bluuebunny/crossref_metadata_2025 huggingface dataset:
Root‐retained overdentures: Survival of abutment teeth with precision attachments on root caps depends on overdenture design
Authors: Berger Camille Henriette , Arnold Caroline , Stalder Anja Katrin , Weber Adrian , Abou‐Ayash Samir , Schimmel Martin
Published: July 2020

Background

Root‐retained overdentures (OD) are one treatment option for partially edentulous patients. However, the available evidence regarding factors influencing abutment survival in root‐retained ODs is limited.

Purpose

This retrospective study included clinical examinations and evaluated the survival rate of roots restored with precision attachments soldered to post‐and‐core (gold cap) retained ODs, analysed with respect to various patient‐ and prosthesis‐related factors.

Methods

Patients receiving at least one OD with gold caps in the past were invited for comprehensive clinical examinations. The primary outcome parameter was the abutment survival rate over the observation period (2002‐2016). Possible contributing factors (eg closed vs open OD design) were analysed. Analyses included Kaplan‐Meier estimators, Cox regressions and hazard ratios (HR).

Results

114 patients with 128 ODs originally retained by 280 abutments, with a cumulative total exposure time of 2035.4 years, were examined. Twenty‐seven abutment teeth (9.6%) were lost after a mean observation period of 7.9 ± 3.4 years. Significant factors associated with abutment loss were a closed, compared to an open OD design (HR 8.38 (95% CI 1.11‐63.59), P = .040), which was independent of the number of abutments per OD. Furthermore, the loss rate was higher when the denture was not worn day‐and‐night (HR 3.52 (95% CI 1.32‐9.40), P = .012). Oral hygiene behaviour was associated with higher HRs.

Conclusions

ODs remain a viable treatment option for patients with few teeth remaining in the dental arch. It is advisable to choose an open design for the OD, irrespective of the number of abutment teeth. Furthermore, gold cap‐retained ODs should not be removed overnight.
Church Voting Recommendations, Voter Preferences, and Political Decisions
Authors: Torgler Benno , Stadelmann David , Portmann Marco
Published: July 2020

In Switzerland, two key church institutions—the Conference of Swiss Bishops and the Federation of Protestant Churches—make public recommendations on how to vote for certain referenda. We leverage this situation to directly measure religious organizations’ power to reflect and shape human decision making. That is, using a direct measure of voters’ commitment to their religious institution, we analyze whether they are more likely to vote in line with this organization's voting recommendation. We find that these recommendations do indeed wield influence, implying that even in a secularized world, religion plays a crucial role in voting decisions. Our results hold for both aggregate and individual‐level voting decisions.
Female reproductive suppression in an Australian arid zone rodent, the spinifex hopping mouse
Authors: Berris K. K. , Breed W. G. , Moseby K. E. , Carthew S. M.
Published: July 2020

The spinifex hopping mouse (Notomys alexis) is an Australian arid zone rodent that undergoes boom and bust population cycles in its natural environment. Most populations studied to date have been sympatric with exotic predators and introduced herbivores, likely affecting their population dynamics. Therefore, it is unclear whether high‐density populations of hopping mice are regulated by purely extrinsic factors or whether intrinsic factors are also at play. We hypothesized that reproductive suppression of female N. alexis may occur in high‐density populations as has been observed in some other rodent species. Reproductive condition of adult female N. alexis was compared between a high‐density population within the Arid Recovery reserve, where exotic predators and introduced herbivores are excluded, and a low‐density population on adjacent pastoral properties (no exclusions). Trap success was 10 times higher inside the reserve than at pastoral sites, and no adult females were observed breeding in the reserve population, despite 26 % of females at pastoral sites recorded breeding. Our results indicate that adult female N. alexis in the high‐density reserve population were reproductively suppressed, but the similar sex ratios in both populations and the high female body mass and body condition in the reserve indicated that this was not due to demographic differences between the two populations or food scarcity. Our study indicates that the ‘busts’ observed in arid zone rodent populations may be amplified due to the presence of exotic predators and/or grazing by introduced herbivores. We contend that prior to the introduction of exotic predators and introduced herbivores in Australia, the arid zone rodent N. alexis would likely have been more abundant and intrinsic population regulation through female reproductive suppression may have played a larger role in population regulation.
‘Whispers and shadows’: A critical review of the professional identity literature with respect to minority physicians
Authors: Wyatt Tasha R. , Balmer Dorene , Rockich‐Winston Nicole , Chow Candace J. , Richards Joslyn , Zaidi Zareen
Published: July 2020

Objectives

Professional identity formation (PIF) is a growing area of research in medical education. However, it is unclear whether the present research base is suitable for understanding PIF in physicians considered to be under‐represented in medicine (URM). This meta‐ethnography examined the qualitative PIF literature from 2012 to 2019 to assess its capacity to shine light on the experiences of minoritised physicians.

Methods

Data were gathered using a search of six well‐known medical education journals for the term ‘professional identit*’ in titles, keywords, abstracts and subheadings, delineated with the date range of 2012‐2019. All non‐relevant abstracts were removed and papers were then further reduced to those that focused only on learners’ experiences. This left 67 articles in the final dataset, which were analysed using a collaborative approach among a team of researchers. The team members used their professional expertise as qualitative researchers and personal experiences as minoritised individuals to synthesise and interpret the PIF literature.

Results

Four conceptual categories were identified as impacting PIF: Individual versus Sociocultural Influences; the Formal versus the Hidden Curriculum; Institutional versus Societal Values; and Negotiation of Identity versus Dissonance in Identity. However, a major gap was identified; only one study explored experiences of PIF in URM physicians and there was an almost complete absence of critical stances used to study PIF. Combined, these findings suggest that PIF research is building on existing theories without questioning their validity with reference to minoritised physicians.

Conclusions

From a post‐colonial perspective, the fact that race and ethnicity have been largely absent, invisible or considered irrelevant within PIF research is problematic. A new line of inquiry is needed, one that uses alternative frameworks, such as critical theory, to account for the ways in which power and domination influence PIF for URM physicians in order to foreground how larger sociohistorical issues influence and shape the identities of minoritised physicians.
Acute and chronic sleep deprivation in residents: Cognition and stress biomarkers
Authors: Choshen‐Hillel Shoham , Ishqer Ahmad , Mahameed Fadi , Reiter Joel , Gozal David , Gileles‐Hillel Alex , Berger Itai
Published: July 2020

Objectives

Insufficient sleep affects circadian hormonal profiles and inflammatory markers and may modulate attention, executive functioning and decision‐making. Medical professionals and specifically resident physicians, who are involved in long‐term nightshift schedules during their post‐graduate training, are prone to acute and chronic sleep deprivation and disruption, putting them at risk for making medical errors. The aim of the study was to evaluate the impact of chronic and acute‐on‐chronic sleep deprivation and disruption among residents on selected physiological and cognitive measures.

Methods

Thirty‐three medical and surgical residents were evaluated twice ‐ at baseline and after a 26‐hour shift. Eighteen young attending physicians who did not engage in nightshift schedules served as controls and were evaluated once. Measures included morning cortisol and high‐sensitivity C‐reactive protein (hs‐CRP), computerised tests of attention and behaviour, the Behaviour Rating Inventory of Executive Function, a risk‐taking questionnaire and the Pittsburgh Sleep Quality Index.

Results

Residents, but not attendings, reported chronic sleep disruption and deprivation. Residents at baseline exhibited reduced morning cortisol levels and elevated hs‐CRP levels, compared to attendings. Residents at baseline had impaired global executive function compared to attendings. A nightshift with acute sleep deprivation further reduced residents' executive function. Residents at baseline and after a nightshift demonstrated increased impulsivity and slower processing time than attendings. Residents and attendings did not differ in risk‐taking tendencies which were assessed in a separate cohort.

Conclusions

In a real‐life setting, resident physicians exhibit increased low‐grade systemic inflammation (hs‐CRP) and impaired HPA‐axis function. Their chronic sleep curtailment is associated with greater impulsivity, slower cognitive processing, and impaired executive function. Future research is warranted to understand how improving working schedule by increasing sleep duration may minimise the short‐term and potential long‐term risks to physicians in training.
How Not to Criticise Scientism
Authors: Hietanen Johan , Turunen Petri , Hirvonen Ilmari , Karisto Janne , Pättiniemi Ilkka , Saarinen Henrik
Published: July 2020

This paper argues that the main global critiques of scientism lose their punch because they rely on an uncharitable definition of their target. It focuses on epistemological scientism and divides it into four categories in terms of how strong (science is the only source of knowledge) or weak (science is the best source of knowledge) and how narrow (only natural sciences) or broad (all sciences or at least not only the natural sciences) they are. Two central arguments against scientism, the (false) dilemma and self‐referential incoherence, are analysed. Of the four types of epistemological scientism, three can deal with these counterarguments by utilizing two methodological principles: epistemic evaluability of reliability and epistemic opportunism. One hopes that these considerations will steer the discussion on scientism to more fruitful pastures in the future. For example, there are interesting methodological considerations concerning what evaluability or reliability and epistemic opportunism entail.
Epistemic Judgments are Insensitive to Probabilities
Authors: Bricker Adam Michael
Published: July 2020

Multiple epistemological programs make use of intuitive judgments pertaining to an individual’s ability to gain knowledge from exclusively probabilistic/statistical information. This paper argues that these judgments likely form without deference to such information, instead being a function of the degree to which having knowledge is representative of an agent. Thus, these judgments fit the pattern of formation via a representativeness heuristic, like that famously described by Kahneman and Tversky to explain similar probabilistic judgments. Given this broad insensitivity to probabilistic/statistical information, it directly follows that these epistemic judgments are insensitive to a given agent’s epistemic status. From this, the paper concludes that, breaking with common epistemological practice, we cannot assume that such judgments are reliable.
Philosophy for Children and the Extrinsic Value of Academic Philosophy
Authors: Gatley Jane
Published: July 2020

External pressure on Higher Education Institutes in the United Kingdom has brought the question of the extrinsic value of academic philosophy into focus. One line of research into questions about the extrinsic value of philosophy comes from the Philosophy for Children (P4C) movement. There is a large body of literature about the benefits of P4C. This paper argues that the distinctive nature of the P4C pedagogy limits the claims made by the P4C literature about the extrinsic value of philosophy to claims about the value of P4C. While this is not a problem within the P4C literature that recognises these limitations, the paper makes three claims about why it is sometimes inappropriate to extend claims from research into the value of P4C to claims about the value of non‐P4C philosophy. It argues that more research is needed to investigate the value of non‐P4C philosophy.
Where is the Fundamental Disagreement Between Naive Realism and Intentionalism?
Authors: Niikawa Takuya
Published: July 2020

This paper aims to reveal the source of the dispute between naive realism and intentionalism. To accomplish this task, it examines Adam Pautz’s challenge to naive realism, according to which a naive intuition about visual phenomenology, which is the only workable case for naive realism, is problematic. It argues that naive realists can address the challenge from Pautz by rejecting his assumption that naive realists and intentionalists agree on the nominal definition of visual phenomenology. The paper then argues that the reason naive realists want to preserve the naive intuition is its irresistibility rather than its reliability. Given this, it concludes that the disagreement between naive realism and intentionalism is rooted in what philosophical projects they tackle. Naive realists are engaged in the philosophical project of delineating a coherent view of the actual world in which the irresistible naive intuition can be true; the intentionalist philosophical project differs from it.
Epistemic Pluralism
Authors: Zangwill Nick
Published: July 2020

In this paper epistemic pluralism concerning knowledge is taken to be the claim that very different facts may constitute knowledge. The paper argues for pluralism by arguing that very different facts can constitute the knowledge‐making links between beliefs and facts. If pluralism is right, we need not anxiously seek a unified account of the links between beliefs and facts that partly constitute knowledge in different cases of knowledge. The paper argues that no good reasons have been put forward in favour of believing in a unified maker of knowledge. It then appeals to the role of knowledge in order to argue that we have positive reason to embrace pluralism.
Impact of invasive aspergillosis occurring during first induction therapy on outcome of acute myeloid leukaemia (SEIFEM‐12B study)
Authors: Candoni Anna , Farina Francesca , Perruccio Katia , Di Blasi Roberta , Criscuolo Marianna , Cattaneo Chiara , Delia Mario , Zannier Maria Elena , Dragonetti Giulia , Fanci Rosa , Martino Bruno , Del Principe Maria Ilaria , Fianchi Luana , Vianelli Nicola , Chierichini Anna , Garzia Mariagrazia , Petruzzellis Giuseppe , Nadali Gianpaolo , Verga Luisa , Busca Alessandro , Pagano Livio
Published: July 2020

Background

Acute myeloid leukaemia (AML) patients are at high risk of invasive aspergillosis (IA) after first induction chemotherapy (CHT). Although IA risk factors have been identified, few data are available on impact of IA, occurring during induction phase, on overall AML outcome.

Patients and results

The end point of this multicentre, case‐control, study was to evaluate whether IA, occurring after first induction CHT, can affect treatment schedule and patient's outcome. We identified 40 AML patients (cases) who developed IA during first induction phase, 31 probable (77.5%) and 9 proven (22.5%). These cases were matched with a control group (80 AML) without IA, balanced according to age, type of CHT, AML characteristics and cytogenetic‐molecular risk factors. The overall response rate to induction CHT was the same in the 2 groups. In the 40 cases with IA, the overall response rate to antifungal treatment was favourable (80%) but it was significantly affected by the achievement of leukaemia complete remission (CR) with induction CHT. In fact, in cases with AML responsive to induction CHT, responses of IA to antifungal therapy were 96% compared to 21% in cases of AML not responsive to induction treatment (P < .0001). The adherence to the schedule and full doses of CHT were reported in 35% of cases (14/40) and in 76% of controls (61/80) (P = .0001; OR 6.7; 95% CI 2.7‐16.6). After first induction CHT, a significant higher number of cases (15/40; 37.5%) compared to controls (9/80; 11%) could not receive additional cycles of CHT (P = .0011, OR 4.8; 95% CI 1.9‐12.3). The IA‐related mortality was 22.5%. The median OS of cases was significantly worse than OS of controls with a difference of 12.3 months (12.1 vs 24.4 months, P = .04). However, the occurrence of IA during first induction phase did not have a significant impact on the OS of cases who achieved a CR of AML with induction CHT which are able to proceed, despite the IA, with their therapeutic program, achieving the same OS as the control group with AML in CR (P = ns).

Conclusions

These data show that IA during first induction CHT can delay the subsequent therapeutic program and has a significant impact on OS, specifically in AML patients who did not achieved a CR of AML with the first course of CHT.
WRECKED CARGOES OF MARMOR LUCULLEUM (AFRICANO) OF THE ROMAN PERIOD. AN ARCHAEOLOGICAL AND ARCHAEOMETRICAL STUDY
Authors: Beltrame Carlo , Lazzarini Lorenzo
Published: July 2020

The article presents the results of new underwater and laboratory investigations carried out on a cargo of columns and blocks of Roman age from a shipwreck sunk off Capo Taormina (Sicily). The archaeometric analyses (powder XRD and OM with thin sections) indicate the use of marmor luculleum (africano) from the ancient Ionian town of Teos for the columns. The authors compare their results with the data obtained from the other two shipwrecks carrying the same marble sunk off the southern coast of France (Dramont I and Chrétienne M) together with abrasive materials (pumice and corundite [emery]), applying the relevant archaeometric analyses. A maritime traffic of the prestigious stone from Teos into the Central Mediterranean, combined with pumice (from Lipari?) and Naxian corundite – both used in the working of marble ‐ is here reconstructed for the first time. We also propose a date for the Taormina cargo.
International Migration and City Growth in the Global South: An Analysis of IPUMS Data for Seven Countries, 1992–2013
Authors: Lerch Mathias
Published: July 2020

Evidence on the demographic components of city growth in the global South is scarce, and the role played by international migration is neglected. We analyze the importance of recent international migration in cities, compare it with that of internal movements, and evaluate the growth contribution across national contexts and the urban hierarchy. Combining individual‐level census data and geographic master files of metropolitan areas with indirect demographic estimation techniques, we cover 377 cities in seven countries. It is found that, in almost one third of cities, population change and replacement has been mainly determined by migration. The international component was larger than the internal one in more than half of cities. Whereas internal migration tends to decrease with rising city size, international movements tend to increase. Positive net international migration substitutes for the net losses from domestic movements in large cities, but complements the gains in intermediate‐sized cities.
Relationships Between Psychological, Sleep, and Physical Activity Measures and Somatosensory Function in People With Peripheral Joint Pain: A Systematic Review and Meta‐Analysis
Authors: Othman Rani , Jayakaran Prasath , Swain Nicola , Dassanayake Suranga , Tumilty Steve , Mani Ramakrishnan
Published: July 2020

Objective

Alteration in somatosensory function has been linked to pain experience in individuals with joint pain. In this systematic review we aimed to establish the level of evidence of associations between psychological, social, physical activity, and sleep measures and somatosensory function that were assessed via quantitative sensory testing (QST) among individuals with joint pain.

Methods

A comprehensive literature search was conducted in 6 electronic databases from their inception to July 2019. Two reviewers independently assessed the methodological quality using a modified Quality in Prognostic Studies (QUIPS) tool and supplemented with recommendations from the Critical Appraisal and Data Extraction for Systematic Review of Prediction Modelling Studies (CHARMS) checklist and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS‐2) tool. The level of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. Data were pooled to evaluate the strength of the relationships of interest.

Results

Seventeen studies related to joint pain were included. Pain catastrophizing, depression, anxiety, and physical activity level have been shown to have a significant (small to fair) association with several QST measures. Pressure pain threshold (PPT) is the only measure that was found to be consistently correlated with all the domains. The overall quality of evidence for all factors ranged from very low to moderate. Subgroup analysis revealed a stronger association for depression and pain catastrophizing and PPT and temporal pain summation in individuals with shoulder pain.

Conclusion

Psychological factors and physical activity levels are associated with somatosensory function in people with joint pain. These factors need to be adjusted when establishing predictive relationships between somatosensory function and pain outcomes in individuals with joint pain.
Phylogenetic, genetic, and phenotypic diversity of Pseudomonas syringae pv. syringae strains isolated from citrus blast and black pit in Tunisia
Authors: Abdellatif Emna , Kałużna Monika , Ferrante Patrizia , Scortichini Marco , Bahri Bochra , Janse Jaap D. , van Vaerenberg Johan , Baeyen Steve , Sobiczewski Piotr , Rhouma Ali
Published: July 2020

Citrus blast and black pit caused by Pseudomonas syringae pv. syringae (Pss) is the only bacterial disease reported in Tunisian Citrus orchards. The phylogenetic relationship between Pss strains was studied based on multilocus sequence analysis (MLSA), using partial sequences of housekeeping genes rpoD, rpoB, gyrB, cts, and pfk for 14 representative Pss Citrus strains, including the reference strain LMG5496. The MLSA revealed that the studied Tunisian Citrus strains are closely related to LMG5496 and cluster in phylogroup 02. Based on the cts gene, the majority of Citrus strains clustered in clades “a” and “b”. However, five strains were placed in a newly defined clade “g”. We describe the presence of six different type III secreted effectors (T3SEs). These were found with frequencies of 100% for the effector hopAN1 and the helper hrpK1, 65% for hopT1‐2, and 14% for hopN1, hopR1, and hopQ1‐2. Investigation of copper resistance showed that 67% of our Pss Citrus strains from Tunisia are resistant to copper sulphate in vitro, and the copper resistance genes copABCDR were detected in 23% of the strains. Our results present new data concerning the genetic diversity and phylogeny, presence of T3SEs, and copper resistance within the Pss populations that affect Citrus in Tunisia.
The power of data synthesis to shape the future of the restoration community and capacity
Authors: Ladouceur Emma , Shackelford Nancy
Published: July 2020

Restoration efforts will be taking place over the next decade(s) in the largest scope and capacity ever seen. Immense commitments, goals, and budgets are set, with impactful wide‐reaching potential benefits for people and the environment. These are ambitious aims for a relatively new branch of science and practice. It is time for restoration action to scale up, the legacy of which could impact over 350 million hectares targeted for the U.N. Decade on Ecosystem Restoration. However, restoration still proceeds on a case‐by‐case, trial by error basis and restoration outcomes can be variable even under similar conditions. The ability to put each case into context—what about it worked, what did not, and why—is something that the synthesis of data across studies can facilitate. The link between data synthesis and predictive capacity is strong. There are examples of extremely ambitious and successful efforts to compile data in structured, standardized databases which have led to valuable insights across regional and global scales in other branches of science. There is opportunity and challenge in compiling, standardizing, and synthesizing restoration monitoring data to inform the future of restoration practice and science. Through global collation of restoration data, knowledge gaps can be addressed and data synthesized to advance toward a more predictive science to inform more consistent success. The interdisciplinary potential of restoration ecology sits just over the horizon of this decade. Through truly collaborative synthesis across foci within the restoration community, we have the opportunity to rapidly reach that potential and achieve extraordinary outcomes together.
Racial profiling?: Theorizing essentialism, whiteness, and scripture in the study of religion
Authors: Newton Richard
Published: July 2020

Leaders in the American Academy of Religion have committed the guild to resisting the current wave of white nationalist and white supremacist machinations, presenting our discipline as particularly suited for the task. But given the study of religion's intimate historical relationship with the modern Christian colonial project, scholars can equally find themselves reinforcing the socio‐interpretive modalities—namely essentialism—upon which whiteness is premised. This paper presents critical scripture studies, particularly its elaboration of processes abbreviated in biblical interpretation, as an avenue for deconstructing assumptions about how whiteness works.
Natural killer cell–derived extracellular vesicles in cancer therapy
Authors: Farcas Marius , Inngjerdingen Marit
Published: July 2020

Cancer is a major cause of death in the industrialized world. New therapies are constantly being developed in order to reduce morbidity and mortality. NK cell–based cellular therapies have shown effect against haematological malignancies, but it has been difficult to target solid tumours due to low NK cell infiltration of the tumour and efficient tumour evasion strategies. NK cells release extracellular vesicles that naturally contain cytolytic proteins and tumour‐targeting molecules. These vesicles can directly interact with and kill malignant cells, and their small size could allow more efficient extravasation into the tumour tissue. Extracellular vesicles are also less sensitive to the hostile tumour microenvironment compared to cells. Based on their features, NK cell–derived extracellular vesicles represent promising novel tools in oncology. In this review, we summarize the current available literature on NK cell–derived extracellular vesicles and discuss how they may be utilized in therapy for solid tumours.
A brief history of Scandinavian society for immunology
Authors: Jonsson Roland , Örn Anders
Published: July 2020

The Scandinavian Society for Immunology (SSI) was established with the purpose to advance the study of immunology in Scandinavia and to facilitate contacts between individuals and laboratories working within the field. To fulfill this the Society should organize scientific meetings and laboratory courses and take any other measure to support the development of immunology. A second objective was to establish contact and scientific exchange with other societies in Europe and overseas. By joining five national societies from the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) into one umbrella society this has given SSI a more powerful voice in international organizations such as European Federation of Immunological Societies (EFIS) and International Union of Immunological Societies (IUIS). The Scandinavian Foundation for Immunology and the Scandinavian Journal of Immunology has greatly facilitated the annual meetings to be of international high quality and by attracting more participants. Thus, SSI provides a forum for Nordic immunologists to share their research results and to increase collaboration over the borders. In conclusion, the SSI has undoubtedly been and will hopefully continue to be a major strength for Scandinavian immunology.
T follicular regulatory cells: Guardians of the germinal centre?
Authors: Fahlquist Hagert Cecilia , Degn Søren E.
Published: July 2020

It is a central tenet of the clonal selection theory, that lymphocyte repertoires are tolerized to self‐antigens during their ontogeny. Germinal centres are the sites in secondary lymphoid tissues where B cells undergo affinity maturation and class‐switching to produce high‐affinity antibodies. This process is crucial, both in our ability to mount protective humoral responses to infections and to vaccinations, but it is also involved in untoward reactions to self‐antigens, which underlie autoimmunity. The process of affinity maturation poses a significant challenge to tolerance, as the random nature of somatic hypermutation can introduce novel reactivities. Therefore, it has been a long‐standing idea that mechanisms must exist which limit the emergence of autoreactivity at the germinal centre level. One of these mechanisms is the requirement for linked recognition, which imposes on B cells a dependence on centrally tolerant T follicular helper cells. However, as linked recognition can be bypassed by adduct formation of autoantigenic complexes, it has been an appealing notion that there should be an additional layer of dominant mechanisms regulating emergence of autoreactive specificities. About a decade ago, this notion was addressed by the discovery of a novel subset of T regulatory cells localizing to the germinal centre and regulating germinal centre B‐cell responses. Here, we detail the progress that has been made towards characterizing this T follicular regulatory cell subset and understanding the functions of these ‘guardians of the germinal centre’.
The diagnostic value of in vivo reflectance confocal microscopy in actinic keratosis
Authors: Tang Zhen , Kang Liyang , Zhang Yuezhong , Huang Jian , Tong Xiaoliang , Zhou Lu , Zeng Jinrong
Published: July 2020

Background

Actinic keratosis (AK) is a pre‐neoplastic skin damage caused by sun exposure with a risk of transforming squamous cell carcinoma (SCC) ranging from 0.1%‐20%, while it should be differentiated with many diseases such as seborrheic keratosis (SK), discoid lupus erythematosus (DLE), Bowen's disease, and basal cell carcinoma(BCC) et al. Reflectance confocal microscopy (RCM) as a non‐invasive method is showing an increasing diagnostic accuracy. Currently, there are a few studies that summarized the characteristics of AK with RCM.

Aim

The study aimed to find the diagnostic value of diagnosing actinic keratosis by reflectance confocal microscopy.

Methods

A total of 92 patients with clinical suspicious diagnosis of actinic keratosis were enrolled in this study, and RCM device imaged their lesions. Fifty‐three of these patients underwent skin biopsies to confirm the diagnosis. We retrospectively analyzed the results of RCM and histological diagnosis and then summarized the RCM characteristics of biopsy‐confirmed lesions.

Results

Based on RCM images, 76 of 92 (82.6%) patients were diagnosed with AK, 9 of 92 (9.8%) patients could not be diagnosed by the dermatologist according to RCM. Of all 53 biopsied lesions, 42 (79.2%) were AK, 1 was seborrheic keratosis, 3 were basal cell carcinoma, three were discoid lupus erythematosus, 1 was Bowen's disease, and three were squamous cell carcinoma.

Conclusion

The value of RCM in the diagnosis and differential diagnosis of AK is good and worthy of clinical application.
Intron 2 substitution resulted in HLA‐DQB1*02:01:01:02 variant in a Kashmiri Brahmin individual from North India
Authors: Sharma Akanksha , Tyagi Shweta , Gautam Shashi Kapoor , Abid Mohd , Kanga Uma
Published: July 2020

HLA‐DQB1*02:01:01:02 differs from HLA‐DQB1*02:01:01:01 by one nucleotide change in intron 2 at position 3949 (G>C).
Intron 2 deletion generated the HLA‐C*08:01:01:05 allele in a Sumi individual from Nagaland, North‐East India
Authors: Keppen Chenole , Sharma Akanksha , Khamo Vinotsole , Kanga Uma
Published: July 2020

HLA‐C*08:01:01:05 differs from HLA‐C*08:01:01:02 by one nucleotide deletion (T > −) at position 674 in intron 2.
Therapeutic plasma exchange taper does not decrease exacerbations in immune thrombotic thrombocytopenic purpura patients
Authors: Raval Jay S. , Mazepa Marshall A. , Rollins‐Raval Marian A. , Kasthuri Raj S. , Park Yara A.
Published: July 2020

BACKGROUND

Despite rapid and intensive treatments with therapeutic plasma exchange (TPE) and immunosuppression, immune thrombotic thrombocytopenic purpura (TTP) patients are at risk of disease exacerbation, i.e., early recurrence of TTP within 30 days of achieving treatment response. TPE taper, a practice of performing additional TPE procedures after achieving treatment response, is commonly performed for decreasing exacerbations, although no evidence supports this practice.

STUDY DESIGN AND METHODS

In this prospective observational investigation over four years, our center switched its standard of care for treating all TTP patients from not performing TPE taper after achieving treatment response (i.e., no‐taper cohort) to performance of TPE taper (i.e., yes‐taper cohort) to characterize impacts on exacerbations. Continuous and categorical data were analyzed by Mann–Whitney, Fisher's exact, and log‐rank tests; significance was defined as p < 0.05.

RESULTS

The two cohorts were well matched and had no significant differences in demographics, presentation laboratory values, or TTP history (p > 0.05 for all). The yes‐taper cohort of 26 patients with 29 consecutive episodes did not have a significantly different exacerbation rate from the no‐taper cohort of 24 patients with 27 consecutive episodes (exacerbation rates of 37.9% vs. 33.3%, respectively; p = 0.78); however, treatment‐related complications directly attributed to the TPE procedures, blood products, or central venous catheters were significantly greater in the yes‐taper cohort (nine vs. one events, respectively; p = 0.01).

CONCLUSION

Since TPE taper did not reduce exacerbations in our TTP patients, we no longer advocate for TPE taper and have reverted to our original standard of care.
Context Factors Facilitating and Hindering Patient Participation in Dialysis Care: A Focus Group Study With Patients and Staff
Authors: Årestedt Liselott , Martinsson Caroline , Hjelm Carina , Uhlin Fredrik , Eldh Ann Catrine
Published: July 2020

Background

Safe health care of good quality depends on structured and unceasing efforts to progress, promoting strategies tailored to the context, including elements such as patients’ preferences. Although patient participation is a common concept in health care, there is yet limited understanding of the factors that facilitate and hinder it in a healthcare context.

Aims

This paper identifies what patients and health professionals depict in terms of enablers and barriers for patient participation in dialysis care.

Methods

An explorative qualitative design was applied with seven focus group discussions with patients, staff, and managers across different types of hospitals, with the texts analyzed with content analysis.

Results

The dialysis context represents three key elements—people, resources, and interactions—that can both enable and hinder patient participation. Both barriers and facilitators for patient participation were found to reside at individual, team, and organizational levels, with a greater number of enabling factors implied by both patients and staff.

Linking Evidence to Action

While the dialysis context comprises opportunities for progress in favor of patient participation, a shared understanding of the concept is needed, along with how contextual factors can facilitate conditions for participation by patient preferences. In addition, the most favorable strategy for implementing person‐centered care is not yet known, but to facilitate patient participation from a patient perspective, creating opportunities to enable staff and patients to share a common understanding is needed, along with tools to facilitate a dialogue on patient participation.
Human anti‐α‐fucose antibodies are xenoreactive toward GGTA1/CMAH knockout pigs
Authors: Burlak Christopher , Taylor R. Travis , Wang Zheng Yu , Tector A. Joseph
Published: July 2020

Progress has been made in overcoming antibody‐mediated rejection of porcine xenografts by deleting pig genes that produce unique carbohydrate epitopes. Pigs deficient in galactose α‐1,3 galactose (gene modified: GGTA1) and neu5Gc (gene modified: CMAH) have reduced levels of human antibody binding. Previously we identified α‐fucose as a glycan that was expressed in high levels on cells of GGTA1/CMAH KO pigs. To validate the α‐fucose phenotype observed previously we compared lectin affinity toward human and pig serum glycoproteins by dot blot analysis and confocal microscopy. Human anti‐fucose antibody isolated by affinity chromatography was tested for specificity to L‐fucose by custom macroarray. The affinity and cytotoxicity of the isolated human anti‐fucose antibody toward human and GGTA1/CMAH KO pig PBMCs was determined by flow cytometry. Dot blot and confocal analysis support out previous findings that α‐fucose is more highly expressed in pigs than humans. Pig kidney glomeruli and tubules contain abundant α‐fucose and may represent focal sites for anti‐α‐fucose antibody binding. The Isolated human anti‐fucose IgA, IgG and IgM bound to GGTA1/CMAH KO pig PBMC and were cytotoxic. Interestingly, the isolated human IgG cross reacted with the methyl pentose, L‐rhamnose. Human anti‐fucose antibody bound and was cytotoxic to GGTA1/CMAH KO pig peripheral blood monocytes. We have shown that α‐fucose is an abundant target for cytotoxic human antibody in the organs of genetically modified pigs important to xenotransplantation.
Upfront use of eculizumab to treat early acute antibody‐mediated rejection after kidney allotransplantation and relevance for xenotransplantation
Authors: Schwotzer Nora , Paganetti Giulia , Barchi Matteo , Perrottet Nancy , Aubert Vincent , Sadallah Salima , Rotman Samuel , Venetz Jean‐Pierre , Matter Maurice , Golshayan Dela , Pascual Manuel
Published: July 2020

Acute antibody‐mediated rejection (AMR) early after transplant remains a challenge, both in allotransplantation and in xenotransplantation. We report the case of an early and severe acute AMR episode in a kidney transplant recipient that was successfully treated with upfront eculizumab. A 58‐year‐old woman had been on dialysis since 2014. She underwent a first kidney transplant in 2018 with primary non‐function and received several blood transfusions. Postoperatively, she developed anti‐HLA antibodies. One year later, she received a second allograft from a deceased donor. At day 0, there was only one preformed low‐level donor‐specific antibody (DSA) anti‐DQ7. After initial excellent allograft function, serum creatinine increased on days 7‐9, and this was associated with oligo‐anuria. On day 7, there was an increase in her DSA anti‐DQ7 and 4 de novo DSA had developed at high MFI values. Allograft biopsy showed severe active AMR with diffuse C4d deposits in peritubular capillaries. The early acute AMR episode was treated with upfront eculizumab administration (2 doses) with efficient CH50 blockade (< 10% CH50). Rituximab was also administered on day 12, and intravenous immunoglobulin (IVIG) was given over the following days. There was an excellent clinical response to eculizumab administration. Eculizumab administration rapidly reversed the acute AMR episode without the need for plasmapheresis. Rituximab and IVIG were also used as B‐cell immunomodulators to decrease DSA. Blocking efficiently the terminal complement pathway may become a useful strategy to treat acute AMR in sensitized recipients of allografts, and possibly in recipients of discordant xenografts.
Dynamic Analysis of a High-Pressure Relief Valve During Opening
Authors: Bossard John , Reich Alton , DiMeo Alex
Published: July 2020

In nuclear power plants, power actuated pressure relief valves serve several purposes. They act as safety valves and open automatically in response to unusually high pressures in the primary system. They also act as power-operated valves and are used to relieve steam in response to automatic or manually initiated control signals. These valves are required to lift completely over a short duration from the time that they receive an actuation signal, or the system pressure exceeds the set point. This short lift time results in the valve disk moving at high velocities, and can result in high impact forces on the piston and stem when the valve fully opens. To quantitatively evaluate the dynamic performance of the Target Rock Pressure Relief Valve, an analysis effort was undertaken which would accommodate both the fluid dynamic features of the valve operation, as well as the kinematic characteristics of the valve, during pressure relief valve operation. To execute the analysis, the Generalized Fluid System Simulation Program (GFSSP) was used. GFSSP is a network flow solver computational fluid dynamics (CFD) code developed by NASA that has the ability to analyze transient, multiphase flows, and conjugate heat transfer, along with the inclusion of custom user subroutines developed by the user which can accommodate other simulation requirements. In this paper, we present the GFSSP model developed, and the computed results that could be compared with corresponding parameters as measured from experimental testing for the pressure relief valve. Adjustments to GFSSP input parameters allow the anchoring of the GFSSP valve model to test data. This makes it possible to use the GFSSP model as a predictive tool for understanding valve dynamics, as well as evaluating proposed pressure relief valve modifications for performance improvements.
Simulation of Cyclic Loading on Pipe Elbows Using Advanced Plane-Stress Elastoplasticity Models1
Authors: Chatziioannou Konstantinos , Huang Yuner , Karamanos Spyros A.
Published: July 2020

This work investigates the response of industrial steel pipe elbows subjected to severe cyclic loading (e.g., seismic or shutdown/startup conditions), associated with the development of significant inelastic strain amplitudes of alternate sign, which may lead to low-cycle fatigue. To model this response, three cyclic-plasticity hardening models are employed for the numerical analysis of large-scale experiments on elbows reported elsewhere. The constitutive relations of the material model follow the context of von Mises cyclic elasto-plasticity, and the hardening models are implemented in a user subroutine, developed by the authors, which employs a robust numerical integration scheme, and is inserted in a general-purpose finite element software. The three hardening models are evaluated in terms of their ability to predict the strain range at critical locations, and in particular, strain accumulation over the load cycles, a phenomenon called “ratcheting.” The overall good comparison between numerical and experimental results demonstrates that the proposed numerical methodology can be used for simulating accurately the mechanical response of pipe elbows under severe inelastic repeated loading. Finally, this paper highlights some limitations of conventional hardening rules in simulating multi-axial material ratcheting.
Thermal and Manufacturing Design Considerations for Silicon-Based Embedded Microchannel-Three-Dimensional Manifold Coolers—Part 2: Parametric Study of EMMCs for High Heat Flux (∼1 kW/cm2) Power Electronics Cooling
Authors: Jung Ki Wook , Hazra Sougata , Kwon Heungdong , Piazza Alisha , Jih Edward , Asheghi Mehdi , Gupta Man Prakash , Degner Michael , Goodson Kenneth E.
Published: July 2020

Thermal management of power electronics modules is one of the limiting factors in the peak power capability of the traction inverter system and overall efficiency of the e-drive. Liquid cooling using embedded microchannels with a three-dimensional (3D)-manifold cooler (EMMC) is a promising technology capable of removing heat fluxes of >1 kW/cm2 at tens of kPa pressure drop. In this work, we utilize computational fluid dynamics (CFD) simulations to conduct a parametric study of selected EMMC designs to improve the thermofluidic performance for a 5 mm × 5 mm heated area with the applied heat flux of 800 W/cm2 using single-phase water as working fluid at inlet temperature of 25 °C. We implemented strategies such as: (i) symmetric distribution of manifold inlet/outlet conduits, (ii) reducing the thickness of cold-plate (CP) substrate, and (iii) increasing fluid–solid interfacial area in CP microchannels, which resulted in a reduction in thermal resistance from 0.1 for baseline design to 0.04 cm2 K/W, while the pressure drop increased from 8 to 37 kPa.
Retrograde urethrosonography with SonoVue in strictures of the male urethra: a pilot study
Authors: Suciu Mihai Domnutiu , Marica Nucu Alexandru , Badea Alexandru Florin , Gavrila Iulia Laura , Badea Radu Ion
Published: July 2020

Aim: To evaluate the effectiveness of SonoVue urethrosonography in diagnosing the adult male anterior urethral strictures pathology in comparison with retrograde urethrography.Material and method: We standardised the method and performed a comparative study evaluating the diagnosis of urethral strictures using retrograde urethrography and retrograde ultrasonographic exploration with SonoVue on 6 male patients.Results: In all patients, the existence of urethral stricture, localization and its extension were confirmed. Contrast-enhanced ultrasonographic exploration brought additional categories of information: the degree of spongiofibrosis, the elasticity of the urethral walls and the presence of urethral lithiasis. There were no periprocedural incidents.Conclusion: This pilot study demonstrates the feasibility and innocuity of urethral ultrasound with SonoVue. Real-time ultrasound exploration highlights aspects that are not seen in radiological examination, so the method can be complementary or alternative to this procedure.
Flapping wing drones show off their skills
Authors: de Croon Guido
Published: July 2020

The identification and solution of a major efficiency loss in small flapping wing drones lead to more agile aerobatic maneuvers.
Disrupting the platelet internal membrane via PI3KC2α inhibition impairs thrombosis independently of canonical platelet activation
Authors: Selvadurai Maria V. , Moon Mitchell J. , Mountford Simon J. , Ma Xiao , Zheng Zhaohua , Jennings Ian G. , Setiabakti Natasha M. , Iman Rizani P. , Brazilek Rose J. , Z. Abidin Nurul Aisha , Chicanne Gaëtan , Severin Sonia , Nicholls Alyce J. , Wong Connie H.Y. , Rinckel Jean-Yves , Eckly Anita , Gachet Christian , Nesbitt Warwick S. , Thompson Philip E. , Hamilton Justin R.
Published: July 2020

First-generation PI3KC2α inhibitors prevent thrombosis without causing bleeding.
siRNA nanoparticles targeting CaMKIIγ in lesional macrophages improve atherosclerotic plaque stability in mice
Authors: Tao Wei , Yurdagul Arif , Kong Na , Li Wenliang , Wang Xiaobo , Doran Amanda C. , Feng Chan , Wang Junqing , Islam Mohammad Ariful , Farokhzad Omid C. , Tabas Ira , Shi Jinjun
Published: July 2020

Targeted siRNA nanoparticles can specifically inhibit pro-atherogenic macrophage pathways to combat atherosclerotic vascular disease.