, EMBASE, and Cochrane Library from inception to September 2020. We included studies comparing patients who underwent HPSD and LPLD strategies for AF ablation and reporting either of the following outcomes: Freedom from atrial tachyarrhythmia (AT) including AF and atrial flutter, procedure time, or periprocedural complications. We combined data using the random‐effects model to calculate the odds ratio (OR) and weight mean difference (WMD) with a 95% confidence interval (CI).

Results

Ten studies from 2006 to 2020 involving 2274 patients were included (1393 patients underwent HPSD strategy and 881 patients underwent LPLD strategy). HPSD strategy was not associated with increased freedom from AT at 12‐month follow‐up (OR = 1.54, 95% CI: 0.99 to 2.40, p = .054). In the subgroup analysis of the randomized controlled trial, the HPSD strategy was associated with increased freedom from AT compared to the LPLD strategy (OR = 3.12, 95% CI: 1.18 to 8.20, p = .02). There was a significant reduction in the HPSD group for the total procedure (WMD = 49.60, 95% CI: 29.76 to 69.44) and ablation (WMD = 17.92, 95% CI: 13.63 to 22.22) times, but not for fluoroscopy time (WMD = 1.15, 95% CI: −0.67 to 2.97). HPSD was not associated with a reduction in esophageal ulcer/atrioesophageal fistula (OR = 0.35, 95% CI: 0.12 to 1.06) or pericardial effusion/cardiac tamponade rates (OR = 1.16, 95% CI: 0.35 to 3.81).

Conclusions

When compared to the LPLD strategy, the HPSD strategy does not improve recurrent AT nor reduce periprocedural complication risks. However, subgroup analysis of the randomized controlled trial showed that HPSD significantly reduces AT recurrence. An HPSD strategy can significantly reduce total procedure and ablation times.
Influence of maxillary lateral incisor width ratio on perception of smile esthetics among orthodontists and laypersons
Authors: Martinez Florez Daniela , Rinchuse Daniel , Zullo Thomas
Published: November 2020

Objective

This study aimed to analyze the impact of different maxillary lateral incisor width ratios on the perception of smile esthetics among orthodontists and laypersons.

Methods

A smile photograph of a male subject showing the lips and gingival margins was selected. The smile was standardized for maxillary central incisor width proportions and ideally perceived smile esthetics. The maxillary lateral incisor width was symmetrically modified in increments of ratios of the central incisor from a ratio of 4:10 to a ratio of 8:10. The images were analyzed by 283 laypersons and 83 orthodontists who ranked the level of attractiveness using a visual analog scale.

Results

There were significant differences between the esthetic perception of the five different width ratios, and between the orthodontists and laypersons in their evaluations of esthetics (P < 0.0004). There were no significant differences in esthetic evaluations between genders.

Conclusions

For orthodontists, the most attractive width ratio was 5.7:10, while the highest ranked ratio among laypersons was 8:10, although laypersons ranked all ratios very similarly. Both groups ranked the width ratio of 4:10 the lowest. Orthodontists were more critical in their assessment of esthetics.

Clinical significance

To what proportions or protocol should a peg‐shaped maxillary lateral incisor or missing lateral, that is, to be replaced with an implant/crown be restored? This is an important clinical question that is often encountered by the orthodontist and the restoring dentist. The literature suggests that orthodontists and laypeople have different perceptions of smile esthetics, and it is important to have patient centered goals when treatment planning. Further research is necessary to identify the width ratio of which the lateral incisor is perceived to be esthetic as well as the ideal ratio to consider when restoring lateral incisors. This research assessed and compared the perception that orthodontists and laypeople have on smile esthetics regarding different width ratios of lateral incisors.
Profiles of Frequent Geriatric Users of Emergency Departments: A Latent Class Analysis
Authors: Dufour Isabelle , Dubuc Nicole , Chouinard Maud‐Christine , Chiu Yohann , Courteau Josiane , Hudon Catherine
Published: November 2020

BACKGROUND/OBJECTIVES

Frequent geriatric users of emergency departments (EDs) represent a complex and heterogeneous population. Identifying their specific subgroups would allow the development of interventions better customized to their needs and characteristics. Thus, this study aimed to develop profiles of frequent geriatric ED users using the individual characteristics of patients.

DESIGN

This was a retrospective cohort study.

SETTING

Databases from the Régie de l'assurance maladie du Québec (RAMQ) were utilized. PARTICIPANTSThis study included individuals aged 65 years or older living in the community in the Province of Quebec (Canada), who consulted in an ED at least four times in the year after an ED index date (an ED visit, chosen randomly, during an index period of January 1, 2012 to December 31, 2013) and who had received a diagnosis of ambulatory care‐sensitive conditions (ACSCs) in the 2 years preceding the index date.

MEASUREMENTS

A latent class analysis was used to identify subgroups of frequent geriatric ED users according to their individual characteristics, including ACSC type, dementia, mental health disorders, cancer diagnosis, and comorbidity index.

RESULTS

The study cohort consisted of 21,393 frequent geriatric ED users. Four groups of frequent geriatric ED users were identified: people with low comorbidity (39.0%), comprising the individuals with the lowest number of physical and mental health conditions; people with cancer (32.7%); people with pulmonaryand cardiac diseases (18.1%); and people with dementia or mental health disorders (10.2%), composed of individuals with the highest proportion of common and severe mental health disease, as well as dementia. This group accounts for the highest use of overall healthcare services.

CONCLUSION

These profiles will be useful in developing customized interventions addressing the needs of each subgroup of frequent geriatric ED users. More research is needed to bridge the remaining gaps, especially regarding the healthiest frequent geriatric users of EDs.
Multicomponent Intervention and Long‐Term Disability in Older Adults: A Nonrandomized Prospective Study
Authors: Park Chan Mi , Oh Gahee , Lee Heayon , Jung Hee‐Won , Lee Eunju , Jang Il‐Young , Kim Dae Hyun
Published: November 2020

BACKGROUND/OBJECTIVES

To evaluate the long‐term association between a multicomponent intervention program and disability in socioeconomically vulnerable older adults.

DESIGN

This was a nonrandomized prospective intervention trial.

SETTING

The setting was a community.

PARTICIPANTS

Participants included older Koreans living alone or receiving government assistance from a low‐income program.

INTERVENTION

The intervention was a 24‐week multicomponent program compromising group exercise, nutritional supplementation, management of depression, deprescribing, and home hazard reduction (n = 187) versus usual care (n = 196).

MEASUREMENTS

The number of dependencies in 17 basic and instrumental activities of daily living was measured every 3 months for 30 months (range: 0–17; greater values indicated worse disability). Inverse probability weighting Poisson regression was used to model the number of dependencies to adjust for confounding bias and higher dropout rates of those with greater disability.

RESULTS

The study population had a mean age of 76 years, and 26% were men. During the 30‐month follow up, 17 died (n = 8, intervention; n = 9, control), 62 (n = 16, intervention; n = 46, control) were institutionalized or received nursing home care, and 34 (n = 15, intervention; n = 19, control) were lost to follow up. After inverse probability weighting, the mean number of dependencies at baseline was 1.21 and 1.29 for the intervention group and the control group, respectively (P = .80). The intervention group had fewer dependencies than the control group, but the difference was attenuated over time: 1.08 versus 1.60 at 6 months (P = .04), 1.29 versus 1.87 at 12 months (P = .03), 1.62 versus 2.17 at 18 months (P = .06), 2.08 versus 2.51 at 24 months (P = .18), and 2.73 versus 2.90 at 30 months (P = .67).

CONCLUSION

A 24‐week multicomponent intervention was associated with a slower progression of disability; however, the diminishing association from 24 months and beyond suggests that reassessment and intervention may be necessary. Due to a lack of randomization, our findings should be interpreted with caution.
Editors’ Introduction to the Special Issue
Authors: DEYOUNG ROBERT , HARTMANN PHILIPP , LAEVEN LUC
Published: November 2020

In February 2019, the Journal of Money, Credit and Banking (JMCB) turned 50. The editors of the journal decided to celebrate this anniversary with two conferences, reflecting the two broad areas that the journal covers. A first conference on “Financial intermediation, regulation and economic policy” was held at the European Central Bank in Frankfurt/Germany on March 28–29, 2019, and addressed topics in the credit and financial intermediation fields. A second conference addressed topics in the macro‐economic and monetary fields, and took place at the Federal Reserve Bank of New York on May 30–31, 2019. This Special Issue displays the best contributions to the first conference. The contributions to the second celebratory conference are published in a separate Special Issue.
My Reflections on the FPC's Strategy
Authors: KASHYAP ANIL K
Published: November 2020

I review the workings of the United Kingdom's Financial Policy Committee to illustrate the challenges of implementing macroprudential policy. I describe the committee's remit, explain my views on the channels of financial instability that the committee tries to mitigate, describe the tools the committee has its disposal and outline the principles it uses in deploying these tools. I conclude by offering some of the lessons I have learned in serving on the committee and highlighting a few challenges for macroprudential policymakers.
Are Banks Finally Resolvable? A Perspective from Europe
Authors: SCHNABEL ISABEL
Published: November 2020

After the global financial crisis, policymakers in many countries promised that banks should never again be bailed out using taxpayers’ money. Therefore, new regulatory measures were introduced, most importantly new bank resolution regimes like the Single Resolution Mechanism in the euro area. This paper shows that these measures contributed to a reduction in bail‐out expectations and a return of market discipline in Europe. But European banks are still far from being truly resolvable. More remains to be done.
Negative Monetary Policy Rates and Systemic Banks' Risk‐Taking: Evidence from the Euro Area Securities Register
Authors: BUBECK JOHANNES , MADDALONI ANGELA , PEYDRÓ JOSÉ‐LUIS
Published: November 2020

We show that negative monetary policy rates induce systemic banks to reach‐for‐yield. For identification, we exploit the introduction of negative deposit rates by the European Central Bank in June 2014 and a novel securities register for the 26 largest euro area banking groups. Banks with more customer deposits are negatively affected by negative rates, as they do not pass negative rates to retail customers, in turn investing more in securities, especially in those yielding higher returns. Effects are stronger for less capitalized banks, private‐sector (financial and nonfinancial) securities and dollar‐denominated securities. Affected banks also take higher risk in loans.
Bank Leverage Limits and Regulatory Arbitrage: Old Question‐New Evidence
Authors: CHOI DONG BEOM , HOLCOMB MICHAEL R. , MORGAN DONALD P.
Published: November 2020

Banks are regulated more than most firms, making them good subjects to study regulatory arbitrage (avoidance). Their latest arbitrage opportunity may be the new leverage rule covering the largest U.S. banks; leverage rules require equal capital against assets with unequal risks, so banks can effectively relax the leverage constraint by increasing asset risk. Consistent with that conjecture, we find that banks covered by the new rule shifted to riskier, higher yielding securities relative to control banks. The shift began almost precisely when the rule was finalized in 2014, well before it took effect in 2018. Security level analysis suggests banks actively added riskier securities, rather than merely shedding safer ones. Despite the risk shifting, overall bank risk did not increase, evidently because the banks most constrained by the new leverage rule significantly increased leverage capital ratios.
Domestic Banks As Lightning Rods? Home Bias and Information during the Eurozone Crisis
Authors: SAKA ORKUN
Published: November 2020

European banks have been criticized for holding excessive domestic government debt during the recent Eurozone crisis, which may have intensified the diabolic loop between sovereign and bank credit risks. By using a novel bank‐level data set covering the entire timeline of the Eurozone crisis, I first reconfirm that the crisis led to the reallocation of sovereign debt from foreign to domestic banks. In contrast to the recent literature focusing only on sovereign debt, I show that the banks' private‐sector exposures were (at least) equally affected by the rise in home bias. Consistent with this pattern, I propose a new debt reallocation channel based on informational frictions and show that the informationally closer foreign banks increase their relative exposures when the sovereign risk rises. The effect of informational closeness is economically meaningful and robust to the use of different information measures and controls for alternative channels of sovereign debt reallocation.
Gendering the Legal Complex: Women in Sri Lanka's Legal Profession
Authors: SAMARARATNE DINESHA
Published: November 2020

Drawing upon feminist standpoint theory and interviews with pioneering women lawyers in Sri Lanka, I argue for a focus on women as a distinct category in ‘legal complex theory’. I consider the following questions in making this claim. What were the internal structures of the legal profession that the older generations of women lawyers encountered as they entered the profession and as they took up positions of leadership? In what ways, if at all, was the ‘culture(s)’ within the profession patriarchal? In what ways, if any, did the entry and advancement of women impact these internal structures of the profession and its culture(s)? And what can we learn from these experiences in predicting the future trajectory of the legal profession? The analytical expansion that I propose reveals gender‐based dynamics within the legal complex, such as gender‐stereotyped perceptions about women lawyers within the profession, the ‘feminization’ of the profession, and ‘gender segmentation’ within its different spheres.
The People in Question: Citizens and Constitutions in Uncertain Times by JOSHAW (Bristol: Bristol University Press, 2020, 336 pp., £75.00)
Authors: PRABHAT DEVYANI
Published: November 2020

In court judgements on nationality, it is common to find references to the constitutions and citizenship provisions of various countries. In addition, the influences of regional as well as global human rights legal instruments are often cited by lawyers in arguments and judges in their decisions. It is surprising, then, that academic scholarship on the topic is usually single‐country or single‐region specific in nature. In her new book The People in Question: Citizens and Constitutions in Uncertain Times, Jo Shaw decisively goes against this trend through critical engagement with a plethora of jurisdictions at various levels of national and international adjudication.
Texture and texture assessment of thickened fluids and texture‐modified food for dysphagia management
Authors: Hadde Enrico K. , Chen Jianshe
Published: November 2020

Thickened fluids and texture‐modified foods are commonly used in the medical management of individuals who suffer from swallowing difficulty (known as dysphagia). However, how to reliably assess texture properties of such food systems is still a big challenge both to industry and to academic researchers. This article aims to identify key physical parameters that are important for objective assessment of such properties by reviewing the significance of rheological or textural properties of thickened fluids and texture‐modified foods for swallowing. Literature reviews have identified that dominating textural properties in relation to swallowing could be very different for thickened fluids and for texture‐modified foods. Important parameters of thickened fluids are generally related with the flow of the bolus in the pharyngeal stage, while important parameters of texture‐modified foods are generally related with the bolus preparation in the oral stage as well as the bolus flow in the pharyngeal stage. This review helps to identify key textural parameters of thickened fluids and texture‐modified foods in relation to eating and swallowing and to develop objective measuring techniques for quality control of thickened fluids and texture‐modified foods for dysphagia management.
Democratic Party Control Reduces Gender Inequality
Authors: Kuk John , Hajnal Zoltan
Published: November 2020

Women earn less than men who work in the same job with the same level of experience. We know much about this gender wage gap but relatively little about its political or partisan sources. In this article, we examine the effects of party control of state government on gender inequality in income, wages, unemployment, and poverty. Employing both a regression discontinuity design and a dynamic difference‐in‐difference analysis, we find that electing a Democratic majority to the state house leads to substantial improvement in women's incomes, wages, and unemployment relative to men—especially in recent years. We also show that greater female representation in office and more liberal policymaking on policies related to women's rights could be driving that process. We find, however, fewer clear effects on poverty and less robust results for partisan control of the governor's office or the state senate. Parties and politics matter, but not always.
Artificial intelligence and the adoption of new technology in medical education
Authors: Webster Craig S.
Published: November 2020

Despite its paradigm changing potential, Webster argues Artificial Intelligence's reliance on context‐insensitive rules will limit its contributions to patient care decisions for the foreseeable future.
Cell size influences inorganic carbon acquisition in artificially selected phytoplankton
Authors: Malerba Martino E. , Marshall Dustin J. , Palacios Maria M. , Raven John A. , Beardall John
Published: November 2020

Cell size influences the rate at which phytoplankton assimilate dissolved inorganic carbon (DIC), but it is unclear whether volume‐specific carbon uptake should be greater in smaller or larger cells. On the one hand, Fick’s Law predicts smaller cells to have a superior diffusive CO2 supply. On the other, larger cells may have greater scope to invest metabolic energy to upregulate active transport per unit area through CO2‐concentrating mechanisms (CCMs).

Previous studies have focused on among‐species comparisons, which complicates disentangling the role of cell size from other covarying traits. In this study, we investigated the DIC assimilation of the green alga Dunaliella tertiolecta after using artificial selection to evolve a 9.3‐fold difference in cell volume. We compared CO2 affinity, external carbonic anhydrase (CAext), isotopic signatures (δ13C) and growth among size‐selected lineages.

Evolving cells to larger sizes led to an upregulation of CCMs that improved the DIC uptake of this species, with higher CO2 affinity, higher CAext and higher δ13C. Larger cells also achieved faster growth and higher maximum biovolume densities.

We showed that evolutionary shifts in cell size can alter the efficiency of DIC uptake systems to influence the fitness of a phytoplankton species.
A double‐edged sword: Role of butyrate in the oral cavity and the gut
Authors: Guan Xiaoyuan , Li Wenjing , Meng Huanxin
Published: November 2020

Butyrate, a four‐carbon short‐chain fatty acid (SCFA), is a metabolite of anaerobic bacteria. Butyrate has primarily been described as an energy substance in the studies on the digestive tract. The multiple mechanisms of its protective function in the gut and on underlying diseases (including metabolic diseases, diseases of the nervous system, and osteoporosis) via interaction with intestinal epithelial cells and immune cells have been well documented. There are many butyrogenic bacteria in the oral cavity as well. As essential components of the oral microbiome, periodontal pathogens are also able to generate butyrate when undergoing metabolism. Considerable evidence has indicated that butyrate plays an essential role in the initiation and perpetuation of periodontitis. However, butyrate is considered to participate in the pro‐inflammatory activities in periodontal tissue and the reactivation of latent viruses. In this review, we focused on the production and biological impact of butyrate in both intestine and oral cavity and explained the possible pathway of various diseases that were engaged by butyrate. Finally, we suggested two hypotheses, which may give a better understanding of the significantly different functions of butyrate in different organs (i.e., the expanded butyrate paradox).
Clinical audit as an educative tool for optometrists: an intervention study in age‐related macular degeneration
Authors: Gocuk Sena A , Lee Ji‐hyun , Keller Peter R , Ayton Lauren N , Guymer Robyn H , McKendrick Allison M , Downie Laura E
Published: November 2020

Purpose

Age‐related macular degeneration (AMD) is a major cause of vision loss. This study investigated whether performing clinical audit and receiving analytical performance feedback altered documentation of the AMD care provided by optometrists.

Methods

Australian optometrists were recruited and completed a survey about their demographics and confidence in AMD care, and a three‐month audit of their practice records using an AMD audit tool (termed the pre‐audit evaluation). After receiving analytical feedback, participants identified areas for improvement and re‐audited their practices after three months to analyse changes in performance (termed the post‐audit evaluation). Paired t‐tests and Wilcoxon signed‐rank tests, as appropriate, were used to compare pre‐ and post‐audit data.

Results

Twenty optometrists, most practising in Victoria, Australia, completed the study. Participants primarily worked in corporate practice and/or rural settings and had a range of optometric experience (2–40 years). At baseline, participants felt confident in their: knowledge of AMD risk factors (65%), advice to patients about these factors (55%) and management of earlier stages of AMD (55%). Each clinician completed (median [IQR]): 15 [IQR: 10–19] and 12 [IQR: 8–16] audits of unique patient records, pre‐ and post‐audit, respectively. Post‐audit, average record documentation (per optometrist) improved for asking about: AMD family history (94% to 100%, p = 0.03), smoking status (21% to 58%, p < 0.01), diet (11% to 29%, p < 0.01) and nutritional supplementation (20% to 51%, p < 0.01). For clinical examination, compliance with documenting pinhole visual acuity, performing an in‐office Amsler grid (upon indication) and using optical coherence tomography improved post‐audit (p < 0.05). Accuracy of severity documentation improved for earlier stages of AMD (p < 0.05). For earlier stages of AMD, documentation of counselling about modifiable risk factors significantly improved post‐audit (p < 0.05). Aspects well‐performed pre‐audit that did not change included documenting: medical histories (100% at both time points, p = 0.06) and retinal imaging (77% at both time points, p = 0.97).

Conclusions

Self‐audit with analytical feedback improved clinical record documentation of: AMD risk factors, clinical examination, AMD severity classification and management advice. These findings support a role for audit to improve optometric clinical care of AMD, as evidenced by improved documentation of the AMD care delivered.
A modified fluoroscopy protocol to minimize radiation exposure during pulmonary vein isolation with second‐generation cryoballoon
Authors: Wieczorek Marcus , Hoeltgen Reinhard
Published: November 2020

Background

Pulmonary vein isolation (PVI) using second‐generation cryoballoon (CB2) is considered to be safe and effective in the treatment of atrial fibrillation (AF). Reported radiation exposure during PVI with CB2 is higher if compared with other technologies. We investigated acute and mid‐term effects of a modified fluoroscopy protocol to minimize radiation exposure during CB2 PVI with regard to safety and efficacy.

Methods

The study comprised 180 consecutive patients undergoing CB2 PVI. In the first 100 patients, PVI was performed using conventional fluoroscopy settings (group 1), while the following 80 patients (group 2) received PVI with a modified protocol. The protocol consisted of (a) general reduction of fluoroscopy frame rate to 3/s, (b) avoidance of cine runs and selective PV angiograms, and (c) enhanced radiation awareness.

Retrospective data analysis was performed in respect to dose area product (DAP), fluoroscopy time, and freedom from AF during a 12‐month follow‐up.

Results

Group 2 patients had lower DAP (426 ± 433 vs 3334 ± 2271 cGycm2), fluoroscopy time (13.8 ± 6.3 vs 16.7 ± 5.6 minutes), LA dwell time (49.3 ± 15.5 vs 61.6 ± 16.2 minutes), and procedure time (85.5 ± 22.9 vs 94.9 ± 23.6 minutes); P < .01 for all. One‐year freedom from AF was comparable between both groups (71% group 1 vs 73% group 2, ns).

Conclusion

Radiation exposure and procedure time during CB2 PVI can be significantly reduced by using a modified fluoroscopy protocol and increased radiation awareness without compromising acute and 1‐year freedom from AF if performed by experienced operators.
Resolution of chronic recurrent pyoderma gangrenosum with latent tuberculosis treatment
Authors: Saklecha Anokhi , Tom Wynnis , Sprague Jessica
Published: November 2020

We present a 14‐year‐old male with chronic, recurrent pyoderma gangrenosum that resolved after treatment of latent tuberculosis. As pyoderma gangrenosum often occurs secondary to underlying diseases, we describe latent tuberculosis as a possible trigger for pyoderma gangrenosum.
Discourse of race and racism in nursing: An integrative review of literature
Authors: Iheduru‐Anderson Kechi , Shingles René Revis , Akanegbu Christiana
Published: November 2020

Background

Race is a barrier and source of inequality affecting ethnic minorities in nursing practice and education.

Purpose

This integrative review study aimed to determine whether racism and institutionalized racism are explicitly named in the titles and abstracts of peer‐reviewed publications on nursing education, leadership, and the nursing profession, and to explore the depth of discussion of racialized concepts in peer‐reviewed nursing literature.

Method

Whittemore and Knafl's integrative review approach was used to review 23 studies published in nursing journals published from 2008 to 2020.

Findings

Four themes were extracted: the context of racism discussions in the literature; consequences of experiences of racism; emotional and physical effects of racism on nurses and students of color; and scholars’ recommendations.

Discussion

Nursing must start to openly acknowledge the issue of racism within the profession, and to address it by providing safe spaces for authentic dialogue in academic and practice settings.
The impact of setting a pregnancy weight gain goal on total weight gain
Authors: Bodnar Lisa M. , Abrams Barbara , Simhan Hyagriv N. , Scifres Christina M. , Silver Robert M. , Parry Samuel , Crosland Brian A. , Chung Judith , Himes Katherine P.
Published: November 2020

Background

Expert groups recommend that women set a pregnancy weight gain goal with their care provider to optimise weight gain.

Objective

Our aim was to describe the concordance between first‐trimester personal and provider pregnancy weight gain goals with the Institute of Medicine (IOM) recommendations and to determine the association between these goals and total weight gain.

Methods

We used data from 9353 women in the Nulliparous Pregnancy Outcomes Study: monitoring mothers‐to‐be. In the first trimester, women reported their personal pregnancy weight gain goal and their provider weight gain goal, and we categorised personal and provider weight gain goals and total weight gain according to IOM recommendations. We used log‐binomial or linear regression models to relate goals to total weight gain, adjusting for confounders including race/ethnicity, maternal age, education, smoking, marital status and planned pregnancy.

Results

Approximately 37% of women reported no weight gain goals, while 24% had personal and provider goals, 31% had only a personal goal, and 8% had only a provider goal. Personal and provider goals were outside the recommended ranges in 12%‐23% of normal‐weight women, 31%‐41% of overweight women and 47%‐63% of women with obesity. Women with both personal and provider pregnancy weight gain goals were 6%‐14% more likely than their counterparts to have a goal within IOM‐recommended ranges. Having any goal or a goal within the IOM‐recommended ranges was unrelated to pregnancy weight gain. Excessive weight gain occurred in approximately half of normal‐weight or obese women and three‐quarters of overweight women, regardless of goal setting group.

Conclusions

These findings do not support the effectiveness of early‐pregnancy personal or provider gestational weight gain goal setting alone in optimising weight gain. Multifaceted interventions that address a number of mediators of goal setting success may assist women in achieving weight gain consistent with their goals.
A motivational standpoint of job insecurity effects on organizational citizenship behaviors: A generational study
Authors: Mahmoud Ali B. , Reisel William D. , Fuxman Leonora , Mohr Iris
Published: November 2020

Our research reports an empirical analysis of a path model linking job insecurity to organizational citizenship behavior (OCB) via two mediators, that is, intrinsic motivation and job satisfaction. The aim is to evaluate the path model invariance across three generational cohorts, that is, generation X, generation Y, and generation Z. A sample of employees in service companies based in Canada was surveyed. We utilized a partial least square structural equation modeling (PLS‐SEM) approach, which included path analysis and multi‐group analysis (MGA) to test proposed hypotheses. We found that job insecurity negatively predicted intrinsic motivation which positively related to job satisfaction. Job satisfaction influenced OCBs positively. Both intrinsic motivation and job satisfaction mediated the indirect effects of job insecurity onto OCBs. Generation X was more pronounced in their reaction to job insecurity than later generations given the strong negative effects on intrinsic motivation and hence on their job. However, generation Z employees followed their parents from generation X regarding engaging more in OCBs when they are satisfied with their job than generation Y. In general, therefore, it should come as no surprise that generation X employees’ OCBs can be expected to plummet due to the elevated levels of job insecurity during pandemic times (e.g., COVID‐19) more intensely than Generation Y. Clearly, with COVID‐19 having led many organizations around the world to adopt virtual workplace environments, generational differences amongst employees have to be considered as a matter of crucial concern for these organizations.
Influence of intra‐row cruciferous surrogate weed growth on crop yield in organic spring cereals
Authors: Melander Bo , McCollough Margaret R.
Published: November 2020

In Northern Europe, inter‐row hoeing has become a popular tactic for controlling weeds in organic cereals. Hoeing is highly effective and can be implemented from crop emergence until stem elongation to maintain a nearly weed‐free inter‐row zone. However, hoeing has a lesser effect on weeds growing in the intra‐row zone, where crop–weed proximity results in heightened competition. In the hoed cereal system, it is investigated whether tall‐growing, competitive, cruciferous weeds in the intra‐row zone affect crop biomass, yield and thousand kernel weight (TKW). An additive experimental design is employed to enable the fitting of rectangular hyperbolas, describing and quantifying the effects of increasing intra‐row surrogate weed density on crop growth parameters. Regressions were studied under the influence of crop (spring barley and spring wheat), row spacing (narrow [12.5 or 15.0 cm] and wide [25.0 cm]) and nitrogen rate (50 and 100 kg NH4‐N/ha). Cruciferous surrogate weeds were found to impact crop yield and quality severely. For example, ten intra‐row plants/m2 of surrogate weed Sinapis alba reduced grains yields by 7%–14% in spring barley and by 7%–32% in spring wheat with yield losses becoming markedly greater in wheat compared to barley as weed density increases. Compared to wheat, barley limited yield and quality losses and suppressed intra‐row weed growth more. Row spacing did not have a consistent effect on crop or weed parameters; in one of six experiments, the 25 cm row spacing reduced yields and increased intra‐row weed biomass in wheat. Nitrogen rate did not affect crop or weed parameters. Results warrant the implementation of additional tactics to control intra‐row weeds and limit crop losses.