bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic significance of P‐wave morphology in patients with coronary artery disease
Authors: Nortamo Santeri , Laitinen Idamaria , Passi Jussi , Tulppo Mikko , Ukkola Olavi H. , Junttila M. Juhani , Kiviniemi Antti M. , Kenttä Tuomas , Huikuri Heikki V. , Perkiömäki Juha S.
Published: July 2019

Introduction

The prognostic significance of P‐wave morphology in patients with coronary artery disease (CAD) is not well‐known.

Methods

A total of 1946 patients with angiographically verified CAD were included in the Innovation to reduce Cardiovascular Complications of Diabetes at the Intersection (ARTEMIS) study. The P‐wave morphology could be analyzed in 1797 patients.

Results

During 7.4 ± 2.0 years, a total of 168 (9.3%) patients died or experienced resuscitation from sudden cardiac arrest (SCA), 43 (2.4%) patients experienced sudden cardiac death (SCD) or were resuscitated from SCA, 37 (2.1%) patients succumbed to non‐SCD (NSCD), and 88 (4.9%) patients to noncardiac death (NCD). Of the P‐wave parameters, the absolute P‐wave residuum (PWR), the heterogeneity of the P‐wave morphology (PWH), and the P‐wave duration (Pdur) had the closest univariate association with the risk of SCD/SCA (0.0038 ± 0.0026 vs 0.0022 ± 0.0017, P < .001; 11.0 ± 5.2 vs 8.6 ± 3.6, P < .01; 142.7 ± 16.9 vs 134.8 ± 14.3 milliseconds, P < .01; SCD/SCA vs no SCD/SCA, respectively). After adjustments with factors that were associated with the risk of SCD/SCA, such as diabetes, smoking, left bundle branch block, high‐sensitivity C‐reactive protein, and high‐sensitivity troponin T, PWR (P < .001), PWH (P < .05), and Pdur (P < 0.01) still predicted SCD/SCA but not non‐sudden cardiac death. When these parameters were added to the SCD/SCA clinical risk model, the discrimination and reclassification accuracy of the risk model increased significantly (P < .05, P < .001) and the C‐index increased from 0.745 to 0.787.

Conclusion

The P‐wave morphology parameters independently predict SCD/SCA in patients with CAD.
Outcome of combined cryo‐ and radiofrequency‐catheter ablation in patients with supraventricular tachycardias
Authors: Miyamoto Koji , Kapa Suraj , Mulpuru Siva K. , Deshmukh Abhishek J. , Asirvatham Samuel J. , Munger Thomas M. , Friedman Paul A. , Packer Douglas L.
Published: July 2019

Background

There are few data regarding the outcome of a combined cryo‐ and radiofrequency (RF)‐catheter ablation of various types of supraventricular tachycardias (SVTs) originating from near the normal conduction system.

METHODS

We analyzed all patients undergoing combined cryo‐ and RF‐ catheter ablation at Mayo Clinic, Rochester, MN as part of the ablation of SVTs with potential risks of injury to the normal conduction system. This study aimed to assess the outcome of a combined cryo‐ and RF‐catheter ablation of various types of SVTs.

RESULTS

The study population consisted of 54 patients (38 ± 17 years, 32 men). A combined cryo‐ and RF‐catheter ablation was attempted for septal accessary pathways (APs) in 26, atrioventricular nodal reentrant tachycardia (AVNRT) in 14, atrial tachycardia (AT) in 7, and junctional ectopic tachycardia in 7 patients. Forty‐one patients (76%) were successfully ablated with cryoablation, and RF ablation after an unsuccessful cryoablation ablated the SVTs successfully at the same location in 6 patients (11%). Complication occurred in 1 patient (deep vein thrombosis). The cumulative freedom from SVT rate at 30 days after the procedure was 78% and there was no significant difference in the recurrence rate among the SVTs.

CONCLUSION

A combined cryo‐ and RF‐catheter ablation is clinically effective in patients undergoing SVT ablation with the potential risk of injury to the normal conduction system.
Safety and efficacy of leadless pacemaker retrieval
Authors: Li Jianwen , Hou Wen‐Bo , Cao Ming‐Kun , Zhou Wen‐Xiu , Wang Yan , Fang Yi , Zhou Chao , Yin Yu‐Xia , Toft Egon S. , Zhang Hai‐Jun
Published: July 2019

Background and Objectives

The success rate of leadless cardiac pacemaker (LP) retrieval remains a major concern for this disruptive technology. The present paper performed a systematic review of the safety and feasibility of the retrieval of LPs.

Methods

Primary publications that performed LP retrieval were collected and included five animal experiments and two worldwide retrieval experiences in human. The procedural details, such as indication, days post implantation, extraction success rate, and complications, were described. The present paper analyzed factors affecting the retrieval and management of the nonfunctional devices.

Results

Retrieval animal models was possible at least up to 2.5 years post implantation, and data from humans suggest that removal of a device that was implanted longer (eg, 4 years and 9 months for Nanostim; 4 years for Micra) could be performed within a reasonable safety profile. The fixed mechanism, implant site, and encapsulation of the LP systems may affect the retrieval process.

Conclusions

A high success rate in the relatively chronic retrieval of LPs was demonstrated, which promotes the extensive use of these devices in the treatment arrhythmia in the future.
Did the Governance of EU Funds Help Italian Regional Labour Markets during the Great Recession?
Authors: Arbolino Roberta , Di Caro Paolo , Marani Ugo
Published: July 2019

European and national policy‐makers have highlighted the role of the cohesion policy in smoothing the effects of the crisis during the programme period 2007–13. To support these claims, however, specific evidence is needed. This article studied the relations between the absorption of the EU funds and regional labour markets in Italian regions during the Great Recession. By applying different panel data models to new data on cohesion policy, three main results were achieved. We found that the cohesion policy made a contribution to the resilience of Italian regional labour markets. Yet the short‐term consequences of the cohesion policy on regional economies were conditional on the heterogeneous quality of regional institutions. We also found that the policy changes introduced in Italy during the crisis increased the effectiveness of the cohesion policy. The analysis was controlled for endogeneity issues and alternative specifications.
Mapping the care transition from hospital to skilled nursing facility
Authors: Campbell Britton Meredith , Petersen‐Pickett Judy , Hodshon Beth , Chaudhry Sarwat I.
Published: July 2019

Purpose

Care transitions between hospitals and skilled nursing facilities (SNFs) are often associated with breakdowns in communication that may place patients at risk for adverse events. Less is known about how to address these issues in the context of busy patient care settings. We used process mapping to examine hospital discharge and SNF admission processes to identify opportunities for improvement.

Methods

A quality improvement (QI) team worked with frontline staff to create a process map illustrating the sequence of events involved with hospital discharge and SNF admission. The project was completed at an academic medical centre and two local SNFs in the north‐eastern United States. Participants represented the care management, medicine, nursing, admissions, and physical therapy services. The data informed hospital QI interventions seeking to improve the quality and safety of hospital‐SNF transfers and reduce unplanned hospital readmissions.

Results

The final process map highlighted numerous activities that need to be coordinated between care teams, including the time‐sensitive exchange of clinical and administrative information. Participants shared insights about how care teams reach critical decisions about patient disposition and post‐acute care utilization.

Conclusions

Process mapping highlighted specific opportunities for improving communication between care teams. Participants advocated for earlier assessments of patients' functional status and support systems, including reliable at‐home services. They also reasoned that improved communication would help patients and providers reach decisions together, coordinate work efforts, and better prepare for hospital discharge and SNF admission. This information can be used to improve patient care transitions between hospitals and SNFs.
Glial and neuronal expression of the Inward Rectifying Potassium Channel Kir7.1 in the adult mouse brain
Authors: Papanikolaou Maria , Lewis Anthony , Butt Arthur M.
Published: July 2019

Inward Rectifying Potassium channels (Kir) are a large family of ion channels that play key roles in ion homeostasis and neuronal excitability. The most recently described Kir subtype is Kir7.1, which is known as a K+ transporting subtype. Earlier studies localised Kir7.1 to subpopulations of neurones in the brain. However, the pattern of Kir7.1 expression across the brain has not previously been examined. Here, we have determined neuronal and glial expression of Kir7.1 in the adult mouse brain, using immunohistochemistry and transgenic mouse lines expressing reporters specific for astrocytes [glial fibrillary acidic protein‐enhanced green fluorescent protein (GFAP‐EGFP], myelinating oligodendrocytes (PLP‐DsRed), oligodendrocyte progenitor cells (OPC, Pdgfra‐creERT2/Rosa26‐YFP double‐transgenic mice) and all oligodendrocyte lineage cells (SOX10‐EGFP). The results demonstrate significant neuronal Kir7.1 immunostaining in the cortex, hippocampus, cerebellum and pons, as well as the striatum and hypothalamus. In addition, astrocytes are shown to be immunopositive for Kir7.1 throughout grey and white matter, with dense immunostaining on cell somata, primary processes and perivascular end‐feet. Immunostaining for Kir7.1 was observed in oligodendrocytes, myelin and OPCs throughout the brain, although immunostaining was heterogeneous. Neuronal and glial expression of Kir7.1 is confirmed using neurone‐glial cortical cultures and optic nerve glial cultures. Notably, Kir7.1 have been shown to regulate the excitability of thalamic neurones and our results indicate this may be a widespread function of Kir7.1 in neurones throughout the brain. Moreover, based on the function of Kir7.1 in multiple transporting epithelia, Kir7.1 are likely to play an equivalent role in the primary glial function of K+ homeostasis. Our results indicate Kir7.1 are far more pervasive in the brain than previously recognised and have potential importance in regulating neuronal and glial function.
Subperiosteal injections during facial soft tissue filler injections—Is it possible?
Authors: Pavicic Tatjana , Yankova Mariya , Schenck Thilo L. , Frank Konstantin , Freytag David L. , Sykes Jonathan , Green Jeremy B. , Hamade Hassan , Casabona Gabriela , Cotofana Sebastian
Published: July 2019

Background

It can be hypothesized that safety during soft tissue filler injection could be enhanced if the product could be positioned between the periosteum and the bone surface i.e. subperiosteal.

Aim

This study investigated the feasibilityof subperiosteal injections.

Patients/Methods

We analysed 126 injection procedures performed in seven Caucasian body donors (4 males, 3 females) with a mean age of 75.29 ± 4.95 years [range: 70 – 87] and a mean body mass index of 23.53 ± 3.96 kg/m2 [range: 16.46 – 32.23]. The injection procedures were performed in the forehead, scalp, zygomatic arch and the mandible bilaterally. Injection procedures were conducted using 25G, 27G and 30G sharp‐tip needles (TSK Laboratory, Tochigi, Japan) and at various angles from the bone surface measured with a goniometer: 90 degrees (perpendicular), 45 degrees and 10 degrees (as tangential as possible to bone surface).

Results

Cadaveric dissections of the injection sites showed that no product was located deep to the periosteum in any of the investigated regions. This indicates that all performed injection procedures positioned the product superficial to the periosteum (100%) with a zero‐success rate of subperiosteal injections.

Conclusion

In the setting of this cadaveric investigation, despite varying needle size and injection angle, subperiosteal injection could not be achieved. This indicates that the product can spread uncontrolled into more superficial layers yielding an increased risk for adverse aesthetic and vascular events.
Presidential Address: Collateral and Commitment
Authors: DEMARZO PETER M.
Published: July 2019

Optimal dynamic capital structure choice is fundamentally a problem of commitment. In a standard trade‐off setting with shareholder‐debtholder agency conflicts, full commitment counterfactually predicts the firm would rely almost exclusively on debt financing. Conversely, absent commitment a Modigliani‐Miller‐like value irrelevance and policy indeterminacy result holds. Thus, the content of dynamic trade‐off theory must depend on the commitment technology. In this context, collateral is valuable as a low‐cost commitment device. Because ex ante optimal commitments are likely to be suboptimal ex post, observed capital structure dynamics will exhibit hysteresis and depart significantly from standard predictions.
Molecular diagnostics in oral cancer and oral potentially malignant disorders—A clinician’s guide
Authors: Yap Tami , Celentano Antonio , Seers Christine , McCullough Michael J. , Farah Camile S.
Published: July 2019

Current risk stratification of individuals for the development of oral squamous cell carcinoma (OSCC), including those with oral potentially malignant disorders (OPMD), remains based on clinical detection of visibly abnormal mucosa and tissue biopsy with histological assessment for the presence of OSCC or oral epithelial dysplasia (OED). In OPMD, the presence of OED remains the only prognostic tool used in standard care for the development of future OSCC, despite its ample limitations. There is assured potential that the analysis of the genome, transcripts and proteome can provide insight into what is occurring at a cellular level preceding the appearance of clinically observable change. The landscape of the role of the genome and its transcriptome on the development of OSCC and relationships with OPMDs are immense with exploration occurring on several fronts. For clinicians involved in the diagnosis and care of patients with OSCC and OPMD, understanding of commonly used molecular diagnostic techniques is imperative to gain useful insight from the expanding literature investigating the development of OSCC and the relationship with the clinical presentations which encompass OPMDs. Here we present an introduction to molecular diagnostic methods used in the study of OSCC and OPMD.
Targeted magnetic nanoparticle hyperthermia for the treatment of oral cancer
Authors: Legge Christopher J. , Colley Helen E. , Lawson Michelle A. , Rawlings Andrea E.
Published: July 2019

Introduction

Patients with oral squamous cell carcinoma currently experience a five‐year survival rate of approximately 60% with conventional surgical, chemotherapy and radiotherapy treatments. Magnetic hyperthermia offers an alternative treatment method by utilising the heating properties of magnetic nanoparticles to produce thermal ablation of the tumour site when exposed to an alternating magnetic field. In this study, we investigate in vitro if targeted magnetic hyperthermia offers a potential treatment for oral squamous cell carcinoma.

Materials and methods

Magnetic iron oxide nanoparticles, with a biocompatible silica coating, were produced and conjugated with antibodies to target integrin αvβ6, a well‐characterised oral squamous cell carcinoma biomarker. Utilising the heating properties of the magnetic nanoparticles, we exposed them to an alternating magnetic field to produce thermo ablation of tumour cells either negative for or overexpressing integrin αvβ6.

Results

The cell surface biomarker, αvβ6 integrin, was upregulated in tissue biopsies from oral squamous cell carcinoma patients compared to normal tissue. Functionalisation of the silica coating with anti‐αvβ6 antibodies enabled direct targeting of the nanoparticles to αvβ6 overexpressing cells and applying thermal therapy significantly increased killing of the targeted tumour cells compared to control cells.

Conclusion

Combining antibody‐targeting magnetic nanoparticles with thermal ablation offers a promising therapy for the targeted treatment of oral squamous cell carcinoma.
Oral submucous fibrosis in Asian countries
Authors: Peng Qian , Li Hongyuan , Chen Juan , Wang Yuehong , Tang Zhangui
Published: July 2019

Oral submucous fibrosis (OSF) is a chronic, insidious, and progressive oral mucosal disease that affects entire oral cavity and sometimes pharynx. This oral potentially malignant disorder has a high rate of malignant transformation (7%‐30%) to oral squamous cell carcinoma (OSCC), posing global problems for public health. Due to enormous efforts dedicated to this disease in the past decades, there have been significant advances in identification of its etiology and pathogenesis as well as development of corresponding therapeutic approaches, in spite of several challenges. This study reviewed the existing literature concerning OSF in Asian countries, encompassing its etiology, histopathology, pathogenesis, clinical manifestations, diagnosis and differential diagnosis, and treatments. For improving treatment of OSF, the multifactorial etiology analysis, incorporation of effective molecular pathways, cytokines and cells for mechanism illustration, and integration of multidisciplinary modalities were also expounded to guide future research and clinical practice.
Optimal fiscal policy in a model with inherited aspirations and habit formation
Authors: Bouché Stéphane , De Miguel Carlos
Published: July 2019

In this paper, we analyze optimal fiscal policies in an overlapping generations framework, where preferences exhibit aspirations in consumption and environmental quality as well as habit formation. We focus on the second best policies when the government needs to finance a given stream of public expenditures by using distortionary taxes. We derive necessary and sufficient conditions under which the competitive equilibrium is characterized by levels of capital and environmental quality that are too small and a level of labor supply that is too large. Our numerical simulations show that an optimal fiscal policy can be used as an effective stabilization device and that when consumption taxes are fixed, the planner implements maintenance investment and capital income subsidies while financing public spending through labor and fixed consumption taxes.
Repeated jumps from Northwest Africa to the European continent: The case of peripheral populations of an annual plant
Authors: Valtueña Francisco Javier , Fernández‐Mazuecos Mario , Rodríguez‐Riaño Tomás , López Josefa , Ortega‐Olivencia Ana
Published: July 2019

Peripheral populations (i.e., those occurring on the edge of a species’ distribution range) can have different origins and genetic characteristics, and they may be critical for the conservation of genetic diversity. We investigated European peripheral populations of Scrophularia arguta, a widespread, annual plant distributed from Arabia to Northwest Africa and Macaronesia. Only two small disjunct population groups of this species occur in Europe, specifically in West‐Central and Southeast Iberia. To disclose the origin of these populations and determine their importance for the conservation of S. arguta genetic diversity, we analyzed DNA sequences from two nuclear and two plastid regions and amplified fragment length polymorphism markers in populations sampled mainly across the western distribution range of the species, and modeled the species distribution under present and late Quaternary conditions. The analyses revealed the presence of three distinct lineages of S. arguta in Europe, as a result of multiple colonization waves at different times in the Quaternary. Two of these lineages, occurring in Southeast Iberia, are the result of more or less recent dispersal from Northwest Africa. In contrast, West‐Central Iberian populations are strongly differentiated from the remaining range of S. arguta and can be considered as peripheral relict populations. Our study is the first to demonstrate the occurrence of at least three colonizations of the European continent from Africa by a native plant species. The diverse histories and genetic makeup of the resulting populations confirm the importance of peripheral populations, and particularly of ancient relict populations, for the conservation of global genetic diversity in widespread species.
Lecanosticta acicola: A growing threat to expanding global pine forests and plantations
Authors: van der Nest Ariska , Wingfield Michael J. , Janoušek Josef , Barnes Irene
Published: July 2019

Lecanosticta acicolacauses brown spot needle blight (BSNB) ofPinusspecies. The pathogen occurs mostly in the Northern Hemisphere but has also been reported in Central America and Colombia. BSNB can lead to stunted growth and tree mortality, and has resulted in severe damage to pine plantations in the past. There have been increasingly frequent new reports of this pathogen in Europe and in North America during the course of the past 10 years. This is despite the fact that quarantine practices and eradication protocols are in place to prevent its spread.

Taxonomy

Kingdom Fungi; Phylum Ascomycota; Subphylum Pezizomycotina; Class Dothideomycetes; Subclass Dothideomycetidae; Order Capniodales; Family Mycosphaerellaceae; GenusLecanosticta.

Host range and distribution

Lecanostictaspp. occur on variousPinusspecies and are found in North America, Central America, South America (Colombia), Europe as well as Asia.

Disease symptoms

Small yellow irregular spots appear on the infected pine needles that become brown over time. They can be surrounded by a yellow halo. These characteristic brown spots develop to form narrow brown bands that result in needle death from the tips down to the point of infection. Needles are prematurely shed, leaving bare branches with tufts of new needles at the branch tips. Infection is usually most severe in the lower parts of the trees and progresses upwards into the canopies.

Useful websites

The EPPO global database providing information onL. acicola(https://gd.eppo.int/taxon/SCIRAC)

Reference genome ofL. acicolaavailable on GenBank (https://www.ncbi.nlm.nih.gov/genome/?term=Lecanosticta+acicola)

JGI Gold Genome database information sheet ofL. acicolasequenced genome (https://gold.jgi.doe.gov/organism?xml:id=Go0047147)
Lateral root initiation requires the sequential induction of transcription factors LBD16 and PUCHI in Arabidopsis thaliana
Authors: Goh Tatsuaki , Toyokura Koichi , Yamaguchi Nobutoshi , Okamoto Yoshie , Uehara Takeo , Kaneko Shutaro , Takebayashi Yumiko , Kasahara Hiroyuki , Ikeyama Yoshifumi , Okushima Yoko , Nakajima Keiji , Mimura Tetsuro , Tasaka Masao , Fukaki Hidehiro
Published: July 2019

Lateral root (LR) formation in Arabidopsis thaliana is initiated by asymmetric division of founder cells, followed by coordinated cell proliferation and differentiation for patterning new primordia. The sequential developmental processes of LR formation are triggered by a localized auxin response. LATERAL ORGAN BOUNDARIES‐DOMAIN 16 (LBD16), an auxin‐inducible transcription factor, is one of the key regulators linking auxin response in LR founder cells to LR initiation.

We identified key genes for LR formation that are activated by LBD16 in an auxin‐dependent manner. LBD16 targets identified include the transcription factor gene PUCHI, which is required for LR primordium patterning. We demonstrate that LBD16 activity is required for the auxin‐inducible expression of PUCHI.

We show that PUCHI expression is initiated after the first round of asymmetric cell division of LR founder cells and that premature induction of PUCHI during the preinitiation phase disrupts LR primordium formation.

Our results indicate that LR initiation requires the sequential induction of transcription factors LBD16 and PUCHI.
A perspective on risk factors for esophageal adenocarcinoma: emphasis on Helicobacter pylori infection
Authors: Kountouras Jannis , Doulberis Michael , Papaefthymiou Apostolis , Polyzos Stergios A. , Vardaka Elizabeth , Tzivras Dimitri , Dardiotis Efthimios , Deretzi Georgia , Giartza‐Taxidou Evaggelia , Grigoriadis Savas , Katsinelos Panagiotis
Published: July 2019

Gastroesophageal reflux disease (GERD) and the increasing rate of its associated complications, including esophageal adenocarcinoma (EAC), has stimulated a plethora of studies attempting to evaluate provocative and protective factors. Helicobacter pylori (Hp) infection (Hp‐I) was initially considered as a beneficial condition in GERD management based on rather limited data. Large‐scale regional studies revealed an alternative approach, by suggesting a positive relationship between Hp‐I and EAC development. Regarding pathophysiology, Hp‐I induces gastric microbiota disturbances through hypochlorhydria and chronic inflammation, with a subsequent possible effect on the GERD−Barrett's esophagus (BE)−EAC cascade. Additionally, both direct effects on esophageal mucosa and indirect effects on known mechanisms of GERD, such as acid pocket and transient lower esophageal sphincter relaxation, remain to be elucidated. Hp contribution to carcinogenesis is related to oncogenic gastrin, cyclooxygenase‐2, and prostaglandins; Ki‐67 is also expressed and represents an index of BE‐related malignancy. Moreover, Hp‐I is vigorously suggested as a risk factor for metabolic syndrome, which may be the link between Hp‐I and EAC. Although further studies are necessary to establish a pathophysiologic risk between Hp‐I and the GERD−BE−EAC sequence, the theory of Hp protection against GERD seems outdated.
Defining mentoring: a literature review of issues, types, and applications
Authors: Mullen Carol A. , Klimaitis Cindy C.
Published: July 2019

This literature review of contemporary mentoring delineates mentoring definitions and anchors these with explanatory discourse. Select empirical studies spanning 1983–2019 were analyzed, with a focus on education across grade levels. Alternative mentoring issues, types, and applications, also located, are integral to this discussion. While researchers describe what mentoring is, it is also important to clarify what it is not. Traditional definitions of mentoring have been losing traction, with mentoring alternatives forging new possibilities within changing learning and work environments. Contexts of mentoring include a personal–professional relationship to an educational process; an organizational, cultural, and global context; and a systemic reform strategy that builds human capacity. This complex definitional terrain is situated within theoretical mentoring frameworks. Mentoring as deep, equitable learning with social transformative value is illustrated. Science, technology, engineering, and mathematics and other educational examples serve this purpose. Challenges to the field from alternative mentoring theory are discussed for transparency around meanings of mentoring and contributions that advance socially just relationships, organizations, and cultures. The article provides a timely and needed framework to discriminate and differentiate mentoring from other developmental relationships.
VpSTS29/STS2 enhances fungal tolerance in grapevine through a positive feedback loop
Authors: Xu Weirong , Ma Fuli , Li Ruimin , Zhou Qi , Yao Wenkong , Jiao Yuntong , Zhang Chaohong , Zhang Jianxia , Wang Xiping , Xu Yan , Wang Yuejin
Published: July 2019

Accumulation of stilbene phytoalexins stimulates resistance mechanisms against the grapevine fungus Uncinula necator. However, the defensive mechanisms triggered by stilbene synthase (STS) genes, remain largely unknown. Here, we report the function and molecular mechanism of the stilbene synthase gene VpSTS29/STS2 from Vitis pseudoreticulata in the regulation of plant responses to powdery mildew. Stilbene synthesis occurred mainly in root tips and mesophyll cells of transgenic grapevines via transport through the vascular bundles. Overexpression of VpSTS29/STS2 in Vitis vinifera increased the abundance of STSs in mesophyll tissue and resulted in the accumulation of biologically active resveratrol derivatives at the invasion site. Similarly, expression of VpSTS29/STS2 in Arabidopsis increased resistance to Golovinomyces cichoracearum. The VpSTS29/STS2‐expressing Arabidopsis lines showed increased piceid accumulation together with more local hypersensitive reactions, inhibition of mycelial growth, and a reduced incidence of pathogens. Transcriptome profiling analyses demonstrated that VpSTS29/STS2‐induced defences led to reprograming of global gene expression and activation of salicylic acid (SA) signalling, thus increasing expression of WRKY‐MYB transcription factors and other defence response genes. We propose a model for resveratrol‐mediated coordination of defence responses in which SA participates in a positive feedback loop.
The Ambiguity of Kant's Concept of the Highest Good: Finding the Correct Interpretation
Authors: Lin Cheng‐Hao
Published: July 2019

The aim of this paper is to resolve the tension between Kant's doctrine of the highest good and his entire philosophical system. The concept of the highest good is the first major ambiguity of the doctrine. There are three pairs of ambiguities: immanent‐transcendent; justice‐perfection; and individual‐community. They are able to form eight combinations. Corresponding to the various combinations and conceptions of the highest good, interpreters also conceive different reasons for the necessity of the doctrine as well as various conditions of its applicability. For example, some emphasize its religious dimension, whereas others understand it in the political sense. In this paper, I adopt a different approach in understanding the highest good's systematic meaning as the moral confirmation, and suggest that only a transcendent, perfect and communal concept of the highest good can provide the most consistent doctrine. Additionally, it explains the importance of the different branches (such as philosophies of religion and of politics) of Kant's system.
Advancing the symptom science model with environmental health
Authors: Castner Jessica , Amiri Azita , Rodriguez Jeannie , Huntington‐Moskos Luz , Thompson Lisa M. , Zhao Shuang , Polivka Barbara
Published: July 2019

Objective

Globally, indoor and outdoor pollutants are leading risk factors for death and reduced quality of life. Few theories explicitly address environmental health within the nursing discipline with a focus on harmful environmental exposures. The objective here is to expand the National Institutes of Health Symptom Science Model to include the environmental health concepts of environmental endotype (causative pathway) and environmental exposure.

Design

Meleis’ research to theory strategy for theory refinement was used. Research workshop proceedings, environmental health nursing research expert consensus, panelist research trajectories, and review of the literature were utilized as data sources.

Results

Ongoing emphasis on the physical environment as a key determinant of health and theoretical perspectives for including environmental exposures and endotypes in symptom science are presented. Definitions of these concepts, further developed, are provided. Recommendations to strengthen environmental health nursing research and practice through capacity building/infrastructure, methods/outcomes, translational/clinical research, and basic/mechanistic research are included.

Conclusion

The revised model deepens theoretical support for clinical actions that include environmental modification, environmental health education, and exposure reduction. This modification will enable a middle‐range theory and shared mental model to inspire the prioritization of environmental health in nursing leadership, research, practice, and education.
The efficacy of UVA1 phototherapy in psoriasis: Clinical and histological aspects
Authors: Silpa‐archa Narumol , Pattanaprichakul Penvadee , Charoenpipatsin Norramon , Jansuwan Natchaya , Udompunthurak Suthipol , Chularojanamontri Leena , Wongpraparut Chanisada
Published: July 2019

Background

Although ultraviolet A1 (UVA1) phototherapy is available for nearly 30 years, only few studies have been conducted for plaque‐type psoriasis.

Objectives

To determine the efficacy and safety of UVA1 phototherapy in psoriasis by assessing the clinical and histological outcomes.

Methods

This open study enrolled 15 patients with moderate to severe plaque‐type psoriasis. All of the patients had skin type IV. A whole‐body UVA1 device consisting of 24 lamps, was irradiated at a medium dose of 50 J/cm2 three‐times weekly for 30 sessions. Topical and systemic psoriasis treatments were discontinued before and during treatment; patients could only use emollients and antihistamines until 1‐month post‐completion. Psoriasis Area and Severity Index (PASI) scores were determined at baseline; at sessions 10th, 20th and 30th; and 1 month after treatment. Four‐millimetre punch biopsies were obtained from the same psoriasis lesion at baseline and session 30th. Changes in histopathological gradings and polymorphonuclear, lymphocyte and Langerhans cell numbers were monitored.

Results

Twelve patients completed the study. The mean age was 41.3 years (range: 25‐71). The median PASI scores at baseline, session 30th and 1‐month post‐treatment were 16 (8.2, 43.3), 11 (4.4, 43.3) and 9.2 (2.7, 36.4), respectively. Although the PASI scores had improved significantly by 1‐month post‐treatment (P = .006), the histological parameters demonstrated minimal changes. All patients tolerated the phototherapy well and the most common side effect was skin tanning.

Conclusions

While medium‐dose UVA1 phototherapy demonstrated some efficacy in moderate to severe plaque‐type psoriasis. However, it might not be an excellent choice.
The Political Side of Consociationalism Reconsidered: Switzerland between a Polarized Parliament and Delicate Government Collegiality
Authors: Freiburghaus Rahel , Vatter Adrian
Published: July 2019

This paper builds upon the concept of “coalescent elite behaviour” which is crucial in consociational theory, but contested regarding its actual conceptualization. Contrary to Lijphart's (1968) original assumption that elites are generally committed to an “overarching cooperation”, we hypothesize that institutional venues must be taken in account. Thus, the aim of this paper is twofold: Conceptually, we try to clarify the nature of “amicable agreement” regarding two core institutions (i.e. parliament, government), and regarding executive‐legislative relations. Empirically, we follow a two‐step empirical approach that combines a cross‐time comparison of the decision‐making process regarding the revision of the Swiss basic pension scheme (AHV) with a cross‐case assessment following Fischer's two‐dimensional typology. More generally, our findings serve to inductively refine the “political side” of consociationalism.
Does Private Schooling Affect Noncognitive Skills? International Evidence Based on Test and Survey Effort on PISA
Authors: DeAngelis Corey A.
Published: July 2019

Objective

This study estimates the effects of private schooling on noncognitive outcomes as measured by patterns of student responses on exams and surveys.

Methods

I use Programme for International Student Assessment (PISA) data from over 300,000 individual students within 44 countries in 2009 and a historical natural experiment to estimate the causal impact of private schooling on student effort. Since nations with larger shares of Catholics in 1900 tend to have larger shares of private schooling today, the study uses the Catholic share of the population in 1900 as an exogenous instrument to predict whether a given child is in a private school in 2009.

Results

The results suggest that private schooling increases student effort on PISA tests, as measured by test decline, while decreasing diligence on student surveys, as measured by careless answer patterns and nonresponse rates. In addition, I find that private schooling substantially increases PISA test scores, and that stronger noncognitive skills are associated with higher PISA scores.

Conclusion

Since this is the first study to connect school sector to these noncognitive outcomes, additional research on this topic is especially welcome. More research is also needed on the validity of measures such as test decline, careless answer patterns, and nonresponse rates.
Clinical Debrief: learning and well‐being together
Authors: Farrington Rebecca , Collins Lisa , Fisher Pip , Danquah Adam , Sergeant Jamie
Published: July 2019

Background

Clinical environments can be so stressful to medical students as to be detrimental to their learning and well‐being. Our intervention, Clinical Debrief, integrates learning through clinical experience with the development of positive coping strategies. Students shared cases and experiences during weekly small group classroom discussions, facilitated by general practitioners (from outside their current hospital placement), throughout two consecutive 12‐week blocks of their first clinical year. Alongside enquiry‐based and clinical reasoning learning, we gave students a safe space to reflect on their affect. Our aim was to critically examine students’ views in Clinical Debrief.

Method

Anonymised quantitative and qualitative evaluation data were collected over 3 years using online questionnaires on completion of each 12‐week block. The data relating to psychological supervision were analysed independently and in parallel, using thematic analysis for qualitative data.

We aim to help students develop positive coping mechanisms, promoting empathy,self‐awarenessand wellbeing

Results

A total of 1857 evaluations were extracted (response rate 67%). The median (interquartile range) overall rating for Clinical Debrief sessions was 9 (8–10), where 10 indicates ‘excellent’ and 1 indicates ‘significant improvement needed’. The rating for the supervisory aspects of the sessions and free‐text comments were positive. Students appreciated safe environments, the session structure, facilitator role modelling, transitional support and processing of emotional experiences.

Discussion

Mandatory integrated longitudinal supervision, using trained clinician facilitators, was positively received by students in transition to clinical placements. Normalising the emotional impact of medical work destigmatises distress. Linking clinical reasoning with affective state awareness to contextualise case management, following Mezirow's transformative learning theory, brings added benefit to learning and well‐being. Student demand for the expansion of Clinical Debrief is evidence of success.
Decreased risk of HIV‐associated TB during antiretroviral therapy expansion in rural Eswatini from 2009 to 2016: a cohort and population‐based analysis
Authors: Kerschberger Bernhard , Schomaker Michael , Telnov Alex , Vambe Debrah , Kisyeri Nicholas , Sikhondze Welile , Pasipamire Lorraine , Ngwenya Siphiwe Mavis , Rusch Barbara , Ciglenecki Iza , Boulle Andrew
Published: July 2019

Objectives

This paper assesses patient‐ and population‐level trends in TB notifications during rapid expansion of antiretroviral therapy in Eswatini which has an extremely high incidence of both TB and HIV.

Methods

Patient‐ and population‐level predictors and rates of HIV‐associated TB were examined in the Shiselweni region in Eswatini from 2009 to 2016. Annual population‐level denominators obtained from projected census data and prevalence estimates obtained from population‐based surveys were combined with individual‐level TB treatment data. Patient‐ and population‐level predictors of HIV‐associated TB were assessed with multivariate logistic and multivariate negative binomial regression models.

Results

Of 11 328 TB cases, 71.4% were HIV co‐infected and 51.8% were women. TB notifications decreased fivefold between 2009 and 2016, from 1341 to 269 cases per 100 000 person‐years. The decline was sixfold in PLHIV vs. threefold in the HIV‐negative population. Main patient‐level predictors of HIV‐associated TB were recurrent TB treatment (adjusted odds ratio [aOR] 1.40, 95% confidence interval [CI]: 1.19–1.65), negative (aOR 1.31, 1.15–1.49) and missing (aOR 1.30, 1.11–1.53) bacteriological status and diagnosis at secondary healthcare level (aOR 1.18, 1.06–1.33). Compared with 2009, the probability of TB decreased for all years from 2011 (aOR 0.69, 0.58–0.83) to 2016 (aOR 0.54, 0.43–0.69). The most pronounced population‐level predictor of TB was HIV‐positive status (adjusted incidence risk ratio 19.47, 14.89–25.46).

Conclusions

This high HIV‐TB prevalence setting experienced a rapid decline in TB notifications, most pronounced in PLHIV. Achievements in HIV‐TB programming were likely contributing factors.
MRI has limited agreement with CT in the evaluation of vertebral fractures of the canine trauma patient
Authors: Gallastegui Aitor , Davies Emma , Zwingenberger Allison L. , Nykamp Stephanie , Rishniw Mark , Johnson Philippa J.
Published: July 2019

Complete assessment of vertebral trauma in dogs currently requires CT and MRI for evaluation of the osseous and soft tissue structures that contribute to vertebral stability. Some studies in people have suggested that MRI may be sensitive and specific at detecting vertebral fractures making this potentially a single modality that could be used in spinal trauma evaluation. This study aimed to assess the ability for observers to evaluate vertebral fractures using MRI when compared to CT, which was used as the reference standard. Twenty‐nine dogs with previously diagnosed acute vertebral fractures and four dogs with no vertebral fracture that had undergone sequential CT and MRI were included into the study. One hundred twenty‐eight vertebrae were evaluated for the presence of fractures. Imaging studies were read by two observers blinded to the history. While both observers had similarly high sensitivity and specificity for simple detection of any fractured vertebrae, interobserver agreement was only moderate (κ = 0.584). When evaluations were specifically limited to detection of structurally unstable fractured vertebrae both observers showed improved specificity and interobserver agreement became substantial (κ = 0.650). Complete agreement for exact fracture location between MRI and CT results was only achieved in 14.3‐32.6% of fractured vertebra with up to 79% of fractures being missed in some vertebral structures. This suggests that although MRI may be able to detect the presence of fractured vertebrae, it is not able to replace CT for the complete evaluation of the traumatized spine and documentation of fracture morphology.
Barriers and Facilitators for the Use of NURSING Bedside Handovers: Implications for Evidence‐Based Practice
Authors: Malfait Simon , Eeckloo Kristof , Van Biesen Wim , Van Hecke Ann
Published: July 2019

Background

Previous studies on bedside handovers have identified nurse‐related barriers and facilitators for implementing bedside handovers, but have neglected the existing ward’s nursing care system as an important influencing factor.

Aims

To determine the association between the existing nursing care system (i.e., decentralized, two‐tier, or centralized) on a ward and the barriers and facilitators of the bedside handover.

Methods

Structured individual interviews (N = 106) on 14 nursing wards in eight hospitals were performed before implementation of bedside handovers. The structured interview guide was based on a narrative review. Direct content analysis was used to determine the nursing care system of a ward and the degree to which barriers and facilitators were present. Pearson’s Chi‐square analysis was used to determine whether there were associations between the nursing care systems concerning the presence of barriers and facilitators for implementing bedside handovers.

Results

Twelve barriers and facilitators were identified, of which three are new to literature: the possible loss of opportunities for socializing, collegiality, and overview; head nurse’s role; and role of colleagues. The extent to which barriers and facilitators were present differed across nursing care systems, with the exception of breach of confidentiality (barrier), and an existing structured handover (facilitator). Overall, nurses working in decentralized nursing care systems report fewer barriers against and more facilitators in favor of using bedside handovers than nurses in two‐tier or centralized systems.

Linking Evidence to Action

Before implementing bedside handovers, the context of the nursing care system may be considered to determine the most effective process to implement change. Based on these study findings, implementing bedside handovers could be more challenging on wards with a two‐tier or centralized care system.
Prevalence and characterization of multidrug resistance and variant Salmonella genomic island 1 in Salmonella isolates from cattle, poultry and humans in Iran
Authors: Ghoddusi Arefeh , Nayeri Fasaei Bahar , Zahraei Salehi Taghi , Akbarein Hesameddin
Published: July 2019

Salmonella enterica is a common food‐borne pathogen with occasional multidrug resistance (MDR). Salmonella genomic island (SGI1) is a horizontally transmissible genomic island, containing an MDR gene cluster. All Salmonella serotypes are public health concern, although there is an additional concern associated with those that harbour SGI1. In Iran, there are no data on the presence of SGI1 variants in Salmonella isolates. The present study was conducted to identify MDR‐ and SGI1‐carrying Salmonella strains isolated from various sources and to compare their genetic relatedness between human and animal sources. In total, 242 Salmonella isolates collected from chicken, cattle, and humans from 2008 through 2014 were studied. The isolates were tested for resistance to 14 antimicrobials via the disc diffusion method. They were also tested for the presence of SGI1 variants via PCR, and genetic relatedness was evaluated based on pulsed‐field gel electrophoresis (PFGE). Resistance to at least one antimicrobial agent was observed in 132 (54%) Salmonella isolates (n = 242), while more than 40% of the isolates showed MDR. Based on PCR analysis, eight variants of SGI1, including SGI1, SGI1‐B, SGI1‐C, SGI1‐D, SGI1‐F, SGI1‐I, SGI1‐J and SGI1‐O, were found in both human and animal isolates. Statistical analysis revealed no significant difference in the prevalence of SGI1 variants between human and animal isolates (p > 0.05). Macrorestriction PFGE analysis of the isolates with the same SGI1 variant and resistance patterns revealed genetic relatedness ranging from 70% to 100% among human and animal isolates. According to our review, this is the first documentation of SGI1 in Salmonella isolates in Iran. The presence of similar SGI1 variants in both humans and animals, along with their related PFGE patterns, suggests that food‐producing animals may be a source of MDR Salmonella isolates in Iran.