bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a Patient-Centered Pelvic Floor Complication Scale
Authors: Fitzgerald Jocelyn , Siddique Moiuri , Miranne Jeannine Marie , Saunders Pamela , Gutman Robert
Published: March 2019

Objective

The aim of the study was to evaluate patient responses on a survey of knowledge, perceptions, concerns, and fears about complications related to pelvic reconstructive surgery (PRS). This is the first step to create a simplified, patient-centered Pelvic Floor Complication Scale that evaluates complications from both the patient and surgeon perspective.

Methods

Subjects for this prospective study included women older than 18 years planning surgery within 12 weeks or who had undergone PRS more than 6 months ago. Patients were asked open-ended questions about postoperative complications as well as to rank the severity of potential PRS complications (as mild, moderate, severe). Using thematic analysis, responses were coded and analyzed using Dedoose (Version 8.0.35).

Results

Thirty-three women (16 preop, 17 postop) participated in telephone interviews (n = 26) and focus groups (n = 7). There were no differences in age, race, education, marital status, and previous surgery. Specific complications such as a single urinary tract infection, short-term constipation (<2 weeks), persistent constipation (present preop), bladder injury not requiring repair or catheterization, vascular injury without sequelae, and extra office visits were considered minor. New recurrent urinary tract infections, new persistent constipation, worsening postop constipation (present preop), blood transfusion, readmission, and reoperation were considered severe complications.

The most common themes included the following: fears of surgical failure, anesthesia, mesh erosion, discharge with a catheter, and pain. Patients were overall very trusting of their female pelvic medicine and reconstructive surgery surgeons and potential risks did not impact surgical decisions.

Conclusions

Our research findings provide significant insight into patient perceptions of complications related to PRS that will aid in future development of a patient-centered Pelvic Floor Complication Scale.
Single cell multi-omics analysis reveals novel roles for DNA methylation in sensory neuron injury responses
Authors: Hu Youjin , An Qin , Fan Guoping
Published: March 2019

DNA methylation is implicated in neuronal injury response and regeneration, but its role in regulating stable transcription changes in different types of dorsal root ganglion (DRG) neurons is unclear. In this study, we simultaneously profiled both the DNA methylome and mRNA transcriptome from single DRG neurons at different ages under either control or peripheral nerve injury condition. We found that age-related expression changes in Notch signaling genes and methylation changes at Notch receptor binding sites are associated with the age-dependent decline in peripheral nerve regeneration potential. Moreover, selective hypomethylation of AP-1 complex binding sites on regeneration-associated gene (RAG) promoters coincides with RAG transcriptional upregulation after injury. Consistent with the findings that different subtypes of DRG neurons exhibit distinct methylome changes upon injury responses, in a hybrid CAST/Ei; C57BL/6 genetic background, we further observed allele-specific gene regulation and methylation changes for many RAGs after injury. We suggest that the genetic background determines distinct allele-specific DNA methylomes, which contribute to age-dependent regulation and neuronal subtype-specific injury-responses in different mouse strains.
Integrating electric field modelling and neuroimaging to explain inter-individual variability of tACS effects
Authors: Kasten Florian H. , Duecker Katharina , Maack Marike C. , Meiser Arnd , Herrmann Christoph S.
Published: March 2019

Understanding variability of transcranial electrical stimulation (tES) effects is one of the major challenges in the brain stimulation community. Promising candidates to explain this variability are individual anatomy and the resulting differences of electric fields inside the brain. We integrated individual simulations of electric fields during tES with source-localization to predict variability of transcranial alternating current stimulation (tACS) aftereffects on α-oscillations. In two experiments, participants received 20 minutes of either α-tACS (1 mA) or sham stimulation. Magnetoencephalogram was recorded for 10 minutes before and after stimulation. tACS caused a larger power increase in the α-band as compared to sham. The variability of this effect was significantly predicted by measures derived from individual electric field modelling. Our results directly link electric field variability to variability of tACS outcomes, stressing the importance of individualizing stimulation protocols and providing a novel approach to analyze tACS effects in terms of dose-response relationships.
Immune profiling in M. tuberculosis infection enables stratification of patients with active disease
Authors: Duffy Darragh , Nemes Elisa , Llibre Alba , Rouilly Vincent , Filander Elizabeth , Africa Hadn , Mabwe Simbarashe , Jaxa Lungisa , Charbit Bruno , Musvosvi Munyaradzi , Mulenga Humphrey ,   the Milieu Intérieur Consortium, Thomas Stephanie , Hatherill Mark , Bilek Nicole , Scriba Thomas J , Albert Matthew L
Published: March 2019

Tuberculosis (TB) is caused byMycobacterium tuberculosis(Mtb) infection and is a major public health problem with an estimated 1.7 billion persons infected worldwide. Clinical challenges in TB include the lack of a blood-based test for active disease, and the absence of prognostic biomarkers for early treatment response. Current blood based tests, such as QuantiFERON-TB Gold (QFT), are based on an IFNγ readout followingMtbantigen stimulation. However, they do not distinguish active TB disease from asymptomaticMtbinfection. We hypothesized that the use of TruCulture, an improved immunomonitoring method for whole blood collection and immune stimulation, could improve the discrimination of active disease from latentMtbinfection. To test our hypothesis, we stimulated whole blood from active TB patients (before and after successful treatment), comparing them to asymptomatic latently infected individuals.Mtb-specific antigens (ESAT-6, CFP-10, TB7.7) and live bacillus Calmette-Guerin (BCG) were used for TruCulture stimulation conditions, with direct comparison to QFT. Protein analyses were performed on the culture supernatants using ELISA and Luminex multi-analyte profiling. TruCulture showed an ability to discriminate active TB cases from latent controls (p < 0.0001, AUC = 0.81, 95% CI: 0.69-0.93) as compared to QFT (p = 0.47 AUC = 0.56, 95% CI: 0.40-0.72), based on an IFNγ readout afterMtbantigen stimulation. The stratification of the two groups could be further improved by using theMtbAg/BCG IFNγ ratio response (p < 0.0001, AUC = 0.918, 95% CI: 0.84-0.98). We also identified additional cytokines that distinguished latent infection from TB disease; and show that the primary differences between the TruCulture and QFT systems were a result of higher levels of non-specific innate immune activation in QFT tubes, due to the lack of a buffering solution in the latter. We conclude that TruCulture offers a next-generation solution for whole blood stimulation and immunomonitoring with the possibility to discriminate active and latently infected persons.
Inter-individual genomic heterogeneity within European population isolates
Authors: Anagnostou Paolo , Dominici Valentina , Battaggia Cinzia , Sarno Stefania , Boattini Alessio , Calò Carla , Francalacci Paolo , Vona Giuseppe , Tofanelli Sergio , Vilar Miguel G. , Colonna Vincenza , Pagani Luca , Bisol Giovanni Destro
Published: March 2019

A number of studies carried out since the early ‘70s has investigated the effects of isolation on genetic variation within and among human populations in diverse geographical contexts. However, no extensive analysis has been carried out on the heterogeneity among genomes within isolated populations. This issue is worth exploring since events of recent admixture and/or subdivision could potentially disrupt the genetic homogeneity which is to be expected when isolation is prolonged and constant over time. Here, we analyze literature data relative to 87,818 autosomal single-nucleotide polymorphisms, which were obtained from a total of 28 European populations. Our results challenge the traditional paradigm of population isolates as genetically (and genomically) uniform entities. In fact, focusing on the distribution of variance of intra-population diversity measures across individuals, we show that the inter-individual heterogeneity of isolated populations is at least comparable to the open ones. More in particular, three small and highly inbred isolates (Sappada, Sauris and Timau in Northeastern Italy) were found to be characterized by levels of this parameter largely exceeding that of all other populations, possibly due to relatively recent events of genetic introgression. Finally, we propose a way to monitor the effects of inter-individual heterogeneity in disease-gene association studies.
Transient upregulation of translational efficiency in prodromal Tg2576 mice precipitates AD symptoms
Authors: Borreca Antonella , Valeri Francesco , De Luca Mariassunta , Ernst Lysianne , Russo Arianna , Cordella Alberto , Corsetti Veronica , Nobili Annalisa , Amadoro Giusy , Mercuri Nicola Biagio , D’Amelio Marcello , Ammassari-Teule Martine
Published: March 2019

Tg2576 mice overexpressing APPK670/671L exhibit elevated hAPP levels from birth but remain at a prodromal stage until 3 months of age. Whether variations in hAPP mRNA specific and overall translation occur during development and precipitates the transition from an asymptomatic to a symptomatic stage is unknown. By performing polysome profiling and distribution of hAPP, and measuring the levels of eukaryotic initial translation factors in hippocampal extracts from pre- and early symptomatic Tg2576 mice, we found that the presence of mRNA and protein polysomal signals was associated with decreased levels of the phosphorylated form of the initial translation factor eIF2α (p-eIF2α), revealing a transient upregulation of overall translation. Differently, the reduction of hAPP mRNA polysomal signals was associated with increased p-eIF2α levels – repressing translation-when mice were symptomatic, suggesting a compensatory mechanism aimed at downregulating hAPP mRNA. Confirming that prodromal upregulation of translational efficiency contributes to AD pathogenesis, pharmacological restoration of proper translational control in early symptomatic mice blocked the manifestation of neural and cognitive AD-like alterations.
Gene regulatory network reconstruction using single-cell RNA sequencing of barcoded genotypes in diverse environments
Authors: Jackson Christopher A , Castro Dayanne M , Saldi Giuseppe-Antonio , Bonneau Richard , Gresham David
Published: March 2019

Understanding how gene expression programs are controlled requires identifying regulatory relationships between transcription factors and target genes. Gene regulatory networks are typically constructed from gene expression data acquired following genetic perturbation or environmental stimulus. Single-cell RNA sequencing (scRNAseq) captures the gene expression state of thousands of individual cells in a single experiment, offering advantages in combinatorial experimental design, large numbers of independent measurements, and accessing the interaction between the cell cycle and environmental responses that is hidden by population-level analysis of gene expression. To leverage these advantages, we developed a method for transcriptionally barcoding gene deletion mutants and performing scRNAseq in budding yeast (Saccharomyces cerevisiae). We pooled diverse genotypes in 11 different environmental conditions and determined their expression state by sequencing 38,285 individual cells. We developed, and benchmarked, a framework for learning gene regulatory networks from scRNAseq data that incorporates multitask learning and constructed a global gene regulatory network comprising 12,018 interactions. Our study establishes a general approach to gene regulatory network reconstruction from scRNAseq data that can be employed in any organism.
Dissociable neural circuits underlie the resolution of three discrete sources of competition during task-switching
Authors: Burke Kelly M. , Molholm Sophie , Butler John S. , Ross Lars A. , Foxe John J.
Published: March 2019

Humans perform sub-optimally when juggling more than one task, but are nonetheless required to multitask during many daily activities. Rapidly and effectively switching attentional focus between tasks is fundamental to navigating complex environments. Task-switching paradigms in conjunction with neuroimaging have identified brain networks underpinning flexible reallocation of cognitive resources and a core network of neural regions is repeatedly implicated (i.e., posterior parietal, inferior frontal, anterior cingulate, and middle frontal cortex). Performance costs such as reduced accuracy and slowed responses accompany the first execution of a task following a task-switch. These costs stem from three main sources of competition: 1) the need to reconfigure task-rules, 2) the immediate history of motor responding, and 3) whether inputs to be acted upon provide congruent or incongruent information regarding the appropriate motor response, relative to the recently “switched-away-from” task. Here, we asked whether both common (domain-general) and non-overlapping (dissociable) neural circuits were involved in resolving these three distinct sources of competition under high-demand task-switching conditions. Dissociable neural circuits were active in resolving each of the three sources of competition. No domain-general regions were implicated in all three. Rather, two regions were common across rule-switching and stimulus incongruence, and five regions to incongruence and response-switching. Each source of conflict elicited activation from many regions including the posterior cingulate, thalamus, and cerebellum, regions not commonly implicated in the task-switching literature. These results suggest that dissociable neural networks are principally responsible for resolving different sources of competition, but with partial interaction of some overlapping domain-general circuitry.
Graphene nanoflakes for acute manipulation of membrane cholesterol and transmembrane signaling
Authors: Kitko Kristina E. , Hong Tu , Lazarenko Roman M. , Rafael Montenegro-Burke J. , Shah Amy T. , Zhang Yuchen , Raghunathan Krishnan , Kenworthy Anne K. , Skala Melissa C. , McLean A. , Xu Ya-Qiong , Zhang Qi
Published: March 2019

Cholesterol is one of the most essential lipids in eukaryotic cell membranes. However, acute and selective manipulation of membrane cholesterol remains challenging. Here, we report that graphene nanoflakes (GNFs) insert into the plasma membrane and directly interact with cholesterol, resulting in acute cholesterol enrichment – and thus structural and functional changes. Using two representative cell preparations, we explore the utility of GNFs in modifying cell communication pathways sensitive to membrane cholesterol. In fibroblasts, GNFs enhance ATP-induced intracellular Ca2+-release by allosteric facilitation of P2Y receptors, a subtype of G protein-coupled receptors, in a cholesterol-dependent manner. In neurons, which possess higher membrane cholesterol levels than most cell types, GNFs further increase cholesterol. Consequently, GNFs change membrane fluidity, especially at synaptic boutons, and potentiate neurotransmitter release by accelerating synaptic vesicle turnover. Together, our results provide a molecular explanation for graphene’s cellular impacts and demonstrate its potential for membrane-oriented engineering of cell signaling.
REMI-seq: Development of methods and resources for functional genomics inDictyostelium
Authors: Gruenheit Nicole , Baldwin Amy , Stewart Balint , Jaques Sarah , Keller Thomas , Parkinson Katie , Chisholm Rex , Harwood Adrian , Thompson Christopher R. L.
Published: March 2019

Genomes can be sequenced with relative ease, but ascribing gene function remains a major challenge. Genetically tractable model systems are crucial to meet this challenge. One powerful model is the social amoebaDictyostelium discoideum, a eukaryotic microbe widely used to study diverse questions in cell, developmental and evolutionary biology. However, its utility is hampered by the inefficiency with which sequence, transcriptome or proteome variation can be linked to phenotype. To address this, we have developed methods (REMI-seq) to (1) generate a near genome-wide resource of individual mutants (2) allow large-scale parallel phenotyping. We demonstrate that integrating these resources allows novel regulators of cell migration, phagocytosis and macropinocytosis to be rapidly identified. Therefore, these methods and resources provide a step change for high throughput gene discovery in a key model system, and the study of genes affecting traits associated with higher eukaryotes.
Determinants of transcription factor regulatory range
Authors: Chen Chen-Hao , Zheng Rongbin , Fan Jingyu , Brown Myles , Liu Jun S. , Meyer Clifford A. , Shirley Liu X.
Published: March 2019

To characterize the genomic distances over which transcription factors (TFs) influence gene expression, we examined thousands of TF and histone modification ChIP-seq datasets and thousands of gene expression profiles. A model integrating these data revealed two classes of TF: one with short-range regulatory influence, the other with long-range regulatory influence. The two TF classes also had distinct chromatin-binding preferences and auto-regulatory properties. The regulatory range of a single TF bound within different topologically associating domains (TADs) depended on intrinsic TAD properties such as local gene density and G/C content, but also on the TAD chromatin state in specific cell types. Our results provide evidence that most TFs belong to one of these two functional classes, and that the regulatory range of long-range TFs is chromatin-state dependent. Thus, consideration of TF type, distance-to-target, and chromatin context is likely important in identifying TF regulatory targets and interpreting GWAS and eQTL SNPs.
Butterfly assemblages from Amazonian flooded forests are not more species-poor than from unflooded forests
Authors: Rabelo Rafael M. , Magnusson William E.
Published: March 2019

The Amazonian flooded and upland forests harbour distinct assemblages of most taxonomic groups. These differences can be mainly attributed to flooding, which may affect directly or indirectly the persistence of species. Here, we compare the density, richness and composition of butterfly assemblages in vaórzea and terra firme forests, and evaluate whether terrain elevation and flooding can be used to predict the assemblage structure. We found that the total abundance and number of species per plot is higher in vaórzea than in terra firme forests. Vaórzea assemblages showed a higher dominance of abundant species than terra firme assemblages, in which low-flying Haeterini butterflies had higher abundance. After standardizing species richness by sample size and/or coverage, species richness estimates for vaórzea and terra firme forests were similar. There was strong turnover in species composition across vaórzea and terra firme forests associated with terrain elevation, most likely due to differences in the duration of flooding. Despite a smaller total area, less defined vegetation strata, more frequent disturbances and the younger geological age of floodplain forests, Nymphalid butterfly assemblages are not more species poor there than in unflooded forests.
From uncertainty to pathogenicity: clinical and functional interrogation of a rare TP53 in-frame deletion
Authors: Quinn Emily A. , Maciaszek Jamie L. , Pinto Emilia M. , Phillips Aaron H. , Berdy David , Khandwala Mohammad , Upadhyaya Santhosh A. , Zambetti Gerard P. , Kriwacki Richard W. , Ellison David W. , Nichols Kim E. , Kesserwan Chimene
Published: March 2019

Li–Fraumeni syndrome (LFS) is a highly penetrant cancer predisposition syndrome caused by heterozygous germline mutations in the TP53 gene. Although more than 200 missense and null TP53 mutations are well established as disease-causing, little is known about the pathogenicity and cancer risks associated with small in-frame deletions. This leads to challenges in variant classification and subsequent difficulty making a molecular diagnosis. We report the genetic testing process for a pediatric patient diagnosed with an undifferentiated high-grade brain tumor following his mother's diagnosis of early-onset bilateral breast cancer. Sequential testing revealed that both harbored a heterozygous three-nucleotide deletion in exon 7 of TP53 (c.764_766delTCA; I255del), which was classified as a variant of uncertain significance. Because the maternal family history was void of any other LFS spectrum tumors, additional information was needed to effectively classify the variant. Targeted TP53 testing of the patient's maternal grandparents confirmed that neither carried the variant; this new de novo data upgraded the variant classification to likely pathogenic. To assess the impact of this mutation on the encoded p53 protein, additional in vitro analyses were performed. Structural modeling predicted that the deletion of isoleucine at codon 255 would disrupt the architecture of the DNA-binding domain, suggesting that it might negatively impact p53 function. Consistent with this notion, the I255del mutant protein exhibited significantly impaired transcriptional activity and greatly reduced growth suppressive properties, similar to more well-characterized LFS-associated p53 mutants. This report illustrates the importance of seeking additional evidence to assign proper pathogenicity classification, which enables optimal genetic counseling and medical management of individuals with LFS and their at-risk relatives.
SCHEMA
Authors: Stone Merlin , Woodcock Neil , Ekinci Yuksel , Aravopoulou Eleni , Parnell Brett David
Published: March 2019

Purpose

This paper aims to review the development of thinking about the information needed by companies to create an accurate picture of how well they manage their engagement with customers, taking into account the evolution of thinking and practice in this area over the past three decades towards the idea of data-driven customer engagement. It then describes the evolution and use of an assessment and benchmarking process and tool which provide the needed information.

Design/methodology/approach

Literature review, conceptual analysis and explanation of the management consulting process are used.

Findings

Companies can get an accurate picture of how well they manage customer engagement provided that a careful assessment approach is used where assessors are properly selected and trained and that there is a strong focus on compliance with requirements rather than “box-ticking” based upon managers’ perceptions.

Research limitations/implications

The assessment and benchmarking process was developed mainly for use by larger companies, though the findings could be adapted for use by smaller companies.

Practical implications

Companies whose success depends upon customer engagement should consider using the assessment and benchmarking tool to guide their planning and implementation. They should heed the warnings about the risks of inaccurate assessments which may arise because of the incentives by which managers are managed.

Social implications

The assessment and benchmarking process has been used by the public sector and government, and given government’s desire to engage citizens better, they should consider adopting the ideas in this paper to reform citizen engagement.

Originality/value

This is the only paper which reviews the development of the assessment process for customer engagement.
The separation of directors and managers
Authors: Segrestin Blanche , Johnston Andrew , Hatchuel Armand
Published: March 2019

Purpose

The purpose of this paper is to contrast the historical rise of the managerial function and its reception in law. It thus contributes to the debates on the separation of ownership and control, by showing that managers were never recognized in law. As a result, the managerial function was not protected in law.

Design/methodology/approach

This paper brings together management history and the history of UK company law to study the emergence of management in the early twentieth century and the law’s response. The authors bring new historical evidence to bear on the company law reforms of the second half of the twentieth century and, in particular, on the changes inspired by the Cohen Committee report of 1945.

Findings

Scientific progress and innovation were important rationales for the emergence of managerial authority. They implied new economic models, new competencies and wider social responsibilities. The analysis of this paper shows that these rationales have been overlooked by company law. The lack of conceptualization of the management in law allowed reforms after 1945 that gave shareholders greater influence over corporate strategy, reducing managerial discretion and the scope for innovation.

Research limitations/implications

This paper focuses on the UK. Further research is needed to confirm whether other countries followed a similar path, both in terms of the emergence of management and in terms of the law’s approach.

Originality/value

This paper is the first, to the authors’ knowledge, to examine the law’s historical approach to management. It calls for a reappraisal of the status of managers and the way corporate governance organizes the separation of ownership and control.
Riding the wave of genomics to investigate aquatic coliphage diversity and activity
Authors: Michniewski Slawomir , Redgwell Tamsin , Grigonyte Aurelija , Rihtman Branko , Aguilo‐Ferretjans Maria , Christie‐Oleza Joseph , Jameson Eleanor , Scanlan David J. , Millard Andrew D.
Published: March 2019

Bacteriophages infecting Escherichia coli (coliphages) have been used as a proxy for faecal matter and water quality from a variety of environments. However, the diversity of coliphages that is present in seawater remains largely unknown, with previous studies largely focusing on morphological diversity. Here, we isolated and characterized coliphages from three coastal locations in the United Kingdom and Poland. Comparative genomics and phylogenetic analysis of phage isolates facilitated the identification of putative new species within the genera Rb69virus and T5virus and a putative new genus within the subfamily Tunavirinae. Furthermore, genomic and proteomic analysis combined with host range analysis allowed the identification of a putative tail fibre that is likely responsible for the observed differences in host range of phages vB_Eco_mar003J3 and vB_Eco_mar004NP2.
Photoplethysmographic evaluation of sympathectomy during lumbar epidural analgesia: A randomized comparison of 0.125% ropivacaine and 0.125% levobupivacaine
Authors: Reiner Kresimir , Lukic Anita , Martinus Marija , Cacic Marko , Mihaljevic Slobodan
Published: March 2019

Background

There are no data on the difference between the impact of ropivacaine and levobupivacaine on sympathetic nerve fibers during central neuraxial blocks. We hypothesized that there is no difference in the degree of sympathectomy between the two drugs during lumbar epidural analgesia for labor pain.

Methods

Sixty healthy parturients were randomized to the type of local anesthetic–opiod solution administered in the epidural space: 10 mL of 0.125% ropivacaine + 100 mcg of fentanyl or 10 mL of 0.125% levobupivacaine + 100 mcg of fentanyl. After the baseline measurement, photoplethysmography signal from the first toe of the leg was recorded 5, 10 and 20 minutes after administration of epidural analgesia.

Results

Area under the curve and the pulse transit time of the toe photoplethysmography increased in both groups during the first 20 minutes after administration of epidural analgesia (P < 0.001 for both parameters in both groups). No difference in the degree of sympathectomy was found between the groups for the area under the curve. The difference in the change of the pulse transit time suggests that the two local anesthetics might differ in the degree of sympathectomy (P = 0.024).

Conclusion

0.125% ropivacaine and 0.125% levobupivacaine do not differ in the terms of sympathectomy–mediated side effects of the epidural block for labor analgesia. However, the photoplethysmography findings suggest a certain difference in the degree of sympathectomy between the two local anesthetics.
A Comparison of Scoring Systems for Predicting Short‐ and Long‐term Survival After Trauma in Older Adults
Authors: Meagher Ashley D. , Lin Amber , Mandell Samuel P. , Bulger Eileen , Newgard Craig
Published: March 2019

Objectives

Early identification of geriatric patients at high risk for mortality is important to guide clinical care, medical decision making, palliative discussions, quality assurance, and research. We sought to identify injured older adults at highest risk for 30‐day mortality using an empirically derived scoring system from available data and to compare it with current prognostic scoring systems.

Methods

This was a retrospective cohort study of injured adults ≥ 65 years transported by 44 emergency medical services (EMS) agencies to 49 emergency departments in Oregon and Washington from January 1, 2011, through December 31, 2011, with follow‐up through December 31, 2012. We matched data from EMS to Medicare, inpatient, trauma registries, and vital statistics. Using a primary outcome of 30‐day mortality, we empirically derived a new risk score using binary recursive partitioning and compared it to the Charlson Comorbidity Index (CCI), modified frailty index, geriatric trauma outcome score (GTOS), GTOS II, and Injury Severity Score (ISS).

Results

There were 4,849 patients, of whom 234 (4.8%) died within 30 days and 1,040 (21.5%) died within 1 year. The derived score, the geriatric trauma risk indicator (GTRI; emergent airway or CCI ≥ 2), had 87.2% sensitivity (95% confidence interval [CI] = 83.0% to 91.5%) and 30.6% specificity (95% CI = 29.3% to 31.9%) for 30‐day mortality (area under the receiving operating characteristic curve [AUROC] = 0.589, 95% CI = 0.566 to 0.611). AUROC values for other scoring systems ranged from 0.592 to 0.678. When the sensitivity for each existing score was held at 90%, specificity values ranged from 7.5% (ISS) to 30.6% (GTRI).

Conclusions

Older, injured adults transported by EMS to a large variety of trauma and nontrauma hospitals were more likely to die within 30 days if they required emergent airway management or had a higher comorbidity burden. When compared to other risk measures and holding sensitivity constant near 90%, the GTRI had higher specificity, despite a lower AUROC. Using GTOS II or the GTRI may better identify high‐risk older adults than traditional scores, such as ISS, but identification of an ideal prognostic tool remains elusive.
Limited evidence of compositional convergence of restored vegetation with reference states after 20 years of livestock exclusion
Authors: Sims Ryan J. , Lyons Mitchell , Keith David A.
Published: March 2019

Native pastures and rangelands may become degraded by intensive pastoral use through clearing of woody components, loss of sensitive native species, invasion of opportunistic exotics and soil erosion, compaction and nutrient imbalance. Livestock exclusion is commonly a first management step to restore ecosystems degraded by overgrazing. However, few studies evaluate the outcomes of livestock exclusion on plant species composition and soil chemistry, while those that do are inconclusive due partly to highly variable responses and to inexplicit performance criteria. We adopted a conceptual model that characterised responses to fencing in terms of divergence from initial states and convergence with targeted states that represent restoration goals. We used the model to design an investigation of fencing effects on grassy woodlands within livestock production landscapes in subhumid southeastern Australia. First, we asked whether fencing initiated divergence from continually grazed vegetation and convergence with reference states with respect to plant species composition and soil properties. Secondly, we asked how responses depend on livestock exclusion time, degradation of the initial state, and soil conditions. Compositional trajectories based on a 17‐year chronosequence showed that livestock exclusion initiated some divergence from unfenced controls but convergence with reference states was limited, variable among sites and unrelated to time‐since‐livestock‐exclusion. Fencing initiated the development of novel communities comprising exotic taxa and a subset of native taxa from the reference species pool. Initial state offered limited explanation for the variability in compositional divergence from unfenced controls. Soil properties did not converge with reference states over time, and initial state did not explain the degree divergence of fenced from unfenced plots. The findings suggest site selection is crucial to successful restoration and reinforce the need to consider supplementary management actions, such as planting, scalping, direct seeding and weed control, in addition to livestock grazing exclusion, to restore woodlands towards desired states.
Rainbow trout resistance to bacterial cold water disease: two new quantitative trait loci identified after a natural disease outbreak on a French farm
Authors: Fraslin C. , Brard‐Fudulea S. , D'Ambrosio J. , Bestin A. , Charles M. , Haffray P. , Quillet E. , Phocas F.
Published: March 2019

In rainbow trout farming, Flavobacterium psychrophilum, the causative agent of bacterial cold water disease, is responsible for important economic losses. Resistance to F. psychrophilum is heritable, and several quantitative trait loci (QTL) with moderate effects have been detected, opening up promising perspectives for the genetic improvement of resistance. In most studies however, resistance to F. psychrophilum was assessed in experimental infectious challenges using injection as the infection route, which is not representative of natural infection. Indeed, injection bypasses external barriers, such as mucus and skin, that likely play a protective role against the infection. In this study, we aimed at describing the genetic architecture of the resistance to F. psychrophilum after a natural disease outbreak. In a 2000‐fish cohort, reared on a French farm, 720 fish were sampled and genotyped using the medium‐throughput Axiom™ Trout Genotyping Array. Overall mortality at the end of the outbreak was 25%. Genome‐wide association studies were performed under two different models for time to death measured on 706 fish with validated genotypes for 30 060 SNPs. This study confirms the polygenic inheritance of resistance to F. psychrophilum with a few QTL with moderate effects and a large polygenic background, the heritability of the trait being estimated at 0.34. Two new chromosome‐wide significant QTL and three suggestive QTL were detected, each of them explaining between 1% and 4% of genetic variance.
Significance of CEP78 and WDR62 gene expressions in differentiated thyroid carcinoma: Possible predictors of lateral lymph node metastasis
Authors: Hammad Maha O. , Elabbasy Lamiaa M. , Abd elghaffar Mahmoud A. , Zaki Marwa M. A. , Bazeed Fagr B. , Zahran Mohammed A.
Published: March 2019

Objectives

This study aimed at investigating the clinical significance of CEP78 and WDR62 in differentiated thyroid carcinoma (DTC). This study also aimed at finding predictors that help in detecting patients with DTC who have high risk for lateral lymph node metastasis (LNM).

Methods

Quantitative real‐time polymerase chain reaction (RT‐qPCR) was performed to examine CEP78, and WDR62 mRNA expressions in 40 tissue specimens of DTC, and 40 goiter tissue specimens. Additionally, we reviewed clinical, ultrasound, laboratory, pathological data of patients to analyze the associations between these characteristics and lateral LNM.

Results

Our results demonstrated that relative CEP78 mRNA levels were significantly decreased in thyroid cancer tissues than goiter tissues (P = 0.002). ROC curve analysis confirmed the diagnostic value of CEP78 mRNA expression, providing an AUC equals to 0.698 (95% confidence intervals (CI), 0.583–0.813; P = 0.002). The relative WDR62 mRNA expression was not statistically different in DTC tissues and goiter tissues (P = 0.686). Furthermore, the DTC patients had been included to examine risk factors for lateral LNM. In multivariate analysis, the significant factors for predicting lateral LNM were low CEP78 mRNA expression (cut off value ≤0.54; P = 0.03; OR = 19.62; 95% CI, 1.3–296.23), central LNM (P = 0.011; OR = 33.6; 95% CI, 2.24–503.6) and calcifications (P = 0.023; OR = 27.187; 95% CI, 1.57–469.5).

Conclusions

CEP78 can be used as a promising molecular biomarker for differentiation between DTC and goiter tissues, in addition it might serve as a predictor of lateral LNM in DTC along with central LNM and calcifications. Unlike CEP78, WDR62 mRNA expression was not statistically different in DTC and goiter.
Motor performance and cognitive correlates in children cooled for neonatal encephalopathy without cerebral palsy at school age
Authors: Jary S , Lee‐Kelland R , Tonks J , Cowan F M , Thoresen M , Chakkarapani E
Published: March 2019

Aim

To investigate whether motor performance in school‐age children without cerebral palsy (CP), cooled for neonatal encephalopathy, is associated with perinatal factors and 18‐month developmental scores and to explore relationships between school‐age motor and cognitive performance.

Methods

Motor and cognitive performance was assessed in 29 previously cooled children at six to eight years using the Movement Assessment Battery for Children‐2 (MABC‐2) and the Wechsler Intelligence Scale for Children (WISC‐IV). Associations between MABC‐2 scores less than/equal (≤) 15th centile and perinatal factors, social/family background, 18‐month Bayley‐III scores and WISC‐IV scores were explored.

Results

Eleven of the 29 (38%) children had MABC‐2 scores ≤15th centile including 7 (24%) ≤5th centile. No significant perinatal or socio‐economic risk factors were identified. Motor scores <85 at 18 months failed to identify children with MABC‐2 scores ≤15th centile. MABC‐2 scores ≤15th centile were associated with lower Full Scale IQ (p = 0.045), Working Memory (p = 0.03) and Perceptual Reasoning (p = 0.005) scores at six to eight years and receiving greater support in school (p = 0.01).

Conclusion

A third of cooled children without CP had MABC‐2 scores indicating motor impairment at school age that was not identified at 18 months by Bayley‐III. Most children with low MABC scores needed support at school. Sub‐optimal MABC‐2 scores indicate need for detailed school‐age cognitive evaluation.
Socioeconomic Status and the Prediction of Health Promoting Dietary Behaviours: A Systematic Review and Meta‐Analysis Based on the Theory of Planned Behaviour
Authors: Li Arthur Sone Wai , Figg Georgia , Schüz Benjamin
Published: March 2019

Background

Dietary behaviours are strongly patterned by socioeconomic status (SES). However, the role of SES in the self‐regulation of health promoting dietary behaviours is not fully understood. This systematic review with meta‐analysis investigated whether four individual‐level measures of SES (income, occupation, education, and ethnicity) moderate the relationships between Theory of Planned Behaviour (TPB) variables and different health promoting dietary behaviours in adults.

Methods

A systematic literature search identified 106 studies from 77 articles providing information on TPB variables, SES, and health promoting dietary behaviours—choosing health promoting foods and restricting health compromising foods. Random‐effects meta‐analyses were conducted to generate pooled correlations corrected for sampling and measurement error, and meta‐regression was used to test moderating effects of study‐level SES.

Results

All TPB variables were significantly and positively associated with both health promoting dietary behaviours, with intention having the strongest correlation with behaviour. However, none of the relationships between TPB variables and health promoting dietary behaviours were significantly moderated by study‐level SES.

Conclusions

Results suggest robust associations between TPB predictors and healthy dietary behaviour that are not patterned by individual‐level SES measures.
Determination and prediction of the apparent and standardized ileal amino acid digestibility in cottonseed meals fed to growing pigs
Authors: Ma Xiaokang , Zhang Sai , Shang Qinghui , Long Shenfei , Piao Xiangshu
Published: March 2019

This experiment was conducted to evaluate the chemical composition and apparent ileal digestibility (AID) and standardized ileal digestibility (SID) of amino acids (AA) in cottonseed meals (CSM) and to develop prediction equations for estimating AA digestibility for growing pigs based on the chemical composition and AA content of CSM. 10 CSM were collected from 10 provinces in China. 11 barrows (initial body weight: 34.4 ± 1.9 kg), fitted with an ileal T‐cannula, were allotted to 6 × 11 Youden square with 6 periods and 11 diets. The diets included one N‐free diet and 10 CSM test diets containing 40% CSM as the sole source of AA. The nitrogen‐free diet was used to measure the basal endogenous losses of CP and AA. The AID and SID for crude protein (CP), Lys, Met, Trp, and Thr among the 10 CSM differed (p < 0.05). With R2 values exceeding 0.30, significant linear regression equations for CP, Lys, and Thr were obtained. The best fit equations for predicting the AID and SID of Lys were: AID of Lys = 82.94–0.65 neutral detergent fiber, with R2 = 0.44, residual standard deviation (RSD) = 4.03 and p = 0.04; and SID of Lys = 135.34–1.01 neutral detergent fiber + 34.27 Thr – 58.06 Trp – 84.93 Met, with R2 = 0.90, RSD = 1.42 and p = 0.01. In conclusion, the results of AID, SID and prediction equations could be used to evaluate the digestibility of CSM in growing pigs.
The point of no return: Up to what point should we be allowed to withdraw consent to the storage and use of embryos and gametes?
Authors: Frith Lucy , Blyth Eric
Published: March 2019

This article discusses when it is ethically acceptable to withdraw consent for the storage and use of embryos and gametes. Currently, the law in the UK states that consent to use of a gamete or embryo can be withdrawn up to the point of the embryo's transfer to the recipient's uterus or when the gamete is used in providing treatment services; that is, the ‘point of no return’. In this article, we will consider other points of no return and argue that having a single point of no return, a one size fits all form of consent can, in some cases, lead to restrictions on individuals’ autonomy and cause particular types of harm. Therefore, having different points of no return that fit different circumstances could extend autonomy and allow people to enter into agreements that are tailored more to their own particular needs and circumstances.
Cognitive regulations in ICT‐supported flipped classroom interactions: An activity theory perspective
Authors: Zheng Xiao‐Li , Kim Hoi‐Soo , Lai Wen‐Hua , Hwang Gwo‐Jen
Published: March 2019

In recent years, most studies on flipped classrooms or flipped learning have focused on learners’ motivation, academic achievement and teachers’ and students’ perceptions of the flipped classroom. Little research has involved interactions in the flipped classroom. This study aims to show that in‐class collaborative learning in the flipped classroom can not only be conceived as a collective activity consisting of discrete actions, but also as a systematic activity. From the activity‐theoretical perspective, contradictions were found between components of an activity such as subject, tools, rules, community, division of labor, object and outcome. This study conducted a pre‐experiment, selecting one lesson of the seventh‐grade Information Technology Course as the learning content, conducted in a flipped classroom. Three triads with different compositions were specifically observed by recording their interactions. More second‐level contradictions existed between subject and tools, and division of labor within the low‐level triad than within the other two triads, and more first‐level contradictions also occurred within the low‐level triad than within the other two triads. Most second‐level contradictions within the high‐level triad were resolved by self‐regulation of cognition. Instead, most second‐level contradictions within the mixed‐level triad were overcome by co‐regulation or shared regulation of cognition. This study sheds light on how to effectively design and implement flipped learning, and provides a new approach for analyzing interactions in the classroom.
Distinct patterns of naive, activated and memory T and B cells in blood of patients with ulcerative colitis or Crohn’s disease
Authors: Rabe H , Malmquist M , Barkman C , Östman S , Gjertsson I , Saalman R , Wold A E
Published: March 2019

Both major subcategories of inflammatory bowel disease (IBD), ulcerative colitis and Crohn’s disease are characterized by infiltration of the gut wall by inflammatory effector cells and elevated biomarkers of inflammation in blood and feces. We investigated the phenotypes of circulating lymphocytes in the two types of IBD in treatment-naive pediatric patients by analysis of blood samples by flow cytometry. Multivariate analysis was used to compare the phenotypes of the blood lymphocytes of children with ulcerative colitis (n = 17) or Crohn’s disease (n = 8) and non-IBD control children with gastrointestinal symptoms, but no signs of gut inflammation (n = 23). The two IBD subcategories could be distinguished based on the results from the flow cytometry panel. Ulcerative colitis was characterized by activated T cells, primarily in the CD8+ population, as judged by increased expression of human leukocyte antigen D-related (HLA-DR) and the β1-integrins [very late antigen (VLA)] and a reduced proportion of naive (CD62L+) T cells, compared with the non-IBD controls. This T cell activation correlated positively with fecal and blood biomarkers of inflammation. In contrast, the patients with Crohn’s disease were characterized by a reduced proportion of B cells of the memory CD27+ phenotype compared to the non-IBD controls. Both the patients with ulcerative colitis and those with Crohn’s disease showed increased percentages of CD23+ B cells, which we demonstrate here as being naive B cells. The results support the notion that the two major forms of IBD may partially have different pathogenic mechanisms.