bluuebunny/crossref_metadata_2025 huggingface dataset:
Einsatz des 2940 nm ER:YAG‐Lasers zur Behandlung der Lentigo maligna
Authors: Fikrle Tomáš , Divišová Barbora , Šuchmannová Jitka , Pizinger Karel
Published: April 2019

Ziele

Die Lentigo maligna ist ein bei älteren Patienten häufig auftretendes malignes Carcinoma in situ mit einem geringen invasiven Progressionsrisiko. Da ein chirurgisches Vorgehen schwierig sein kann oder vom Patienten abgelehnt wird, besteht ein Bedarf an nichtoperativen Therapieoptionen wie beispielsweise eine Laserbehandlung.

Patienten und Methoden

Wir berichten über 17 Patienten, die wegen einer histopathologisch gesicherten Lentigo maligna mit einem 2940 nm Er:YAG‐Laser (Erbium‐dotierter Yttrium‐Aluminium‐Granat‐Laser) behandelt wurden. Die Ablation der Läsionen schloss einen Sicherheitsabstand von 5 mm ein und wurde unter Lokalanästhesie mit überlappenden Laserspots (3,5 mm), einer Energiedichte von 6,5 J/cm2 und einer Wiederholungsrate von 5 Hz durchgeführt. Trat im abladierten Bereich während der nachfolgenden drei Monate eine klinisch erkennbare Pigmentierung auf, wurde die Läsion erneut behandelt. Bei allen Patienten erfolgte eine Nachkontrolle auf residuale oder rezidivierende Tumoren.

Ergebnisse

Wir konnten bei allen 17 Patienten klinische Tumorfreiheit erreichen. Während der Nachsorge traten drei Rezidive auf (9, 30 und 36 Monate nach der Laserbehandlung). Alle Patienten waren mit dem Behandlungsverlauf und dem kosmetischen Ergebnis zufrieden. Die mittlere Dauer der Nachkontrolle betrug 28 Monate.

Schlussfolgerungen

Die Laserablation ist eine interessante alternative Therapieoption bei Lentigo maligna. Sie kann in ausgewählten Fällen eingesetzt werden, bei denen ein chirurgisches Vorgehen kontraindiziert oder schwierig ist oder vom Patienten abgelehnt wird.
Takotsubo cardiomyopathy in a man with no trigger and multiple cardioembolic complications—A rare constellation
Authors: Kalra Dinesh K. , Lichtenstein Seth J. , Bai Charlotte , Parekh Keyur , Sanghani Rupa , Tracy Melissa , Feinstein Steven
Published: April 2019

Takotsubo Cardiomyopathy (TC) is an uncommon, transient, reversible cardiomyopathy, with a classic pattern of wall‐motion abnormalities, usually seen in women after an emotional stressor. Despite its increased recognition, there remain gaps in the exact mechanisms, predisposing factors, and predictors of recovery; this is particularly true for males where the condition occurs far less frequently than in females. TC typically resolves within weeks, and the prognosis is favorable compared to acute coronary syndromes. Nonetheless, about 1% of cases may be complicated by left ventricular (LV) thrombus and embolism. Herein we describe an atypical case of a man with no obvious trigger, who developed TC with left ventricular thrombus and multiple embolic complications, but subsequently showed complete and full resolution. Multimodality imaging including echocardiography, cardiac CT and cardiac MRI was instrumental in this diagnostic dilemma, as well as useful in guiding treatment options and informing prognosis.
Actor–Partner Interdependence of Compassion toward Others with Qualities of Marital Relationship and Parent–Child Relationships in Chinese Families
Authors: Jiang Yongqiang , Lin Xiuyun , Hinshaw Stephen P. , Chi Peilian , Wu Qinglu
Published: April 2019

Considering the nature of compassion and cultural and times characteristics of Chinese families, individuals' general dispositional compassion toward others may have potential benefits for relationship qualities in Chinese families. In this study, we explored how men's and women's compassion related to their own (actor effects) and the partners' (partner effects) marital relationship and parent–child relationships, respectively, using the Actor–Partner Interdependent Model. Participants were from a cross‐sectional sample of 534 Chinese heterosexual married couples (females' mean age = 37.20,SD = 4.28; males' mean age = 40.29,SD = 5.39) whose biological children were pupils (mean age = 9.28,SD = 1.11). Results revealed that: (a) within marital relationships, couple members' actor effects and partner effects were found both significant; but (b) within parent–child relationships, couple members' actor effects were significant, whereas only mothers' partner effect of compassion on father–child relationship was significant. These findings support the benefits of couple members' individual compassion with respect to family relationship quality in contemporary China. Limitations, implications, and future directions are discussed.
Structural insight into the unique dsDNA binding topology of the human ORC2 wing helix domain
Authors: Zhang Jiahai , Guo Qiong , Gao Jun , Xu Chao , Zhang Beibei , Li Mingwei , She Jiaqi , Shi Yunyu , Zhang Zhiyong , Ruan Ke , Wu Jihui
Published: April 2019

The origin recognition complex (ORC) is indispensable for the initiation of DNA replication during the cell cycle. The DNA‐binding modes of the human ORC winged helix domain (WHD) remain enigmatic, as the dsDNA recognition sites of archaeal and Saccharomyces cerevisiae ORC WHDs are distinct. Here, we solved the high‐resolution crystal structure of the human ORC2 WHD, although its complex with dsDNA is difficult to crystallize due to its weak binding affinities. The near‐complete NMR backbone assignments and chemical shift perturbations reveal a new dsDNA binding topology in addition to the conserved β‐sheet hairpin region, in which residues show higher dynamics. The key interacting residues (R540, K548, and K549) were validated by mutagenesis studies. Our data suggest that the ORC2 WHD recognizes dsDNA sequences through its flexible β‐sheet hairpin as an anchor point, while the rest of the protein adopts various orientations in different species. This weak but real interaction module identified by NMR is useful for the structural reconstruction of large biomolecular complexes using cryo‐EM. The binding topology and dynamics of ORC2 WHDs were also underpinned by molecular dynamics simulations.
Geriatric syndromes and quality of life in older adults with diabetes
Authors: Yang Yi‐Ching , Lin Ming‐Hsing , Wang Chong‐Shan , Lu Feng‐Hwa , Wu Jin‐Shang , Cheng Hui‐Ping , Lin Sang‐I
Published: April 2019

Aim

To describe geriatric syndromes and their relationships with quality of life in older adults with diabetes.

Methods

Community‐dwelling older adults (aged >60 years) with diabetes (n = 316) participated in the present study. Eight geriatric syndromes, including polypharmacy (number of medications), pain (Brief Pain Inventory), urinary incontinence (International Consultation on Incontinence Questionnaire), sleep disturbance (hours of sleep), lower cognitive level (Mini‐Mental State Examination), falls, depressive symptoms (Geriatric Depression Scale short form) and functional limitation (Barthel Index and Instrumental Activity of Daily Living), were assessed. The WHOQOL‐BREF Taiwan version was used to measure physical, psychological, social and environmental domains of quality of life.

Results

Polypharmacy was the most common geriatric syndrome (46.6%), followed by pain (41.5%). Participants with any of the geriatric syndromes, except for polypharmacy and sleep disturbance, had significantly poorer quality of life than those without. The Geriatric Depression Scale score was the only common and significant contributor to all four domains of quality of life, explaining 16~29% of the variance. Number of medications, pain level and cognitive level were also significant contributors, although they explained a small amount (<5%) of the variance. The number of geriatric syndromes (mode = 2) was significantly correlated with all four domains of quality of life (partial correlation r = −0.278~0.460, all P < 0.001).

Conclusions

Geriatric syndromes, especially polypharmacy and pain, were common among older adults with diabetes. A greater number of geriatric syndromes or a higher Geriatric Depression Scale score were associated with poorer quality of life. Further studies focusing on combinations of different geriatric syndromes or comorbidities are required. Geriatr Gerontol Int 2019; 19: 518–524.
Does the unification of health financing affect the distribution pattern of out‐of‐pocket health expenses in Turkey?
Authors: Cinaroglu Songul , Baser Onur
Published: April 2019

Turkey has implemented health reforms for over a decade and has taken significant steps toward unifying health financing. This study investigated the financial burden associated with out‐of‐pocket (OOP) expenditures under universal health coverage, using national 2003–2015 household budget data from the Turkish Statistical Institute. Progress was evaluated using Kakwani–Suits indices and Lorenz concentration curves. The results indicate that overall, more than a decade after its unification, redistribution of wealth in the Turkish health financing system has benefitted the wealthy but not the poor. Both curve and index approaches (Kakwani index 2003 = −0.50; 2015 = −0.44) reveal an increasingly regressive pattern of OOP health expenditures. The effective use of fiscal space and good political leadership are essential for the successful continuation of reforms to combat poverty in Turkey.
Transcriptome‐wide analysis of N6‐methyladenosine uncovers its regulatory role in gene expression in the lepidopteran Bombyx mori
Authors: Li B. , Wang X. , Li Z. , Lu C. , Zhang Q. , Chang L. , Li W. , Cheng T. , Xia Q. , Zhao P.
Published: April 2019

N6‐methyladenosine (m6A) methylation is the most common form of RNA modification in eukaryotes and has been shown to act as an important epitranscriptomic marker, which can regulate gene expression, messenger RNA stability, alternative splicing and translation efficiency. Recent progress on determining insect m6A function has been limited to the dipteran Drosophila melanogaster, in which m6A is involved in neuronal functions and sex determination. Methylation and function of m6A in other insects, however, remain unknown. Here, we investigated a transcriptome‐wide profile of m6A in the lepidopteran Bombyx mori and identified the methyltransferase subunits B. mori methyltransferase‐like 3 (BmMETTL3) and BmMETTL14 in the m6A methylation pathway. Strikingly, loss of BmMETTL3 and BmMETTL14 in cultured B. mori cells led to arrest of cell cycle progression and caused deficiency of chromosome alignment and segregation. Specifically, we identified 2853 m6A peaks representing transcripts of 2043 genes, and the target genes with m6A methylation were shown to be involved in gene expression and translation. It was interesting that we found that the highly expressed genes tended to be methylated by m6A, and comparative analysis of RNA m6A and DNA N6‐methyladenine (6mA) revealed two distinct regulatory mechanisms for gene expression. Overall, our work suggests RNA m6A and DNA 6mA play important roles in RNA and DNA epigenetic regulation in B. mori.
Wernicke encephalopathy hearing loss and palinacousis
Authors: Nguyen Janette T. T. , Franconi Catherine , Prentice Andrew , Wycoco Victor
Published: April 2019

Wernicke encephalopathy (WE) is a neurological emergency that develops in the setting of thiamine deficiency, and is characterised by symptoms of confusion, ophthalmoplegia and gait ataxia. Less recognised signs and symptoms include vestibular dysfunction, hearing impairment, peripheral neuropathy, and in severe cases, coma. This case study describes a non‐alcoholic patient, who presents with significant auditory and vestibular changes in addition to the classic symptoms of WE. This case report describes a non‐alcoholic patient who developed deafness, severe horizontal canal paresis and symptoms of palinacousis in the setting of WE as a complication of a recent gastric sleeve operation.
The African elephant Loxodonta spp conservation programmes of North Carolina Zoo: two decades of using emerging technologies to advance in situ conservation efforts
Authors: Wilson J. W. , Bergl R. A. , Minter L. J. , Loomis M. R. , Kendall C. J.
Published: April 2019

The North Carolina Zoo (Asheboro, NC, USA) has been actively involved with field‐based conservation initiatives targeting wild elephants in Africa for over 20 years. To overcome resource and logistical constraints faced by our African collaborators working in rural areas, the Zoo has helped to develop several emerging techniques and technologies. The Zoo's oldest field programme, which is still ongoing, uses novel anaesthesia techniques to fit satellite‐tracking collars on elephants in the field to gain a better understanding of their movement patterns in West and Central Africa. In addition, rangers use the real‐time tracking data generated from these collars as an early‐warning system to redirect roaming elephants back to protected areas before they come into conflict with human activities. The Zoo is also strengthening capacity for anti‐poaching activities by digitizing and standardizing patrol data collection. To this end, the Zoo has supported the development and implementation of Spatial Monitoring and Reporting Tool (SMART) conservation software, a freely available and fully customizable package that allows patrol data to be collected on handheld devices such as smartphones, from where it can be imported into computers for automated analysis and report generation. To date, the Zoo has helped implement SMART at 14 protected areas in five African countries, several of which contain substantial elephant populations. To ensure the effectiveness and sustainable use of these technologies, ongoing training and technical support are provided, and are considered vital components of all our field programmes.
Effects of substrate, ceramic thickness, translucency, and cement shade on the color of CAD/CAM lithium‐disilicate crowns
Authors: Czigola Alexandra , Abram Emese , Kovacs Zoltan I. , Marton Krisztina , Hermann Peter , Borbely Judit
Published: April 2019

Objective

The aim of this in vitro study was to evaluate the effects of substrate colors, different levels of ceramic thickness and translucency, and cement shades on the color difference from a reference color of lithium‐disilicate crowns.

Materials and Methods

A premolar tooth preparation was made on a study model for 1.0 and 1.5 mm thick full‐ceramic crowns. Digital impressions were taken (3Shape TRIOS) and crowns designed in a CAD program (DentalDesigner). Shade A1 crowns were milled (Everest, Kavo) from high‐translucency (HT) and low‐translucency IPS e.max (Ivoclar Vivadent) blocks. Twelve substrates were made of different colors and materials (Natural Die Material, Co‐Cr, zirconia, and gold‐colored alloy). Three different shades of try‐in pastes were used to simulate the effect of cements (Variolink Esthetic try‐in paste; Ivoclar). Shade measurement was done three times for each crown by a spectrophotometer (VITA Easyshade Advance); averages were compared to a reference crown (A1, HT, 1.5 mm, ND2 abutment, neutral try‐in paste) with ΔE00 (CIEDE2000, according to the CIE latest standard) calculated.

Results

All the examined parameters influenced the ΔE00 of the crowns. The weakest effect was exerted by the try‐in paste.

Conclusions

All examined parameters influenced the final color of e.max CAD lithium‐disilicate ceramic crowns.

Clinical Significance

Matching the shade of ceramic crowns to the natural tooth color is a great challenge in dentistry. To meet patients' increasing esthetical expectations, CAD/CAM methods are very popular for full‐ceramic crowns. However, several factors such as the shade of the abutment, luting cement color, ceramic thickness, and translucency may influence the final color. Our objective was to measure the optical effect of these factors on the final shade of CAD/CAM lithium‐disilicate ceramic crowns.
The global economic costs of substituting dietary protein from fish with meat, grains and legumes, and dairy
Authors: Cazcarro Ignacio , López‐Morales Carlos A. , Duchin Faye
Published: April 2019

This paper estimates the costs to replace fish by protein from meat, from grains and legumes, or from dairy products. We apply the World Trade Model, an input–output model of the interactions among major world regions based on comparative advantage, to analyze alternative scenarios about protein content and sources in global diets. We find that the substitution of fish by meat or dairy entails several trillion U.S. dollars of additional costs annually, corresponding to increased use of pastureland, cropland, water, and other factors of production. The price of animal products increases steeply as higher‐cost producers need to come online, yielding rents to owners of scarce resources. By contrast, the global economy adjusts at significantly lower costs to the substitution of fish by grains and legumes, but this dietary shift involves substantial modification in the mix of agricultural output and its geographic distribution. There have been few analytic studies able to associate costs and prices directly with specific combinations of dietary options. We provide a flexible economic framework for analyzing alternative scenarios about the present and future production of food. The focus on the provision of protein for the human diet, allowing for substitutions between land‐based and aquatic sources, lays the groundwork for subsequent closer examinations of the potential future contribution of aquaculture and, in a yet broader framework, the impact of the coming generation of large dams on fish habitat and freshwater ecosystems more generally.
Role of the posterodorsal medial amygdala in predator odour stress‐induced puberty delay in female rats
Authors: Li Xiao Feng , Adekunbi Daniel A. , Alobaid Hussah M. , Li Shengyun , Pilot Michel , Lightman Stafford L. , O'Byrne Kevin T.
Published: April 2019

Puberty onset is influenced by various factors, including psychosocial stress. The present study investigated cat‐odour stress on puberty onset and oestrous cyclicity in rats. Female weanling rats were exposed to either soiled cat litter or fresh unused litter for 10 consecutive days. Following vaginal opening (VO), rats were smeared for 14 days to determine oestrous cyclicity. Anxiety‐like behaviour was assessed using standard anxiety tests. Brains were collected to determine corticotrophin‐releasing factor (CRF), CRF receptor 1 (CRF‐R1) and CRF receptor 2 (CRF‐R2) mRNA in the paraventricular nucleus (PVN), as well as the central nucleus of the amygdala (CEA) and the medial nucleus of the amygdala (MEA). Cat odour delayed VO and first oestrus, disrupted oestrous cycles and caused anxiogenic responses. Cat odour elicited increased CRF mRNA expression in the PVN but not in the CeA. CRF‐R1 and CRF‐R2 mRNA levels in the PVN and CeA were unaffected by cat odour; however, CRF‐R1 mRNA levels were decreased in the MeA. The role of CRF signalling in the MeA, particularly its posterodorsal subnucleus (MePD), with respect to pubertal timing was directly examined by unilateral intra‐MePD administration of CRF (0.2 nmol day‐1 for 14 days) via an osmotic mini‐pump from postnatal day 24 and was shown to delay VO and first oestrus. These data suggest that CRF signalling in the MePD may be associated with predator odour‐induced puberty delay.
Femoral morphology of sciuromorph rodents in light of scaling and locomotor ecology
Authors: Wölfer Jan , Amson Eli , Arnold Patrick , Botton‐Divet Léo , Fabre Anne‐Claire , van Heteren Anneke H. , Nyakatura John A.
Published: April 2019

Abstract

Sciuromorph rodents are a monophyletic group comprising about 300 species with a body mass range spanning three orders of magnitude and various locomotor behaviors that we categorized into arboreal, fossorial and aerial. The purpose of this study was to investigate how the interplay of locomotor ecology and body mass affects the morphology of the sciuromorph locomotor apparatus. The most proximal skeletal element of the hind limb, i.e. the femur, was selected, because it was shown to reflect a functional signal in various mammalian taxa. We analyzed univariate traits (effective femoral length, various robustness variables and the in‐levers of the muscles attaching to the greater, third and lesser trochanters) as well as femoral shape, representing a multivariate trait. An ordinary least‐squares regression including 177 species was used to test for a significant interaction effect between body mass and locomotor ecology on the variables. Specifically, it tested whether the scaling patterns of the fossorial and aerial groups differ when compared with the arboreal, because the latter was identified as the ancestral sciuromorph condition via stochastic character mapping. We expected aerial species to display the highest trait values for a given body mass as well as the steepest slopes, followed by the arboreal and fossorial species along this order. An Ornstein–Uhlenbeck regression fitted to a phylogenetically pruned dataset of 140 species revealed the phylogenetic inertia to be very low in the univariate traits, hence justifying the utilization of standard regressions. These variables generally scaled close to isometry, suggesting that scaling adjustments might not have played a major role for most of the femoral features. Nevertheless, the low phylogenetic inertia indicates that the observed scaling patterns needed to be maintained during sciuromorph evolution. Significant interaction effects were discovered in the femoral length, the centroid size of the condyles, and the in‐levers of the greater and third trochanters. Additionally, adjustments in various femoral traits reflect the acquisitions of fossorial and aerial behaviors from arboreal ancestors. Using sciuromorphs as a focal clade, our findings exemplify the importance of statistically accounting for potential interaction effects of different environmental factors in studies relating morphology to ecology.
Are there interventions that improve breastfeeding and the use of breast milk in late preterm infants?
Authors: Evans Louise , Hilditch Cathie , Keir Amy
Published: April 2019

To answer the clinical question ‘Among late preterm infants are there any interventions that improve the rates of breastfeeding and the use of breast milk compared with current practice?’. MEDLINE via Ovid, Embase via Ovid, the Maternity and Infant Care Database and the Cochrane Library were searched for relevant articles. Articles were excluded if they did not discuss specific interventions to improve breastfeeding, for example, if they only commented on factors such as age, race and education. Articles were also excluded if they were not specific to the late preterm infant population. A total of 516 articles were found and screened by title and abstract independently by two reviewers. The full text of 17 articles was independently reviewed. The reference lists of these full‐text articles were screened, and 14 abstracts were subsequently reviewed. The final analysis included three studies. There is limited high‐quality research evidence for interventions to improve breastfeeding in late preterm infants. In the absence of robust academic research, clinical practice should be guided by clinical expertise and involve a multidisciplinary team, including qualified lactation consultants. While it seems reasonable for hospitals to support interventions that improve breastfeeding in term infants, managing late preterm infants as healthy term infants without additional specialist support may result in high breastfeeding failure rates among late preterm infants.
Testing of life history traits of a soilborne pathogen in vitro: Do characteristics of oospores change according the strains of Aphanomyces euteiches and the host plant infected by the pathogen?
Authors: Billard Estelle , Quillévéré‐Hamard Anne , Lavaud Clément , Pilet‐Nayel Maire Laure , Le May Christophe
Published: April 2019

Aphanomyces euteiches is a polyphagous, homothallic soilborne pathogen producing asexual (zoospores) and sexual (oospores) spores. Even if oospores are essential for disease development and survival, to date, no study has focused on the production rates of oospores or the quality of the offspring produced by oospores. In this study, a nonabrasive oospore extraction method from infected roots of leguminous species (pea, faba bean and vetch) was developed. This methodology includes steps of grinding and filtration. The quality of oospores (viable, dormant and dead) was assessed with tetrazolium bromide staining, and germination of oospores was tested using exudates of peas, faba bean and vetch. The average yield of the extraction method was approximately 21%. Staining revealed some differences between strains and between leguminous species. The germination percentage of oospores extracted from pea, faba bean and vetch was 25%, 62% and 70%, respectively, and a significant difference was observed according to the origin of A. euteiches‐inoculated strains. Application of exudates seems to stimulate the germination of oospores (2% for the control, 18% for pea exudates and 1% for vetch exudates). Differences observed between A. euteiches strains and leguminous species indicate that more knowledge concerning the biology of oospores is needed. This will help to better estimate evolution process of the pathogen and manage resistance and crop successions.
Melatonin differentially regulates pathological and physiological cardiac hypertrophy: Crucial role of circadian nuclear receptor RORα signaling
Authors: Xu Longwei , Su Yuanyuan , Zhao Yichao , Sheng Xincheng , Tong Renyang , Ying Xiaoying , Gao Lingchen , Ji Qingqi , Gao Yu , Yan Yang , Yuan Ancai , Wu Fujian , Lan Feng , Pu Jun
Published: April 2019

Exercise‐induced physiological hypertrophy provides protection against cardiovascular disease, whereas disease‐induced pathological hypertrophy leads to heart failure. Emerging evidence suggests pleiotropic roles of melatonin in cardiac disease; however, the effects of melatonin on physiological vs pathological cardiac hypertrophy remain unknown. Using swimming‐induced physiological hypertrophy and pressure overload‐induced pathological hypertrophy models, we found that melatonin treatment significantly improved pathological hypertrophic responses accompanied by alleviated oxidative stress in myocardium but did not affect physiological cardiac hypertrophy and oxidative stress levels. As an important mediator of melatonin, the retinoid‐related orphan nuclear receptor‐α (RORα) was significantly decreased in human and murine pathological hypertrophic cardiomyocytes, but not in swimming‐induced physiological hypertrophic murine hearts. In vivo and in vitro loss‐of‐function experiments indicated that RORα deficiency significantly aggravated pathological cardiac hypertrophy, and notably weakened the anti‐hypertrophic effects of melatonin. Mechanistically, RORα mediated the cardioprotection of melatonin in pathological hypertrophy mainly by transactivation of manganese‐dependent superoxide dismutase (MnSOD) via binding to the RORα response element located in the promoter region of the MnSOD gene. Furthermore, MnSOD overexpression reversed the pro‐hypertrophic effects of RORα deficiency, while MnSOD silencing abolished the anti‐hypertrophic effects of RORα overexpression in pathological cardiac hypertrophy. Collectively, our findings provide the first evidence that melatonin exerts an anti‐hypertrophic effect on pathological but not physiological cardiac hypertrophy via alleviating oxidative stress through transactivation of the antioxidant enzyme MnSOD in a RORα‐dependent manner.
Longitudinal assessment of microbial dysbiosis, fecal unconjugated bile acid concentrations, and disease activity in dogs with steroid‐responsive chronic inflammatory enteropathy
Authors: Guard Blake C. , Honneffer Julia B. , Jergens Albert E. , Jonika Michelle M. , Toresson Linda , Lawrence Yuri A. , Webb Craig B. , Hill Steve , Lidbury Jonathan A. , Steiner Joerg M. , Suchodolski Jan S.
Published: April 2019

Background

Mounting evidence from human studies suggests that bile acid dysmetabolism might play a role in various human chronic gastrointestinal diseases. It is unknown whether fecal bile acid dysmetabolism occurs in dogs with chronic inflammatory enteropathy (CE).

Objective

To assess microbial dysbiosis, fecal unconjugated bile acids (fUBA), and disease activity in dogs with steroid‐responsive CE.

Animals

Twenty‐four healthy control dogs and 23 dogs with steroid‐responsive CE.

Methods

In this retrospective study, fUBA were measured and analyzed. Fecal microbiota were assessed using a dysbiosis index. The canine inflammatory bowel disease activity index was used to evaluate remission of clinical signs. This was a multi‐institutional study where dogs with steroid‐responsive CE were evaluated over time.

Results

The dysbiosis index was increased in dogs with CE (median, 2.5; range, −6.2 to 6.5) at baseline compared with healthy dogs (median, −4.5; range, −6.5 to −2.6; P = .002) but did not change in dogs with CE over time. Secondary fUBA were decreased in dogs with CE (median, 29%; range, 1%‐99%) compared with healthy dogs (median, 88%; 4%‐96%; P = .049). The percent of secondary fUBA in dogs with CE increased from baseline values (median, 28%; range, 1%‐99%) after 2‐3 months of treatment (median, 94%; range, 1%‐99%; P = 0.0183).

Conclusions and Clinical Importance

These findings suggest that corticosteroids regulate fecal bile acids in dogs with CE. Additionally, resolution of clinical activity index in dogs with therapeutically managed CE and bile acid dysmetabolism are likely correlated. However, subclinical disease (i.e., microbial dysbiosis) can persist in dogs with steroid‐responsive CE.
Market Integration and Volatility Transmission in England’s Housing Markets
Authors: Tsai I‐Chun
Published: April 2019

In addition to evaluating the long‐term and short‐term relationships between housing markets on the regional and nationwide scales, this study also explores risk diffusion associated with market integration. Data from January 1995 to July 2017 in nine regions in England and in the overall England housing market are adopted. Through simultaneous estimates of volatility in various regions, the systemic risk and overall risk of each region are evaluated. The results reveal that housing markets in the central regions diffuse risks easily, and their volatility is easily affected by stock market return and money supply changes. By contrast, the volatility of housing markets in the southern regions is easily affected by changes in the interest rate, and these markets demonstrate high transmission with the overall housing market in the short term. Notably, except for times when financial crises occurred, housing market risks in the southern regions have been lower than those of other regions. In particular, London exhibits significantly low risk and high return in its housing market and high informativeness in its house prices. The results of this paper show the patterns and the factors influencing risk diffusion.
Anorectal pressures measured with high‐resolution manometry in healthy people—Normal values and asymptomatic pelvic floor dysfunction
Authors: Oblizajek Nicholas R. , Gandhi Sangeetha , Sharma Mayank , Chakraborty Subhankar , Muthyala Anjani , Prichard David , Feuerhak Kelly , Bharucha Adil E.
Published: April 2019

Background

High‐resolution manometry (HRM) is used to measure rectoanal pressures in defecatory disorders and fecal incontinence. This study sought to define normal values for rectoanal HRM, ascertain the effects of age and BMI on rectoanal pressures, and compare pressures in asymptomatic women with normal and prolonged balloon expulsion time (BET).

Methods

High‐resolution manometry pressures and BET were measured in 163 asymptomatic healthy participants. Women (96) and men (47) with normal BET were used to estimate normal values and the effects of age/BMI on pressures using a Medtronic 4.2‐mm‐diameter rectoanal catheter.

Key Results

Age is associated with lower resting pressure, higher rectal pressure during evacuation, and a higher rectoanal gradient during evacuation in women and men. In women, the BET is also inversely correlated with age while the BMI is correlated with a higher threshold volume for discomfort and a longer BET. The anal squeeze pressure increment, squeeze duration, and HPZ length are higher in men than women. The rectoanal gradient during evacuation is also lower (ie, more negative) in asymptomatic women with an abnormal than a normal BET.

Conclusions & Inferences

These findings provide an expanded database of normal values for anorectal HRM in men and women. Age and sex affect anal resting and squeeze pressures, respectively; rectal pressure during evacuation is also higher in older people. Less than 15% of asymptomatic people have BET >60 seconds, which is associated with manometry features of impaired evacuation.
Normative Explanation And Justification*
Authors: Väyrynen Pekka
Published: April 2019

Normative explanations of why things are wrong, good, or unfair are ubiquitous in ordinary practice and normative theory. This paper argues that normative explanation is subject to a justification condition: a correct complete explanation of why a normative fact holds must identify features that would go at least some way towards justifying certain actions or attitudes. I first explain and motivate the condition I propose. I then support it by arguing that it fits well with various theories of normative reasons, makes good sense of certain legitimate moves in ordinary normative explanatory discourse, and helps to make sense of our judgments about explanatory priority in certain cases of normative explanation. This last argument also helps to highlight respects in which normative explanation won't be worryingly discontinuous with explanations in other domains even though these other explanations aren't subject to the justification condition. Thus the paper aims not only to do some constructive theorizing about the relatively neglected topic of normative explanation but also to cast light on the broader question of how normative explanation may be similar to and different from explanations in other domains.
Methadone's effects on pentylenetetrazole‐induced seizure threshold in mice: NMDA/opioid receptors and nitric oxide signaling
Authors: Kazemi Roodsari Soheil , Bahramnejad Erfan , Rahimi Nastaran , Aghaei Iraj , Dehpour Ahmad Reza
Published: April 2019

Methadone is a synthetic opioid used to treat opiate withdrawal and addiction. Studies have demonstrated the impact of methadone on seizure susceptibility. This study investigated the modulatory impacts of acute and subchronic (three times daily for 5 days) intraperitoneal methadone treatment on pentylenetetrazole‐induced clonic seizure threshold (CST) in mice, as well as the involvement of the nitric oxide, N‐methyl‐d‐aspartate (NMDA), and µ‐opioid pathways. Acute administration of different doses of methadone (0.1, 0.3, 1, and 3 mg/kg) 45 min before CST significantly decreased the seizure threshold. Additionally, pretreatment with noneffective doses of an opioid receptor antagonist (naltrexone) and NMDA receptor antagonists (ketamine and MK‐801) inhibited methadone's proconvulsive activity in the acute phase, while l‐NAME (a nonspecific nitric oxide synthase (NOS) inhibitor) did not affect that activity. In the subchronic phase, methadone (3 mg/kg) demonstrated an anticonvulsive effect. Although subchronic pretreatment with noneffective doses of l‐NAME and 7‐nitroindazole (a specific neuronal NOS inhibitor) reversed methadone's anticonvulsive activity, aminoguanidine (a specific inducible NOS inhibitor), naltrexone, MK‐801, and ketamine did not change methadone's anticonvulsive characteristic. Our results suggest that NMDA and µ‐opioid receptors may be involved in methadone's proconvulsive activity in the acute phase, while methadone's anticonvulsive activity may be modulated by neuronal NOS in the subchronic phase.
The chromatin‐remodelling factor PICKLE interacts with CONSTANS to promote flowering in Arabidopsis
Authors: Jing Yanjun , Guo Qiang , Zha Ping , Lin Rongcheng
Published: April 2019

In many flowering plants, successful reproductive development depends on the plant's ability to sense seasonal photoperiodic changes and adjust its vegetative growth accordingly. In Arabidopsis thaliana, the day‐length‐dependent accumulation of CONSTANS (CO) is crucial for the rhythmic activation of FLOWERING LOCUS T (FT) expression at dusk under long days. However, the regulation of photoperiod‐dependent changes of the diurnal FT expression pattern at the chromatin level is largely unknown. In this study, we show that the ATPase‐dependent chromatin‐remodelling factor PICKLE (PKL) acts through the CO‐FT regulatory module and contributes to FT activation in leaf vasculature. PKL physically interacts with CO, and this interaction facilitates their binding to the common regions of FT chromatin in response to photoperiod. Long‐day signal triggers the FT chromatin switch between the active state at dusk and the inactive state at night, and PKL is responsible for the diurnal state switch. Thus, our study reveals that PKL activates FT transcription likely through facilitating access of CO to FT chromatin at dusk to synchronize flowering time in response to environmental cues.
Isolated, small, and large hospitals have fewer nursing resources than urban hospitals: Implications for rural health policy
Authors: Smith Jessica G. , Plover Colin M. , McChesney Moira C. , Lake Eileen T.
Published: April 2019

Objective

The purpose was to compare nurse education, patient‐to‐nurse staffing, nursing skill mix, and nurse work environments across hospitals depending on extent of rurality.

Design

Cross‐sectional, comparative, and descriptive.

Sample

The final sample included 566 urban, 49 large, 18 small, and 9 isolated hospitals from California, Florida, and Pennsylvania.

Measurement

Data collected from large random samples from the 2005–2008 Multi‐State Nursing Care and Patient Safety Study funded by the National Institute of Nursing Research and National Institutes of Health were linked to 2005–2006 American Hospital Association data. Rural–Urban Commuting Area codes developed by the University of Washington and the United States Department of Agriculture Economic Research Service were used to determine the extent of hospital rurality across the sample.

Results

Hospital percentages of baccalaureate prepared nurses differed significantly among urban (38%), large (28%), small (31%), and isolated rural hospitals (21%). Patient‐to‐registered nurse ratios in urban (4.8), large (5.6), small (5.6), and isolated rural hospitals (7.3) differed. Rural hospital nursing skill mix differed, and was lowest in isolated rural hospitals (65%). Nursing foundations for quality care were poorer in large, small, and isolated rural hospitals.

Conclusion

Results support bolstering rural nursing resources in more remote locations, potentially through rural health policies.
From Policy to Practice: From Ideas to Results, From Results to Trust
Authors: Kettl Donald F.
Published: April 2019

Few areas of public administration have been more discouraging, over a longer period of time, than the struggle to build public trust in government's work. However, new research suggests that public administrators can build trust by improving the results they produce for citizens. Practical, practicable steps can produce big improvements: improving government's focus on citizens' needs; engaging employees; focusing on fairness; and, especially, concentrating on the delivery of public services at the “retail” level. Citizens, research shows, can discriminate among levels of government, the administration of different programs in different functional areas, and the work of individual administrators. That provides strong hope for improving trust, in an era when too often government appears too untrustworthy.
A review of alternative pond harvesting schedules for male and female redclaw crayfish Cherax quadricarinatus, reared in intensive monosex commercial conditions: a stochastic bioeconomic approach
Authors: Hernández‐Llamas Alfredo , Núñez‐Amao Lavinia , Naranjo‐Páramo José , Vargas‐Mendieta Mayra , Villarreal Humberto
Published: April 2019

We use a bioeconomic model to analyse two alternative harvesting schedules for male and female redclaw: simultaneous (same day) harvests of ponds for each sex and harvesting ponds independently for each sex (different days). The results show that, for simultaneous harvests, best results are obtained after 120 days of cultivation yielding, with 95% confidence, a mean net revenue (NR) of 26,820 USD$ ha−1 and mean benefit–cost ratio (B/C) of 3.08. For independent harvests, best results are obtained by harvesting males after 109 (NR) and 97 (B/C) days, and females after 120 (NR) and 107 (B/C) days. At these optimum harvesting times, with 95 % confidence, expected mean NR for males was 30560 USD$ ha−1 and mean B/C was 3.56; while for females NR was 23,620 USD$ ha−1 and B/C was 2.92. Results show that using independent harvests maximizes benefits. Better economic performance and statistical confidence were observed for males. The dynamics of commercial grade categories is the most important factor influencing the stochastic variability of NR, while the cost of production of pre‐adults is negligible, indicating the reliability of the cultivation technology for the nursery stage. Bioeconomic modelling provides an objective framework for farming practices evaluation and avenues for improvement. Monosex redclaw crayfish culture is environmentally sustainable, with a consistent production technology that is economically viable. With increasing world demand, it should be considered a strong candidate species for diversification.
Tidal currents and wind waves controlling sediment distribution in a subtidal point bar of the Venice Lagoon (Italy)
Authors: Ghinassi Massimiliano , D'Alpaos Andrea , Tommasini Laura , Brivio Lara , Finotello Alvise , Stefani Cristina
Published: April 2019

The present study aims to improve current understanding of the sedimentation of subtidal point bars, analyzing interaction between tidal currents and waves in shaping a submerged meander bend of the microtidal Venice Lagoon (Italy), and it is based on coupling of sedimentological studies, geophysical analyses and numerical modelling. The Venice Lagoon is characterized by an average depth of about 1·5 m over subtidal platforms and a mean tidal range of about 1·0 m. The morphodynamic evolution of the lagoon is strongly affected by intense seasonal windstorms, which promote the formation of wind waves triggering sediment resuspension and bottom erosion. The study channel is 70 to 100 m wide, it has a radius of curvature of about 260 m and cuts through a permanently submerged subtidal platform. Water depth ranges from 1·0 to 5·0 m below mean sea level on the subtidal platform and channel thalweg, respectively. Different from classical architectural models, the study point‐bar beds do not show sigmoidal geometries, but consist of horizontally‐bedded deposits abruptly overlying clinostratified beds. Sedimentation in the study bar is hypothesized to stem from the interaction between the in‐channel secondary helical flow, as for most meander bends, and wave winnowing of the subaqueous overbank areas. Laterally accreting point‐bar deposits point out that the curvature‐induced helical flow redistributed sediment from the channel thalweg to the bar top and contributed to the development of the ‘classical’ fining‐upward grain size trend. The marked truncation surface, separating clinostratified bar deposits from overlying horizontally‐bedded platform sediments is interpreted here as due to bar top wave‐winnowing, which also possibly promoted bank collapses. In the proposed model, sediments remobilized from bar top and subaqueous overbank areas were transported into the channel, forming peculiar ‘apron‐like’ accumulations, where sand accumulated through avalanching processes and mud settled down from suspension.
A retrospective cost analysis of the frequency and cost of transfusion premedications
Authors: Christensen Bradley W. , Rubinstein Samuel M. , Bastakoty Dikshya , Savani Bipin N. , Booth Garrett S.
Published: April 2019

BACKGROUND

Acetaminophen and diphenhydramine are routinely administered to prevent febrile non‐hemolytic and allergic blood transfusion reactions despite multiple randomized controlled trials demonstrating that this practice lacks efficacy. As a result, patients are exposed to the adverse effects of these medications and their financial burdens with no expected benefit. The aim of this study was to quantify the frequency and cost of transfusion premedications in patients with acute myeloid leukemia (AML).

STUDY DESIGN AND METHODS

This was a retrospective study of patients with AML admitted to Vanderbilt University Medical Center (VUMC) for induction chemotherapy between January 2008 and December 2016. Data were collected on the number of platelet and packed red blood cell (PRBC) transfusions each patient received during the initial inpatient encounter for AML, as well as on the administration of premedications prior to each transfusion.

RESULTS

During the 9‐year study period, 948 AML patients received a total of 19,820 transfusions. Of these, 30% were preceded by oral diphenhydramine, 8% by intravenous diphenhydramine, and 39% by oral acetaminophen. The percentage of patients that received a transfusion preceded by a premedication increased over the study period (p = 0.03), as did the percentage of transfusions preceded by a premedication (p = 0.02). The total unadjusted cost of pre‐transfusion medications to the institution during the study period was $50,309.77, or $52.67 per patient with AML. The cost of premedications per patient did not increase over the study period (p = .45).

CONCLUSIONS

Routine transfusion premedication administration is common in AML patients and not well‐supported by available evidence.