bluuebunny/crossref_metadata_2025 huggingface dataset:
The TCR is an allosterically regulated macromolecular machinery changing its conformation while working
Authors: Schamel Wolfgang W. , Alarcon Balbino , Minguet Susana
Published: August 2019

The αβ T‐cell receptor (TCR) is a multiprotein complex controlling the activation of T cells. Although the structure of the complete TCR is not known, cumulative evidence supports that the TCR cycles between different conformational states that are promoted either by thermal motion or by force. These structural transitions determine whether the TCR engages intracellular effectors or not, regulating TCR phosphorylation and signaling. As for other membrane receptors, ligand binding selects and stabilizes the TCR in active conformations, and/or switches the TCR to activating states that were not visited before ligand engagement. Here we review the main models of TCR allostery, that is, ligand binding at TCRαβ changes the structure at CD3 and ζ. (a) The ITAM and proline‐rich sequence exposure model, in which the TCR's cytoplasmic tails shield each other and ligand binding exposes them for phosphorylation. (b) The membrane‐ITAM model, in which the CD3ε and ζ tails are sequestered inside the membrane and again ligand binding exposes them. (c) The mechanosensor model in which ligand binding exerts force on the TCR, inducing structural changes that allow signaling. Since these models are complementary rather than competing, we propose a unified model that aims to incorporate all existing data.
mTOR and other effector kinase signals that impact T cell function and activity
Authors: Myers Darienne R. , Wheeler Benjamin , Roose Jeroen P.
Published: August 2019

T cells play important roles in autoimmune diseases and cancer. Following the cloning of the T cell receptor (TCR), the race was on to map signaling proteins that contributed to T cell activation downstream of the TCR as well as co‐stimulatory molecules such as CD28. We term this “canonical TCR signaling” here. More recently, it has been appreciated that T cells need to accommodate increased metabolic needs that stem from T cell activation in order to function properly. A central role herein has emerged for mechanistic/mammalian target of rapamycin (mTOR). In this review we briefly cover canonical TCR signaling to set the stage for discussion on mTOR signaling, mRNA translation, and metabolic adaptation in T cells. We also discuss the role of mTOR in follicular helper T cells, regulatory T cells, and other T cell subsets. Our lab recently uncovered that “tonic signals”, which pass through proximal TCR signaling components, are robustly and selectively transduced to mTOR to promote baseline translation of various mRNA targets. We discuss insights on (tonic) mTOR signaling in the context of T cell function in autoimmune diseases such as lupus as well as in cancer immunotherapy through CAR‐T cell or checkpoint blockade approaches.
Disclosure of confidential information by mental health nurses, of patients they assess to be a risk of harm to self or others: An integrative review
Authors: Conlon Darren , Raeburn Toby , Wand Timothy
Published: August 2019

There is a duty of confidentiality on the part of mental health nurses when they handle confidential patient information. Nonetheless, it may be necessary to disclose confidential information of a patient if the patient is assessed as being a risk to self or others, to protect the patient or others from harm. However, disclosing information inappropriately may constitute a breach of confidentiality. There is a paucity of information on how mental health nurses understand the rules of confidentiality when deciding to withhold or disclose confidential information in these circumstances. An integrative review of the literature was undertaken to explore the disclosure of confidential information by mental health nurses when they assess a patient as being a risk of harm. The findings indicate the rules of confidentiality are not well understood, or are not adhered to by mental health nurses. Risk assessments were found to underpin deliberations to withhold or disclose confidential information of a patient, despite risk being difficult to predict with any certainty. For risk assessment, mental health nurses were noted to prefer their unstructured clinical judgement over actuarial methods; and defer to their clinical intuition over scores of a structured risk assessment instrument, when making structured clinical judgement‐backed decisions in this area of their practice. Gaps in the literature that may be addressed by future empirical research were revealed during this integrative review.
Circ_0136474 and MMP‐13 suppressed cell proliferation by competitive binding to miR‐127‐5p in osteoarthritis
Authors: Li Zhao , Yuan Bo , Pei Zheng , Zhang Keshi , Ding Zhentao , Zhu Si , Wang Yichuan , Guan Zhenpeng , Cao Yongping
Published: August 2019

Osteoarthritis (OA) is a prevalent degenerative joint disease whose pathogenesis remains unclear. The research aims to investigate the roles of Circ_0136474/miR‐127‐5p/MMP‐13 axis in OA. Differentially expressed circRNAs and miRNAs in OA cartilage tissue were screened out and visualized by R project based on RNA‐seq data and microarray data respectively. qRT‐PCR was carried out for detection of relative expression levels of Circ_0136474, miR‐127‐5p, MMP‐13 and other inflammatory factors and Western blot analysis was conducted to detect the protein expression level of MMP‐13. CCK‐8 assay and flow cytometry were conducted to determine cell proliferation and cell apoptotic ability respectively. RNA‐fluorescence in situ hybridization (RNA‐FISH) experiments were conducted to confirm the immune‐localization of the Circ_0136474 and MMP‐13 in human tissues. Targeted relationships were predicted by bioinformatic analysis and verified by dual‐luciferase reporter assay. Our findings revealed that the expression levels of both Circ_0136474 and MMP‐13 in OA cartilage tissue were significantly higher than that in normal cartilage tissue. Circ_0136474 could suppress cell proliferation by facilitating MMP‐13 expression and suppressing miR‐127‐5p expression in OA. Overexpression of miR‐127‐5p negatively regulated MMP‐13 expression to enhance cell proliferation. Our study demonstrated that Circ_0136474 and MMP‐13 suppressed cell proliferation, while enhanced cell apoptosis by competitive binding to miR‐127‐5p in OA, which may well provide us with a new therapeutic strategy for osteoarthritis.
Up‐regulated CST5 inhibits bone resorption and activation of osteoclasts in rat models of osteoporosis via suppression of the NF‐κB pathway
Authors: Wang Fei , Zhang Chuanzhu , Ge Wei , Zhang Guoqiang
Published: August 2019

Here, we aim at exploring the effect of CST5 on bone resorption and activation of osteoclasts in osteoporosis (OP) rats through the NF‐κB pathway. Microarray analysis was used to screen the OP‐related differentially expressed genes. Osteoporosis was induced in rats by intragastric retinoic acid administration. The serum levels of tartrate‐resistant acid phosphatase (TRAP), bone alkaline phosphatase (BALP) and osteocalcin (OC) and the expression of CD61 on the surface of osteoclasts were examined. The number of osteoclasts and the number and area of resorption pits were detected. Besides, the pathological changes and bone mineral density in bone tissues of rats were assessed. Also, the relationship between CST5 and the NF‐κB pathway was identified through determining the expression of CST5, RANKL, RANK, OPG, p65 and IKB. Poorly expressed CST5 was indicated to affect the OP. CST5 elevation and inhibition of the NF‐κB pathway decreased serum levels of TRAP, BALP and OC and expression of CD61 in vivo and in vitro. In OP rats, CST5 overexpression increased trabecular bones and bone mineral density of bone tissues, but decreased trabecular separation, fat within the bone marrow cavities and the number of osteoclasts through inhibiting the NF‐κB pathway. In vivo experiments showed that CST5 elevation inhibited growth in number and area of osteoclastic resorption pits and restrained osteoclastic bone absorption by inhibiting the NF‐κB pathway. In summary, overexpression of CST5 suppresses the activation and bone resorption of osteoclasts by inhibiting the activation of the NF‐κB pathway.
Anatomically specific reactive oxygen species production participates in Marfan syndrome aneurysm formation
Authors: Emrich Fabian , Penov Kiril , Arakawa Mamoru , Dhablania Nathan , Burdon Grayson , Pedroza Albert J. , Koyano Tiffany K. , Kim Young M. , Raaz Uwe , Connolly Andrew J. , Iosef Cristiana , Fischbein Michael P.
Published: August 2019

Marfan syndrome (MFS) is a connective tissue disorder that results in aortic root aneurysm formation. Reactive oxygen species (ROS) seem to play a role in aortic wall remodelling in MFS, although the mechanism remains unknown. MFS Fbn1C1039G/+ mouse root/ascending (AS) and descending (DES) aortic samples were examined using DHE staining, lucigenin‐enhanced chemiluminescence (LGCL), Verhoeff's elastin‐Van Gieson staining (elastin breakdown) and in situ zymography for protease activity. Fbn1C1039G/+ AS‐ or DES‐derived smooth muscle cells (SMC) were treated with anti‐TGF‐β antibody, angiotensin II (AngII), anti‐TGF‐β antibody + AngII, or isotype control. ROS were detected during early aneurysm formation in the Fbn1C1039G/+ AS aorta, but absent in normal‐sized DES aorta. Fbn1C1039G/+ mice treated with the unspecific NADPH oxidase inhibitor, apocynin reduced AS aneurysm formation, with attenuated elastin fragmentation. In situ zymography revealed apocynin treatment decreased protease activity. In vitro SMC studies showed Fbn1C1039G/+‐derived AS SMC had increased NADPH activity compared to DES‐derived SMC. AS SMC NADPH activity increased with AngII treatment and appeared TGF‐β dependent. In conclusion, ROS play a role in MFS aneurysm development and correspond anatomically with aneurysmal aortic segments. ROS inhibition via apocynin treatment attenuates MFS aneurysm progression. AngII enhances ROS production in MFS AS SMCs and is likely TGF‐β dependent.
Comorbid Depressive Symptoms and Chronic Medical Conditions Among US Chinese Older Adults
Authors: Kong Dexia , Solomon Phyllis , Dong XinQi
Published: August 2019

OBJECTIVES

The prevalence and health consequences of comorbid depressive symptoms (DSs) and chronic medical conditions (CMCs) among older ethnic minority populations remain poorly understood. To bridge this gap, the present cross‐sectional study examined the prevalence of comorbid DS‐CMC and the association between such comorbidity and health services use among US Chinese older adults.

DESIGN AND SETTING

Data were from the Population Study of Chinese Elderly in Chicago (N = 3157). The relationship between comorbid DS‐CMC and health service use (ie, emergency department [ED] visits and hospitalizations) was investigated by stratifying the sample into four groups: (1) neither DSs nor CMCs (ie, heart disease, stroke, cancer, high cholesterol, diabetes, high blood pressure, hip fraction, thyroid, and osteoarthritis); (2) DSs only; (3) CMCs only; and (4) comorbid DS‐CMC. Multivariate negative binomial regression models were conducted to determine the relationship between comorbid DS‐CMC and health service use.

RESULTS

Participants were 73 years old on average. The prevalence of comorbid DSs ranged between 0.7% and 4.6% across various CMCs. The odds of DSs were at least twice as high among US Chinese older adults with CMCs than those without the various conditions. Compared with US Chinese older adults with neither DSs nor CMCs, those with comorbid DS‐CMC had more ED visits (rate ratio [RR] = 3.32; 95% confidence interval [CI] = 2.03‐5.42) and hospitalizations (RR = 3.12; 95% CI = 1.95‐4.97).

CONCLUSION

Recognition and treatment of comorbid DS‐CMC warrant increased policy and clinical attention. The findings underscore the potential need to develop effective services targeting DSs among US Chinese older adults with CMCs. J Am Geriatr Soc 67:S545–S550, 2019.
Sources and Variations in Social Support and Risk for Elder Mistreatment in a US Chinese Population
Authors: Zheng Shenglin , Li Mengting , Kong Dexia , Dong XinQi
Published: August 2019

OBJECTIVES

Research has examined the relationships between positive social support (PSS) and elder mistreatment (EM) but less is known regarding the negative aspect of social support (NSS), especially among minority groups in the United States. This study aimed to investigate the relationships between PSS/NSS from different sources and EM among US Chinese older adults.

Design

Population‐based cross‐sectional study.

Setting

Greater Chicago, IL, area.

PARTICIPANTS

A representative sample of Chinese older adults aged 60 years or older (N = 3157) from the Population Study of ChINese Elderly in Chicago in 2011 to 2013.

Measurements

We applied a 10‐item widely used instrument to assess EM. PSS and NSS from spouse/family members/friends were measured by a 12‐item scale. Multivariate logistic regression analyses were conducted to examine the relationships.

RESULTS

After adjusting for confounders, higher levels of overall PSS from all three sources, including spouse, family members, and friends (odds ratio [OR] = 0.88 [95% confidence interval {CI} = 0.85‐0.91]), were associated with lower risk of EM. But participants with a higher level of overall NSS from all three sources (OR = 1.51 [95% CI = 1.41‐1.61]) were more likely to experience EM. The results on the relationships between PSS from spouse (OR = 0.70 [95% CI = 0.64‐0.76]), PSS from family members (OR = 0.73 [95% CI = 0.68‐0.79]), and EM were similar to overall PSS. But PSS from friends had a nonsignificant association with EM. Greater levels of NSS from spouse (OR = 1.84 [95% CI = 1.64‐2.07]), family members (OR = 2.36 [95% CI = 2.03‐2.75]), and friends (OR = 1.69 [95% CI = 1.32‐2.17]) were associated with increased risks of EM.

CONCLUSION

Higher levels of SS were not always associated with lower risks of EM among US Chinese older adults. NSS might have counter effects. Future qualitative or longitudinal research needs to explore detailed cultural explanations and casual relationships between SS and EM. J Am Geriatr Soc 67:S499–S505, 2019.
Implantable Cardioverter‐Defibrillators and Cardiac Resynchronization Therapy in Older Adults With Heart Failure
Authors: Sandhu Amneet , Levy Andrew , Varosy Paul D. , Matlock Daniel
Published: August 2019

BACKGROUND/OBJECTIVES

Implantable cardioverter‐defibrillators (ICDs) and cardiac resynchronization therapy (CRT) are cardiac implantable electronic devices that may improve morbidity and mortality in select patients with heart failure. Although the benefits of these devices have been well defined, competing mortality risks, comorbid conditions, and frailty pose difficulty in determining risk‐benefit trade‐offs when these options are considered for older adults.

CONCLUSION

In this review, we focus on the benefit, risk, and use of ICD and CRT in older adults, particularly because the goals of care for many older adults include a shift away from life‐prolonging interventions. Additionally, we discuss periprocedural risk, cost, and maintenance in older populations. Finally, we introduce a framework for helping clinicians and older adults make these challenging decisions collectively. J Am Geriatr Soc 67:2193–2199, 2019
30‐Day Emergency Department Revisit Rates among Older Adults with Documented Dementia
Authors: Kent Tyler , Lesser Adriane , Israni Juhi , Hwang Ula , Carpenter Christopher , Ko Kelly J.
Published: August 2019

OBJECTIVES

Published literature on national emergency department (ED) revisit rates among older adults with dementia is sparse, despite anecdotal evidence of higher ED utilization. Thus we evaluated the odds ratio (OR) of 30‐day ED revisits among older adults with dementia using a nationally representative sample.

DESIGN

We assessed the frequency of claims associated with a 30‐day ED revisit among Medicare beneficiaries with and without a dementia diagnosis before or at index ED visit. We used a logistic regression model controlling for dementia, age, sex, race, region, Medicaid status, transfer to a skilled nursing facility after ED, primary care physician use 12 months before index, and comorbidity.

SETTING

A nationally representative sample of claims data for Medicare beneficiaries aged 65 and older who maintained continuous fee‐for‐service enrollment during 2015 and 2016. Only outpatient claims associated with an ED visit between January 2016 and November 2016 were included as a qualifying index encounter.

PARTICIPANTS

We identified 240 249 patients without dementia and 54 622 patients for whom a dementia code was recorded in the year before the index encounter in 2016.

RESULTS

Our results indicate a significant difference in unadjusted 30‐day ED revisit rates among those with an ED dementia diagnoses (22.0%) compared with those without (13.9%). Our adjusted results indicated that dementia is a significant predictor of 30‐day ED revisits (P < .0001). Those with a dementia diagnosis at or before the index ED visit were more likely to have experienced an ED revisit within 30 days (OR = 1.27; 95% confidence interval = 1.24‐1.31).

CONCLUSION

Dementia diagnoses were a significant predictor of 30‐day ED revisits. Further research should assess potential reasons why dementia is associated with markedly higher revisit rates, as well as opportunities to manage and transition dementia patients from the ED back to the community more effectively. J Am Geriatr Soc 67:2254–2259, 2019
Characteristics of the transverse 2D uniserial arrangement of rows of decussating enamel rods in the inner enamel layer of mouse mandibular incisors
Authors: Smith Charles E. , Hu Yuanyuan , Hu Jan C‐C. , Simmer James P.
Published: August 2019

The 2D arrangement of rows of enamel rods with alternating (decussating) tilt angles across the thickness of the inner layer in rat and mouse incisor enamel is well known and assumed to occur in a uniform and repetitive pattern. Some irregularities in the arrangement of rows have been reported, but no detailed investigation of row structure across the entire inner enamel layer currently exists. This investigation was undertaken to determine if the global row pattern in mouse mandibular incisor enamel is predominately regular in nature with only occasional anomalies or if rows of enamel rods have more spatial complexity than previously suspected. The data from this investigation indicate that rows of enamel rods are highly variable in length and have complex transverse arrangements across the width and thickness of the inner enamel layer. The majority of rows are short or medium in length, with 87% having < 100 rods per row. The remaining 13% are long rows (with 100–233 rods per row) that contain 46% of all enamel rods seen in transverse sections. Variable numbers of rows were associated with the lateral, central and mesial regions of the enamel layer. Each region contained different ratios of short, medium and long rows. A variety of relationships was found along the transverse length of rows in each region, including uniform associations of alternating rod tilts between neighboring rows, and instances where two rows having the same rod tilt were paired for variable distances then moved apart to accommodate rows of opposite tilt. Sometimes a row appeared to branch into two rows with the same tilt, or conversely where two rows merged into one row depending upon the mesial‐to‐lateral direction in which the row was viewed. Some rows showed both pairing and branching/merging along their length. These tended to be among the longest rows identified, and they often crossed the central region with extensions into the lateral and mesial regions. The most frequent row arrangement was a row of petite length nestled at the side of another row having the same rod tilt (30% of all rows). These were termed ‘focal stacks’ and may relate to the evolution of uniserial rat and mouse incisor enamel from a multilayered ancestor. The mesial and lateral endpoints of rows also showed complex arrangements with the dentinoenamel junction (DEJ), the inner enamel layer itself, and the boundary area to the outer enamel layer. It was concluded that the diversity in row lengths and various spatial arrangements both within and between rows across the transverse plane provides a method to interlock the enamel layer across each region and keep the enamel layer compact relative to the curving DEJ surface. The uniserial pattern for rows in mouse mandibular incisors is not uniform, but diverse and very complex.
Lifting vs volumizing—The difference in facial minimally invasive procedures when respecting the line of ligaments
Authors: Casabona Gabriela , Frank Konstantin , Koban Konstantin C. , Freytag David L. , Schenck Thilo L. , Lachman Nirusha , Green Jeremy B. , Toni Sabiha , Rudolph Christina , Cotofana Sebastian
Published: August 2019

Background

The arrangement of the facial soft tissue layers is different with respect to the line of ligaments: medially oblique and laterally in parallel.

Aims

This split‐face study was designed to investigate the effects on midfacial volumization if the same medial vs lateral injection points are targeted in various sequences.

Methods

Twelve patients (3 males, 9 females; 46.67 years ± 4.5) were included in this interventional study. On the right side of the face, lateral injection points were performed first, whereas on the left side, medial injection points were executed first. The infraorbital hollowness score, the upper cheek fullness score, the global aesthetic improvement scale, and the injected volume were assessed.

Results

No side differences were observed after the intervention with P = 1.00 for all scores. When the lateral injection points were performed first, the volume injected into the medially located injection points (0.46 ± 0.26 cc vs 0.73 ± 0.31 cc [P = .037]), into the lateral injection points (0.79 ± 0.40 cc vs 1.15 ± 0.28 cc [P = .017]), and overall (1.26 ± 0.64 cc vs 1.88 ± 0.57 cc [P = .02]) was significantly reduced.

Conclusion

The results of the present study emphasize the importance of respecting the layered arrangement of the facial soft tissues when performing minimally invasive soft tissue filler injections. Targeting injection points lateral to the line of ligaments first reduces the volume needed to symmetrically and aesthetically appealing manner and volumizes the infraorbital and upper cheek regions.
Natural selection acting on integrated phenotypes: covariance among functional leaf traits increases plant fitness
Authors: Damián Xóchitl , Ochoa‐López Sofía , Gaxiola Aurora , Fornoni Juan , Domínguez César A. , Boege Karina
Published: August 2019

Plant functional strategies are usually accomplished through the simultaneous expression of different traits, and hence their correlations should be promoted by natural selection. The adaptive value of correlations among leaf functional traits, however, has not been assessed in natural populations.

We estimated intraspecific variation in leaf functional traits related to the primary metabolism and anti‐herbivore defence in a population of Turnera velutina. We analysed whether natural selection favoured the expression of individual traits, particular combinations of traits or leaf phenotypic integration.

Patterns of covariation among traits were related to water and nitrogen economy, and were similar among genotypes, but the magnitude of their phenotypic integration differed by 10‐fold. Although families did not differ in the mean values of leaf functional traits, directional selection favoured low nitrogen content and low chemical defence, high content of chlorophyll, sugar in extrafloral nectar and trichome density. Families with higher phenotypic integration among leaf traits grew faster and produced more flowers.

We suggest that the coordinated expression of leaf traits has an adaptive value, probably related to optimisation in the expression of traits related to water conservation and nitrogen acquisition.
Dr. S.ʼs Badereisen
Authors: Kulishkina Olga , Polubojarinova Larissa N.
Published: August 2019

Die Studie stellt sich zur Aufgabe, aufgrund einiger poetischer Texte W. G. Sebalds aus den Jahren 1975–2000 sowie der Badeort‐Episoden aus Schwindel. Gefühle. und Austerlitz die starke Verankerung des Autors im europäischen Netzwerk der Kurortnarrative aufzuzeigen. Des weiteren sollen die Hauptparameter der (vor allem in Austerlitz) erfolgenden Unterminierung bzw. Sprengung von Grunddispositionen dieses Nexus untersucht werden. Es zeigt sich, dass das in Sebalds Texten angesprochene europäische Kurortnetzwerk des neunzehnten und angehenden zwanzigsten Jahrhunderts vor allem auf der Achse Autor–Leser als ein multipler Gedächtnisort der europäischen Moderne par excellence kommuniziert werden kann. Die von der posthistoire bzw. postmemory geschärfte Optik macht besonders am Beispiel der Marienbader Episode in Austerlitz die heterotop geprägte potenzierte Fähigkeit des Kurort‐Raums offensichtlich, als Spuren‐ und Zeichenträger der darin abgelagerten, im Medium der Sebaldschen Texte sich bricolageartig „zusammenreimenden“ „Psychologismen“, „Identifikationen“ bzw. „Utopismen“ zu erscheinen. Angesichts dieser Zeichen und Spuren wird auch die notorische „Gespaltenheit“ der Protagonisten bei Sebald in ein neues Licht gestellt und als Inversion einer „typischen“ Disposition eines Romanhelden ausgehandelt.
Revision Surgery after Percutaneous Endoscopic Transforaminal Discectomy Compared with Primary Open Surgery for Symptomatic Lumbar Degenerative Disease
Authors: Liang Jin‐qian , Chen Chong , Zhao Hong
Published: August 2019

Objective

To evaluate the clinical outcome of reoperation after percutaneous endoscopic lumbar discectomy (PELD) as compared with primary spinal decompression and fusion.

Methods

A retrospective study from December 2014 to December 2017 was conducted at Peking Union Medical College Hospital and comprised 39 patients with symptomatic lumbar degenerative disease (LDD): 13 post‐PELD who underwent reoperation (revision surgery group) and 26 who received primary spinal decompression and fusion (primary open surgery group). The two groups were compared regarding: operative time, blood loss, transfusion, hospitalization, postoperative visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, Japanese Orthopedic Association (JOA) improvement rate, and postoperative complications. The Mann–Whitney U‐test was applied to analyze continuous parameters, and the χ2‐test for categorical parameters. Fisher's exact test was used for small data subsets.

Results

There was no statistically significant difference between the two groups in mean age (52.7 years vs 52.9 years), gender ratio (6 men‐to‐7 women vs 12 men‐to‐14 women), body mass index, medical history, preoperative diagnosis, or surgical spine level (P > 0.05). The mean operative time of the revision surgery group was significantly longer than that of the primary open surgery group (160.0 min vs 130.2 min, P < 0.05). The revision surgery group also had a significantly higher mean estimated blood loss, postoperative drainage, and length of hospital stay (P < 0.05). However, no significant differences were found between the two groups in terms of hemoglobin and hematocrit values, preoperatively and postoperatively. The rate of transitional neurological irritation was higher in the revision surgery group (61.5% vs 3.8%; P < 0.05), as was intraoperative durotomy and cerebrospinal fluid leakage (30.8% vs 3.8%, P < 0.05). At 1 month, the VAS and ODI scores of the primary open surgery group were significantly better than those of the revision surgery group, while the improvement in JOA scores was similar. After 6 and 12 months’ follow‐up, the VAS and ODI scores and the rates of JOA improvement were comparable.

Conclusion

Patients with LDD who received primary spinal decompression and fusion experienced lower rates of perioperative complications and shorter hospitalization compared with patients who underwent revision surgery after PELD, but the clinical outcomes at the last follow‐up of both groups were satisfactory.
A framework for the management of the pediatric airway
Authors: Engelhardt Thomas , Fiadjoe John E. , Weiss Markus , Baker Paul , Bew Stephanie , Echeverry Marín Piedad , von Ungern‐Sternberg Britta S
Published: August 2019

Critical airway incidents in children are a frequent problem in pediatric anesthesia and remain a significant cause of morbidity and mortality. Young children are at particular risk in the perioperative period. Delayed management of airway obstruction can quickly lead to serious complications due to the short apnea tolerance in children. A simple, time critical, and pediatric‐specific airway management approach combined with dedicated teaching, training, and frequent practice will help to reduce airway‐related pediatric morbidity and mortality. There is currently no pediatric‐specific universal framework available to guide practice. Current algorithms are modifications of adult approaches which are often inappropriate because of differences in age‐related anatomy, physiology, and neurodevelopment. A universal and pragmatic approach is required to achieve acceptance across diverse pediatric clinicians, societies, and groups. Such a framework will also help to establish minimum standards for pediatric airway equipment, personnel, and medications whenever pediatric airway management is required.
Correlations of serum leptin and leptin resistance with depression and anxiety in patients with type 2 diabetes
Authors: Cernea Simona , Both Emőke , Huţanu Adina , Şular Floredana Laura , Roiban Andrada Larisa
Published: August 2019

Aim

The associations of serum leptin/soluble leptin receptor (sObR) and leptin resistance with symptoms of depression and anxiety were investigated in patients with type 2 diabetes (T2D).

Methods

We report the results of two cross‐sectional studies, performed 2 years apart, that included 216 and 237 T2D patients, respectively. Symptoms of depression and anxiety were assessed with specific questionnaires (Patient Health Questionnaire‐9, Center for Epidemiologic Studies Depression Scale, and Generalized Anxiety Disorder‐7, respectively). Laboratory data (including leptin and sObR) were collected, and free leptin index (FLI), as an estimate of leptin resistance, was calculated. One hundred forty patients had laboratory data available on both occasions, and were evaluated longitudinally. Simple and multiple correlations between depression/anxiety and parameters of interest were performed.

Results

In both studies, serum leptin levels were higher, whereas resting energy expenditure/leptin ratios were lower in T2D patients with depressive and moderate–severe anxiety symptoms. In the second study, patients with depressive symptoms had higher FLI and lower sObR levels, while those with moderate–severe anxiety only had higher FLI. Depression scores correlated with serum leptin (r = 0.29, [95%CI: 0.14–0.42]; r = 0.32, [95%CI: 0.18–0.45]) and FLI (r = 0.30, [95%CI: 0.15–0.43]; r = 0.32, [95%CI: 0.17–0.45]; P < 0.0001 for all). Multiple regression analyses identified leptin (β = 0.167; t ratio = 1.98) and FLI (β = 2.935, t ratio = 2.44) (P < 0.05 for both) as variables that significantly contributed to depressive symptoms. Depressive symptoms were present in significantly more patients with leptin levels in the highest versus the lowest quartiles on both evaluations (odds ratio: 5.98, 95%CI [1.76–20.32], P < 0.01).

Conclusion

Depressive and moderate–severe anxiety symptoms were associated with high leptin concentrations and leptin resistance in T2D patients.
The influence of health literacy on emergency department utilization and hospitalizations in adolescents with sickle cell disease
Authors: Caldwell Elizabeth Perry
Published: August 2019

Objective

Healthcare spending in the US is $3.2 trillion. $1.1 trillion is attributed to hospital care, including emergency department (ED) visits and hospitalizations. There is a relationship between ED utilization, hospitalizations, and health literacy in the general population. Health literacy may play a role in frequent ED visits and hospitalizations in patients with sickle cell disease (SCD). The purpose of this paper is to describe the relationship among health literacy levels, annual hospital encounters, annual clinic visits, annual ED visits, and annual hospitalizations in 134 Black, non‐Hispanic adolescents aged 10–19 years with SCD.

Design

This is a cross‐sectional, descriptive correlational study evaluating facilitators and barriers to health literacy and clinical outcomes in adolescents with SCD.

Sample

Data were collected from 134 Black, non‐Hispanic adolescents with SCD at a large, tertiary care center in Texas.

Measurements

The Newest Vital Sign and REALM‐Teen health literacy instruments were used to evaluate health literacy.

Results

Contrasting previous studies evaluating the influence of health literacy on ED visits and hospitalizations in the general population, there were no significant relationships within this sample.

Conclusions

This study gives insight into future research to evaluate other potential influences on ED utilization and hospitalizations in pediatric patients with SCD.
A unique autopsy case of ascending aortic dissection caused by giant cell arteritis without drug therapy
Authors: Takase Yukari , Murakami Yosuke , Nishi Jumpei , Tokunaga Osamu , Matsumoto Toshiharu , Aishima Shinichi
Published: August 2019

Giant cell arteritis is a granulomatous inflammation of large and medium‐sized arteries, occurring predominantly in older women. In this case, a 76‐year‐old woman was hospitalized for examination because of a high C‐reactive protein (CRP) level, but nothing remarkable was found on thoracicoabdominal computed tomography (CT) or head magnetic resonanse imaging (MRI). On the 46th day from the first visit, she died suddenly due to cardiac tamponade. On pathological autopsy, we found the cause of death to be acute aortic dissection (Stanford type A) due to giant cell arteritis occurred in the ascending aorta. Histologically, granulomatous vasculitis with giant cells was recognized in the ascending aorta, thoracic descending aorta and abdominal aorta and their branches. Interestingly, similar granulomatous vasculitis was also found in the medium and small vessels of other plural organs, including the heart, liver, uterine corpus, and its appendages. To our knowledge, giant cell arteritis with multiple‐organ granulomatous changes has not been reported before. We herein reported a unique autopsy case of giant cell arteritis in a patient not treated with medication.
Socially oriented thinking and the biological stress response: Thinking of friends and family predicts trajectories of salivary cortisol decline
Authors: Vine Vera , Hilt Lori M. , Marroquín Brett , Gilbert Kirsten E.
Published: August 2019

The cortisol stress response has been related to perceived social support, but previous studies rely on self‐reported social support variables. The cortisol recovery phase in particular has been theorized to serve a social coping function, but individual differences in recovery slope have not yet been examined in relation to social coping‐relevant indices. This study addressed these gaps by examining the relationship of cortisol trajectories after a socioevaluative task to individual differences in covertly assessed cognitions related to close social relationships. We examined trajectories of cortisol change related to socially oriented thinking, the semi‐implicit activation of cognitive representations of friends or family. Young adults (N = 64) gave salivary cortisol samples before and for 45 min after a speech task. Participants' thoughts were sampled repeatedly; the frequency of words related to friends or family was assessed to index socially oriented thinking. A free curve slope intercept latent growth curve model showed excellent fit with the cortisol data. Socially oriented thinking was unrelated to overall magnitude of cortisol response to the task (latent intercept) but predicted the latent cortisol trajectory, independently of cortisol intercept and baseline cortisol levels. Socially oriented thinkers showed more gradual cortisol declines, whereas nonsocially oriented thinkers showed a steeper downslope driven primarily by cortisol changes 45 min after the task. Individual differences in socially oriented thinking may manifest in different rates of biological changes following a performance task.
Estimation of Proportions in Small Areas: Application to the Labour Force Using the Swiss Census Structural Survey
Authors: Molina Isabel , Strzalkowska-Kominiak Ewa
Published: August 2019

The main objectives of this paper are to find efficient but computationally simple estimators for the proportions of people in the labour force (economic activity rates) in Swiss communes and to estimate their mean-squared error (MSE) over the sampling replication mechanism (the design MSE). This will be done by combining survey data with administrative data provided by the Swiss Federal Statistical Office. We find estimators with considerably greater efficiency than currently used direct estimators and that are easy to implement. We show that, under a generalized linear mixed model with logit link, the computationally expensive empirical best predictor does not perform appreciably better than a plug-in estimator. Moreover, for moderate proportions of active workers, the empirical best linear unbiased predictor (EBLUP) based on a much simpler linear mixed model performs similarly to the above estimators. We propose new bootstrap estimators of the design MSE of the EBLUPs, which ‘borrow strength’ similarly to EBLUPs. Realistic simulation studies carried out under both model- and design-based set-ups indicate great gains in efficiency of the selected small area estimators over the traditional direct estimators and acceptable performance of the proposed bootstrap MSE estimators. In the application using the Swiss data, coefficient-of-variation reductions of the estimates obtained for the communes are remarkable.
Social (Dis)Approval and Collective Action Participation: Re‐evaluating the Positive Linearity Thesis
Authors: Blocq Daniel , Damen Marie‐Louise
Published: August 2019

Survey‐based studies on collective action generally assume that social approval of participation in collective action has a positive and linear effect on actual participation. However, this assumption has not yet been subjected to a genuine empirical evaluation. This article investigates the positive linearity thesis, using survey data on participation and non‐participation in a street demonstration in The Hague in 2011. Statistical analyses provide evidence in support of a curvilinear relation between social approval and participation—an increased rate of participation in case of both approvalanddisapproval by peers. We discuss two processes underlying the observed relation: one pertaining to rebelliousness and the other regarding political awareness. The article generally illustrates the need for further empirical research on social influence and participation in collective action.
Hierarchies, scale, and privilege in the reproduction of national belonging
Authors: Clarke Amy
Published: August 2019

It is increasingly recognised both that belonging divides hierarchically and that people have different capacities to be seen as belonging. However, while the existence of hierarchies of belonging is well documented from the perspective of ethnically minoritised and migrant groups, what characterises, produces, and underpins these hierarchies is largely unaddressed, as is a geographically informed analysis of their reproduction. This paper, based on interviews with white British people in the suburbs of London, takes a novel approach, examining the reproduction of national belonging among people for whom such belonging is relatively privileged. The paper identifies three constructions of national belonging within white British narratives – “belonging in Britain,” “belonging to Britain,” and “being of Britain” – and argues that, although not always recognised as such, the three constructions are hierarchical in their differing temporalities and connections to whiteness. The elucidation of these different belongings and, crucially, the recognition of their hierarchisation and scalar reproduction, represent major contributions to research on belonging, and also help to explain the exclusion from a full sense of national belonging articulated by British people of colour.
The Economic Policy Uncertainty in China, the United States, and Europe: The Empirical Impact on Chinese Stock Markets
Authors: Supachart Wannakomol
Published: August 2019

The objective of this paper is to analyze the impact of economic policy uncertainty (EPU) in China, the United States, and Europe, which are influent to the Chinese stock markets. We employed Vector Autoregression (VAR) model with relative variables including the EPU indices and three Chinese stock markers indices to display the impulse responses of the markets to the EPUs. Our results indicate that the Chinese stock markets negatively respond to their domestic economic policy uncertainty in the first, second, and third month after the EPU shocks. Moreover, we also found the negative responses of the Chinese markets to the EPU from the United States that require five months to rebalance the markets. However, the Chinese markets seem positively respond to the shocks of the economic policy uncertainty in Europe and also took five months to archive market rebalancing. The significant correlation of the economic policy uncertainty between China and the United States resulted in cross-sectional correlation estimates among the EPU indices. Furthermore, there is the reasonable interesting result to claim that the economic policy uncertainty in China is statistically influenced by their own trade and fiscal policy uncertainty that may be considered to be related with China-US trade war in our conclusion.
Why converting field emission voltages to macroscopic fields before making a Fowler-Nordheim plot has often led to spurious characterization results
Authors: Forbes Richard G.
Published: August 2019

An important parameter used to characterize large-area field electron emitters (LAFEs) is the characteristic apex field enhancement factor γC. This parameter is normally extracted from the slope of a Fowler-Nordheim (FN) plot. Several years ago, the development of an “orthodoxy test” allowed a sample of 19 published FN plots relating to LAFEs to be tested, and it was found that about 40% of the related papers were reporting spuriously high values for γC. In technological papers relating to LAFE characterization, the common practice is to preconvert the measured voltage into an (apparent) value of the macroscopic field before making and analyzing an FN plot. This paper suggests that the cause of the “spurious field enhancement factor value” problem is the widespread use of a preconversion equation that is defective (for example, not compatible with ordinary electrical circuit theory) when it is applied to so-called “nonideal” field emission devices/systems. Many real devices/systems are nonideal. The author argues that FN plots should be made using raw experimental current-voltage data, that an orthodoxy test should be applied to the resulting FN plot before any more-detailed analysis, and that (in view of growing concerns over the reliability of published “scientific” results) reviewers should scrutinize field emission materials characterization papers with enhanced care.
Tat-Dependent Heterologous Secretion of Recombinant Tyrosinase by Pseudomonas fluorescens Is Aided by a Translationally Fused Caddie Protein
Authors: Ryu Jaewook , Byun Hyunjong , Park Joseph P. , Park Jiyeon , Noh Kyung Ha , Chung Joo Hee , Lee Haeshin , Ahn Jung Hoon
Published: August 2019

We observed that the
S. antibioticus
extracellular tyrosinase secretion level was even higher in its nonnatural translationally conjugated fusion protein form than in the natural complex of two separated polypeptides. The results of this study demonstrate that tyrosinase-expressing
P. fluorescens
can be a stable source of bacterial tyrosinase through exploiting the secretory machinery of
P. fluorescens
.
Streamlined Genetic Manipulation of Diverse
Bacteroides
and
Parabacteroides
Isolates from the Human Gut Microbiota
Authors: García-Bayona Leonor , Comstock Laurie E.
Published: August 2019

We have entered an era when studies of the gut microbiota are transitioning from basic questions of composition and host effects to understanding the microbial molecules that underlie compositional shifts and mediate health and disease processes. The importance of the gut
Bacteroidales
to human health and disease and their potential as a source of engineered live biotherapeutics make these bacteria of particular interest for in-depth mechanistic study. However, there are still barriers to the genetic analysis of diverse
Bacteroidales
strains, limiting our ability to study important host and community phenotypes identified in these strains. Here, we have overcome many of these obstacles by constructing a series of vectors that allow easy genetic manipulation in diverse gut
Bacteroides
and
Parabacteroides
strains. These constructs fill a critical need and allow streamlined allelic replacement in diverse gut
Bacteroidales
, including the growing number of multiantibiotic-resistant strains present in the modern-day human intestine.
Association between vitamin D supplementation and mortality: systematic review and meta-analysis
Authors: Zhang Yu , Fang Fang , Tang Jingjing , Jia Lu , Feng Yuning , Xu Ping , Faramand Andrew
Published: August 2019

Objective

To investigate whether vitamin D supplementation is associated with lower mortality in adults.

Design

Systematic review and meta-analysis of randomised controlled trials.

Data sources

Medline, Embase, and the Cochrane Central Register from their inception to 26 December 2018.

Eligibility criteria for selecting studies

Randomised controlled trials comparing vitamin D supplementation with a placebo or no treatment for mortality were included. Independent data extraction was conducted and study quality assessed. A meta-analysis was carried out by using fixed effects and random effects models to calculate risk ratio of death in the group receiving vitamin D supplementation and the control group.

Main outcome measures

All cause mortality.

Results

50 trials with a total of 74 655 participants were identified. Vitamin D supplementation was not associated with all cause mortality (risk ratio 0.98, 95% confidence interval 0.95 to 1.02, I
2
=0%), cardiovascular mortality (0.98, 0.88 to 1.08, 0%), or non-cancer, non-cardiovascular mortality (1.05, 0.93 to 1.18, 0%). Vitamin D supplementation statistically significantly reduced the risk of cancer death (0.85, 0.74 to 0.97, 0%). In subgroup analyses, all cause mortality was significantly lower in trials with vitamin D
3
supplementation than in trials with vitamin D
2
supplementation (P for interaction=0.04); neither vitamin D
3
nor vitamin D
2
was associated with a statistically significant reduction in all cause mortality.

Conclusions

Vitamin D supplementation alone was not associated with all cause mortality in adults compared with placebo or no treatment. Vitamin D supplementation reduced the risk of cancer death by 15%. Additional large clinical studies are needed to determine whether vitamin D
3
supplementation is associated with lower all cause mortality.

Study registration

PROSPERO registration number CRD42018117823.