bluuebunny/crossref_metadata_2025 huggingface dataset:
Canadian smart cities: Are we wiring new citizen‐local government interactions?
Authors: Johnson Peter A. , Acedo Albert , Robinson Pamela J.
Published: May 2020

Governments around the world are developing smart city projects, with the aim to realize diverse goals of increased efficiency, sustainability, citizen engagement, and improved delivery of services. The processes through which these projects are conceptualized vary dramatically, with potential implications for how citizens are involved or engaged. This research examines the 20 finalists in the Canadian Smart Cities Challenge, a Canadian federal government contest held from 2017 to 2019 to disburse funding in support of smart city projects. We analyzed each of the finalist proposals, coding all instances of citizen engagement used to develop the proposal. A significant majority of the proposals used traditional types of citizen engagement, notably citizen meetings, round tables, and workshops, to develop their smart city plans. We also noted the use of transactional forms of citizen engagement, such as apps, and the use of social media. Despite the general rhetoric of innovation in the development of smart cities, this research finds that citizens are most commonly engaged in traditional ways. This research provides cues for governments that are developing smart city projects, placing an emphasis on the importance of the process of smart city development, and not simply the product.
Next generation sequencing analysis of consecutive Russian patients with clinical suspicion of inborn errors of immunity
Authors: Suspitsin Evgeny N. , Guseva Marina N. , Kostik Mikhail M. , Sokolenko Anna P. , Skripchenko Nataliya V. , Levina Anastasia S. , Goleva Olga V. , Dubko Margarita F. , Tumakova Anastasia V. , Makhova Maria A. , Lyazina Lidiya V. , Bizin Ilya V. , Sokolova Natalia E. , Gabrusskaya Tatiana V. , Ditkovskaya Liliya V. , Kozlova Olga P. , Vahliarskaya Svetlana S. , Kondratenko Irina V. , Imyanitov Evgeny N.
Published: May 2020

Primary immune deficiencies are usually attributed to genetic defects and, therefore, frequently referred to as inborn errors of immunity (IEI). We subjected the genomic DNA of 333 patients with clinical signs of IEI to next generation sequencing (NGS) analysis of 344 immunity‐related genes and, in some instances, additional genetic techniques. Genetic causes of the disease were identified in 69/333 (21%) of subjects, including 11/18 (61%) of children with syndrome‐associated IEIs, 45/202 (22%) of nonsyndromic patients with Jeffrey Modell Foundation (JMF) warning signs, 9/56 (16%) of subjects with periodic fever, 3/30 (10%) of cases of autoimmune cytopenia, 1/21 (5%) of patients with unusually severe infections and 0/6 (0%) of individuals with isolated elevation of IgE level. There were unusual clinical observations: twins with severe immunodeficiency carried a de novo CHARGE syndrome‐associated SEMA3E c.2108C>T (p.S703L) allele; however, they lacked clinical features of CHARGE syndrome. Additionally, there were genetically proven instances of Netherton syndrome, Х‐linked agammaglobulinemia, severe combined immune deficiency (SCID), IPEX and APECED syndromes, among others. Some patients carried recurrent pathogenic alleles, such as AIRE c.769C>T (p.R257*), NBN c.657del5, DCLRE1C c.103C>G (p.H35D), NLRP12 c.1054C>T (p.R352C) and c.910C>T (p.H304Y). NGS is a powerful tool for high‐throughput examination of patients with malfunction of immunity.
The influence of titanium base abutments on peri‐implant soft tissue inflammatory parameters and marginal bone loss: A randomized clinical trial
Authors: Pamato Saulo , Honório Heitor Marques , da Costa Jorge Alexandre , Traebert Jefferson Luiz , Bonfante Estevam Augusto , Pereira Jefferson Ricardo
Published: May 2020

Background

Some techniques in implant dentistry have been suggested that may potentially alter peri‐implant soft and hard tissue parameters.

Purpose

To evaluate the peri‐implant soft tissue inflammatory parameters and crestal bone loss around titanium base abutments.

Materials and Methods

Fifty two implants were placed in 21 patients and restored by single crowns. Subjects were randomly allocated into two groups: cement‐retained abutment (n = 24) and titanium base (n = 28). Peri‐implant probing depth, and mesial and distal marginal bone loss (MBL) were evaluated at implant loading (T1), 6 and 12 months (T2 and T3, respectively). Peri‐implant bleeding‐on‐probing was evaluated at T2 and T3. Two‐way repeated measures analysis of variance, Tukey test, Man Whitney, and Pearson correlation were performed for statistical analysis at P < .05.

Results

The mean difference of peri‐implant MBL from implant installation to 12 months in function was 1.15 ± 0.82 mm for the cement‐retained group, and 1.23 ± 0.79 mm for the titanium base group. No statistically significant difference was found between the two groups for clinical and radiographic peri‐implant evaluation.

Conclusions

Titanium base abutments present no negative effect on peri‐implant soft tissue and MBL. When used to support single crowns, both approaches performed likewise regarding clinical and radiographic parameters.
BeingIn FrontIs Good—But Where IsIn Front? Preferences for Spatial Referencing Affect Evaluation
Authors: Bender Andrea , Teige‐Mocigemba Sarah , Rothe‐Wulf Annelie , Seel Miriam , Beller Sieghard
Published: May 2020

Speakers of English frequently associate location in space with valence, as in moving up and down the “social ladder.” If such an association also holds for the sagittal axis, an object “in front of” another object would be evaluated more positively than the one “behind.” Yet how people conceptualize relative locations depends on which frame of reference (FoR) they adopt—and hence on cross‐linguistically diverging preferences. What is conceptualized as “in front” in one variant of the relative FoR (e.g.,translation) is “behind” under another variant (reflection), and vice versa. Do such diverging conceptualizations of an object's location also lead to diverging evaluations? In two studies employing an implicit association test, we demonstrate, first, that speakers of German, Chinese, and Japanese indeed evaluate the object “in front of” another object more positively than the one “behind.” Second, and crucially, the reversal of which object is conceptualized as “in front” involves a corresponding reversal of valence, suggesting an impact of linguistically imparted FoR preferences on evaluative processes.
AFF1 inhibits adipogenic differentiation via targeting TGM2 transcription
Authors: Chen Yaqian , Wang Yuan , Lin Weimin , Sheng Rui , Wu Yunshu , Xu Ruoshi , Zhou Chenchen , Yuan Quan
Published: May 2020

Objectives

AF4/FMR2 family member 1 (AFF1), known as a central scaffolding protein of super elongation complex (SEC), regulates gene transcription. We previously reported that AFF1 inhibited osteogenic differentiation of human mesenchymal stromal/stem cells (hMSCs). However, its role in adipogenic differentiation has not been elucidated.

Materials and methods

hMSCs and 3T3‐L1 pre‐adipocytes were cultured and induced for adipogenic differentiation. Small interfering RNAs (siRNAs) were applied to deplete AFF1 while lentiviruses expressing HA‐Aff1 were used for overexpression. Oil Red O staining, triglyceride (TAG) quantification, quantitative real‐time PCR (qPCR), Western blot analysis, immunofluorescence staining, RNA sequencing (RNA‐seq) analysis and ChIP‐qPCR were performed. To evaluate the adipogenesis in vivo, BALB/c nude mice were subcutaneously injected with Aff1‐overexpressed 3T3‐L1 pre‐adipocytes.

Results

AFF1 depletion leads to an enhanced adipogenesis in both hMSCs and 3T3‐L1 pre‐adipocytes. Overexpression of Aff1 in 3T3‐L1 cells results in the reduction of adipogenic differentiation and less adipose tissue formation in vivo. Mechanistically, AFF1 binds to the promoter region of Tgm2 gene and regulates its transcription. Overexpression of Tgm2 largely rescues adipogenic differentiation of Aff1‐deficient cells.

Conclusions

Our data indicate that AFF1 inhibits adipogenic differentiation by regulating the transcription of TGM2.
The importance of reliable monitoring methods for the management of small, isolated populations
Authors: Elliot Nicholas B. , Bett Alice , Chege Monica , Sankan Kasaine , de Souza Nadia , Kariuki Linus , Broekhuis Femke , Omondi Patrick , Ngene Shadrack , Gopalaswamy Arjun M.
Published: May 2020

To effectively manage wildlife populations, it is essential to reliably estimate their abundance. This is particularly the case for small, isolated populations, which are vulnerable to extirpation. Lake Nakuru National Park in Kenya is one such small, isolated area where an introduced population of African lions (Panthera leo) is vulnerable to genetic degradation and catastrophic events. A founder population of six individuals was introduced between 1984 and 1992, with no further recorded immigration. We used Bayesian spatially‐explicit capture–recapture models to estimate lion density and abundance based on unstructured spatial sampling. For individuals over the age of 1 year, posterior mean lion density was estimated to be 6.75 (mode = 5.93, posterior SD = 0.92) individuals/100 km2, with a mean abundance of 11.37 (mode = 10, posterior SD = 1.54), and a sex ratio of 1.38♀:1♂. Previous reports provided abundance figures much higher than ours. However, our estimates are the result of the first scientifically robust survey and we discuss why they should be viewed as a baseline rather than being suggestive of population decline, and how the discrepancy highlights the need for regular systematic surveys using a standardized framework. Given the small population size and prolonged genetic isolation, we provide long‐term management recommendations to secure this lion population.
Model for early allograft function is predictive of early graft loss in donation after circulatory death liver transplantation
Authors: Richards James A. , Sherif Ahmed E. , Butler Andrew J. , Hunt Fiona , Allison Michael , Oniscu Gabriel C. , Watson Christopher J. E.
Published: May 2020

Donation after circulatory death (DCD) liver transplantation is associated with higher rates of graft loss. In this paper, we explored whether the Model for Early Allograft Function (MEAF) predicted outcome in DCD liver transplantation. We performed a retrospective analysis of prospectively collected data from all adult DCD (Maastricht 3) livers transplanted in Cambridge and Edinburgh between 1 January 2011 and 30 June 2017, excluding those undergoing any form of machine perfusion. 187 DCD liver transplants were performed during the study period. DCD liver transplants with a lower MEAF score had a significantly better survival compared to those with a high MEAF score (Mantel‐Cox P < .0001); this was largely due to early graft loss. Beyond 28 days post‐transplant, there were no significant long‐term graft or patient survival differences irrespective of the grade of MEAF (Mantel‐Cox P = .64 and P = .43, respectively). The MEAF score correlated with the length of ICU (P = .0011) and hospital stay (P = .0007), but did not predict the requirement for retransplantation for ischemic cholangiopathy (P = .37) or readmission (P = .74). In this study, a high MEAF score predicted early graft loss, but not the subsequent need for re‐transplantation or late graft failure as a result of intrahepatic ischemic bile duct pathology.
Persistence of Antipsychotic Use After Clozapine Discontinuation: A Real‐World Study Across Antipsychotics
Authors: Stam Noraly , Taipale Heidi , Tanskanen Antti , Isphording Luka , Okhuijsen‐Pfeifer Cynthia , Schuiling‐Veninga Catharina C.M. , Bos Jens H.J. , Bijker Bert J. , Tiihonen Jari , Luykx Jurjen J.
Published: May 2020

Although clozapine treatment is often discontinued due to limited efficacy or low tolerability, there is a lack of guidelines and evidence on treatment options after discontinuation of clozapine in patients with schizophrenia. Persistence has proven to be an adequate indicator for treatment effectiveness in patients with schizophrenia. The aim of this study was, therefore, to compare persistence of antipsychotic use between antipsychotic treatment options in patients after stopping clozapine treatment. Registry data from a prescription database representative of the Dutch population (1996–2017) was collected to investigate persistence in patients with schizophrenia who had been using clozapine for ≥ 90 days. Persistence with antipsychotics after clozapine discontinuation was analyzed using Cox‐proportional hazard regression models. Our study population consisted of 321 participants, of whom 138 re‐initiated clozapine and 183 started some other antipsychotic in the year after clozapine discontinuation (N = 518 antipsychotic use periods, N = 9,178 months). Second‐generation antipsychotics (SGAs) as a group were associated with better persistence compared to first‐generation antipsychotics (adjusted hazard ratio (aHR), 0.73; 95% confidence interval (CI) 0.57–0.93; P = 0.011). Compared with other antipsychotics, the following oral monotherapy antipsychotics were associated with significantly better persistence: restarting clozapine (aHR 0.48; 95% CI 0.32–0.71; P < 0.001) and switching to risperidone (aHR 0.52; 95% CI 0.32–0.84; P = 0.008) or olanzapine (aHR 0.55; 95% CI 0.35–0.87; P = 0.010). Sensitivity analyses confirmed the results. In conclusion, oral SGAs are associated with better persistence than alternative antipsychotic treatment options in patients discontinuing clozapine for undefined reasons. Especially clozapine (except in those with previous serious adverse reactions to clozapine), olanzapine and risperidone should be considered as oral monotherapy for these patients.
UNHCR and LGBTI refugees in Kenya: the limits of ‘protection’
Authors: Pincock Kate
Published: May 2020

This paper problematises the framing and implementation of protection of lesbian, gay, bisexual, transgender, and intersex (LGBTI) refugees in Kenya by the United Nations Refugee Agency (UNHCR). Despite increased international attention being paid to them, the extant literature focuses on asylum‐seeking at Western borders; there is a dearth of scholarship on LGBTI refugees’ experiences in first countries of asylum in the Global South. Building on essential humanitarian governance literature, the paper suggests that how protection is framed by UNHCR, and practical restrictions on the implementation of protection in Kenya, leave LGBTI refugees unsafe. Yet, their own attempts to secure protection, often drawing on the same human rights discourse that UNHCR utilises in its guidance, renders them even less ‘protectable’ by UNHCR and Kenyan activists. This paper argues for a more critical and contextualised approach to ‘protection’ as a form of humanitarian assistance, given its place within the broader dynamics of global refugee governance.
What psychosocial interventions work to reduce hospital admissions in people with diabetes and elevated HbA1c: a systematic review of the evidence
Authors: Moulson H. , Sanders S. , Coppin S. , Meyrick J.
Published: May 2020

Background

Diabetes is a chronic condition that can lead to devastating complications if not managed effectively. Individuals with elevated HbA1c are at higher risk of developing complications resulting in diabetes‐related hospital admissions, an additional pressure and expense for healthcare systems.

Aim

To systematically review evidence of the effectiveness of psychosocial interventions among individuals with elevated HbA1c, as indicated by hospital admissions.

Methods

Electronic databases (MEDLINE, PsychINFO, CINAHL, AMED, Embase and Scopus) were used to identify studies systematically. Studies were screened against eligibility criteria and included if they evaluated the effectiveness of a psychosocial intervention on diabetes‐related hospital admissions in individuals with elevated HbA1c. Risk of bias was assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies, and a narrative synthesis was conducted.

Results

Of 15 362 studies, five were included in the review. Psychosocial interventions were found to significantly reduce diabetes‐related hospital admissions in four of these studies and interventions involving psychotherapy in particular were found to reduce admissions. The methodological quality of studies ranged from weak to moderate, due to lack of blinding, weak study design and issues with withdrawals and drop‐outs.

Conclusions

Psychosocial interventions may reduce diabetes‐related hospital admissions in individuals with elevated HbA1c; however, due to variability in methodological rigour, the conclusion remains tentative. Further research targeting this group, particularly within the adult population, is recommended. (PROSPERO registration number: CRD42019133456).
Asymmetric response of forest and grassy biomes to climate variability across the African Humid Period: influenced by anthropogenic disturbance?
Authors: Phelps Leanne N. , Chevalier Manuel , Shanahan Timothy M. , Aleman Julie C. , Courtney‐Mustaphi Colin , Kiahtipes Christopher Albert , Broennimann Oliver , Marchant Rob , Shekeine John , Quick Lynne J. , Davis Basil A. S. , Guisan Antoine , Manning Katie
Published: May 2020

A comprehensive understanding of the relationship between land cover, climate change and disturbance dynamics is needed to inform scenarios of vegetation change on the African continent. Although significant advances have been made, large uncertainties exist in projections of future biodiversity and ecosystem change for the world's largest tropical landmass. To better illustrate the effects of climate–disturbance–ecosystem interactions on continental‐scale vegetation change, we apply a novel statistical multivariate envelope approach to subfossil pollen data and climate model outputs (TraCE‐21ka). We target paleoenvironmental records across continental Africa, from the African Humid Period (AHP: ca 14 700–5500 yr BP) – an interval of spatially and temporally variable hydroclimatic conditions – until recent times, to improve our understanding of overarching vegetation trends and to compare changes between forest and grassy biomes (savanna and grassland). Our results suggest that although climate variability was the dominant driver of change, forest and grassy biomes responded asymmetrically: 1) the climatic envelope of grassy biomes expanded, or persisted in increasingly diverse climatic conditions, during the second half of the AHP whilst that of forest did not; 2) forest retreat occurred much more slowly during the mid to late Holocene compared to the early AHP forest expansion; and 3) as forest and grassy biomes diverged during the second half of the AHP, their ecological relationship (envelope overlap) fundamentally changed. Based on these asymmetries and associated changes in human land use, we propose and discuss three hypotheses about the influence of anthropogenic disturbance on continental‐scale vegetation change.
Anagrelide in Essential Thrombocythemia (ET): Results from 150 patients over 25 years by the “Ph1‐negative Myeloproliferative Neoplasms Latium Group”
Authors: Mazzucconi Maria Gabriella , Baldacci Ermina , Latagliata Roberto , Breccia Massimo , Paoloni Francesca , Di Veroli Ambra , Cedrone Michele , Anaclerico Barbara , Villivà Nicoletta , Porrini Raffaele , Montefusco Enrico , Andriani Alessandro , Montanaro Marco , Scaramucci Laura , Spadea Antonio , Rago Angela , Cimino Giuseppe , Spirito Francesca , Santoro Cristina
Published: May 2020

Background and aims

Anagrelide is a drug effective in reducing platelet counts in essential thrombocythemia (ET) and Ph1‐negative myeloproliferative neoplasms. The aim of this study was to evaluate the real‐life use of anagrelide in patients with ET followed over 25 years at the Haematological Institutes belonging to “Ph1‐negative Myeloproliferative Neoplasms Latium Group.”

Patients and methods

Eligibility criteria were diagnosis of ET and treatment with anagrelide. Data were collected through an ad hoc case report form.

Results

One hundred and fifty patients received anagrelide for a median time of 7.4 years (0.1‐23.2). Anagrelide was administered as first‐line therapy in 34.7% of patients, as second‐line in 52% and as third‐line in 13.3%: 85.4% responded to therapy. Sixty‐eight/136 evaluable patients reported side effects: palpitations, peripheral vasodilation, anaemia, diarrhoea and gastric distress. Fourteen thrombotic (arterial 10, venous 4) and 51 bleeding events (minor 48, major 3) occurred. Sixteen/150 (10.6%) patients developed secondary myelofibrosis and 3/150 (2%) an acute myeloid leukaemia.

Conclusions

In our experience, anagrelide is an effective drug in reducing platelet levels in a high percentage of patients with ET. It is especially addressed to younger people. A careful assessment of the thrombotic risk and monitoring of cardiac function, at diagnosis and during follow‐up, is mandatory.
Nurses’ job satisfaction during the mass gathering of the Hajj 2018 in Saudi Arabia
Authors: Banaser Manal , Ghulman‬ Fatimah , Almakhalas Hadi , Alghamdi Mohammad
Published: May 2020

Aim

To explore job satisfaction of nurses during the Hajj season 2018 in Saudi Arabia, determine predictors of nurses’ job satisfaction and inform future healthcare provision and policy.

Background

Mass gatherings of large numbers of people inevitably pose unique public health concerns and challenges for organizers. A mass gathering happens annually in Saudi Arabia during the Hajj pilgrimage. There was a paucity of evidence regarding nurses’ experiences during Hajj. This gap in knowledge needed to be addressed.

Methods

A cross‐sectional survey was conducted in 198 nurses across 12 healthcare settings along the Hajj pilgrimage route. A 24‐item Nurses’ Job Satisfaction Questionnaire was developed exploring six domains: supervision, nature of work, retention, communication, workload and co‐workers.

Results

Nurses reported a high level of job satisfaction. All six domains were strong predictors of job satisfaction. Nurses reported the lowest level of job satisfaction when assessed against the items ‘multiple policies and procedures that were perceived as complicating nursing work’, ‘incompetence of other people they work with’ and ‘too much burden at work’.

Conclusion

Job satisfaction levels for nurses during Hajj 2018 appeared higher than during previous Hajj pilgrimages, probably influenced by the additional healthcare measures put in place during Hajj 2018, such as improved technology.

Implications for nursing policy and practice

Hajj‐specific skills training must be designed to enhance the knowledge, competencies and capabilities of nurses. Policies and procedures must prevent heavy workloads and avoid complicating nurses’ work during Hajj. Improvements to the nurse work environment should focus on evidence‐based interventions promoting effective resource planning, interprofessional relationships and communication, for instance via innovative, technological approaches. These findings can be shared with organizers of other mass gatherings worldwide.
A randomized controlled clinical trial comparing the use of displacement cords and aluminum chloride paste
Authors: Bennani Vincent , Aarts John M. , Brunton Paul
Published: May 2020

Objectives

This clinical study measured the change in opening and height of the displaced gingiva using paste and cord retraction materials for definitive impression making of natural teeth and assessed if they were comparable and clinically acceptable.

Methods

Impressions of 4 maxilla premolars from 10 participants were taken using a split‐mouth protocol. All participants were free of periodontal disease, had a thick biotype, a minimal of 3 mm height of keratinized gingival tissue and gingival sulci depths of 2 mm. The bleeding index (BI), gingival index (GI) plaque index (PI), sulcular depth, level of attachment and tooth sensitivity were recorded at baseline, just after retraction, at 24 hours and at 2 weeks. Impressions were poured in stone and then after initial analysis were cross‐sectioned to allow measurements of the gingival height change and gap size to be recorded.

Results

The paste produced a slightly smaller gap compared to the cord (0.041 mm less, P = .014) whilst the mean displacement for the cord was 0.282 mm and paste was 0.241 mm respectively. Gingival height with the paste was 0.047 mm lower than that achieved by the cord (P = .208).

Conclusions

Cord and paste retraction produced comparable clinically acceptable gingival gaps, with the cord producing statistically larger gap size.

Clinical significance

The cord and paste retraction materials produced comparable clinically acceptable gingival retraction.
Intraoral repair of a chipped porcelain‐zirconia restoration
Authors: Meirelles Potira Dalques , da Rocha Larissa Simião , Pecho Oscar E. , Della Bona Alvaro , Benetti Paula
Published: May 2020

Objective

Ceramic fracture is an undesirable outcome of the rehabilitation with fixed partial dentures (FPD), mainly because it may involve additional cost and clinical time for intraoral repair or replacement of the restoration. This clinical report describes a 5 years survival intraoral repair of a chipped porcelain veneered zirconia framework restoration using a resin‐based composite.

Clinical considerations

A FPD of porcelain veneered zirconia was made. After 18 months, the FPD presented a porcelain chip (porcelain fracture without exposure to the zirconia structure) on the buccal side of the pontic. An epoxy resin replica of the fractured surface was obtained and was examined under scanning electron microscopy. Fracture origin was found at the cervical area of the pontic. Intraoral repair by bonding the chipped fragment back in place was performed. After 15 days, the porcelain fragment debonded without patient knowledge and the fragment was lost. Then, intraoral repair using composite resin to restore the fractured area was performed and is still in function to date.

Conclusions

Based on the 5‐years survival of the performed intraoral repair, the composite resin reconstruction technique has shown to be an adequate alternative treatment for fractured FPD.

Clinical significance

A resin composite repair of the fracture site can be performed in one clinical session, using much less time and cost than for the replacement of FPD. This clinical case survived 5 years to date.
Microencapsulation of Lactobacillus plantarum by spray drying with mixtures of Aloe vera mucilage and agave fructans as wall materials
Authors: Ceja‐Medina Luis Isaac , Ortiz‐Basurto Rosa Isela , Medina‐Torres Luis , Calderas Fausto , Bernad‐Bernad Maria Josefa , González‐Laredo Ruben Francisco , Ragazzo‐Sánchez Juan Arturo , Calderón‐Santoyo Montserrat , González‐ávila Marisela , Andrade‐González Isaac , Manero Octavio
Published: May 2020

In this work, a spray‐drying process is used to encapsulate a probiotic strain of Lactobacillus plantarum with mixtures of Aloe vera mucilage (AVM) (Aloe barbadensis Miller) and agave fructans of high degree of polymerization (AFHDP). Physicochemical properties of the powders reveal moisture contents lower than 10% and water activity between 0.195 and 0.3, suggesting stability during storage. A non‐Newtonian shear‐thinning behavior arises in the reconstituted powders under steady shear flow and viscosity is shown to depend on the concentration, pH, and temperature. A predominant viscous behavior is exhibited in the viscoelastic properties under small amplitude oscillatory flow with equal values of the elastic and viscous moduli at high frequencies (G´ = G´´), suggesting a random coil conformation. Scanning electron microscope observations reveal a spherical microcapsule morphology possessing homogeneous surfaces with modal particle‐size distribution (D [4,3] =21.3 μm). The addition of arabic gum to the AVM‐AFHDP mixtures induces a shift in the glass transition temperature (Tg) to 150°C. Preserved stability of the AVM‐AFHDP functional groups with the probiotic after spray drying reveals the effective encapsulation of the microorganism, as corroborated by transmission electron microscopy and Fourier‐transform infrared. Enhanced microorganism survival rate of 70% in the mixture is recorded, representing an alternative for probiotic encapsulation.

PRACTICAL APPLICATIONS

Nowadays, the use of mixtures of prebiotic biopolymers as encapsulating wall materials is highly appreciated by the food and pharmaceutical industry. This research demonstrated that mixtures of Aloe vera mucilage and agave fructans are suitable for the microencapsulation of L. plantarum through studies on their rheological, morphological, and calorimetric properties. High survival rates and stable powders are obtained in samples subjected to spray drying. Results of this investigation may help to develop new delivery drug systems, which are able to protect bioactive compounds or probiotic cells through the gastrointestinal tract. Increasing health benefits, including probiotic and symbiotic effects, are expected with the intake of dietary fibers.
Pain Management with Early Regional Anesthesia in Geriatric Hip Fracture Patients
Authors: Garlich John M. , Pujari Amit , Moak Zachary , Debbi Eytan , Yalamanchili Raj , Stephenson Sam , Stephan Stephen , Polakof Landon , Little Milton , Moon Charles , Anand Kapil , Lin Carol A.
Published: May 2020

BACKGROUND

Geriatric hip fracture patients are susceptible to the adverse effects of opioid‐induced analgesia. Fascia iliaca blocks (FIBs) have emerged as an analgesic technique for this population. There are limited data on a preoperative FIB's effect on perioperative opioid intake. We hypothesized that preoperative FIB would reduce perioperative opioid consumption, measured in morphine milliequivalents (MMEs).

DESIGN

This is a prospective observational study.

SETTING

A level 1 trauma center in California.

PARTICIPANTS

From March 2017 to December 2017, patients 65 years and older presenting with a hip fracture received a preoperative FIB and were prospectively observed. This cohort was compared with a historical control.

INTERVENTION

All prospectively enrolled patients were given FIBs. For a single‐shot FIB, a 30‐ to 40‐mL bolus of 0.25% bupivacaine with 1:200,000 epinephrine was injected. For a continuous FIB, a bolus of 10 to 20 mL of 0.2% bupivacaine was injected, followed by a continuous infusion of 0.2% bupivacaine at 6 mL/h ending on the morning of postoperative Day 1.

RESULTS

A total of 725 patients were included in this study, with 92 in the prospectively collected cohort. The mean age of this cohort was 84.2 (standard deviation = 8.4) years, and 69.2% were female. Patients who received a preoperative FIB consumed less MME preoperatively, 18.0 (interquartile range = 6.0–44.5) versus 29.5 (interquartile range = 6.0–56.5) (P = .007), with no change in pain scores. No differences were found in postoperative opioid consumption between groups. There was no difference in MME or pain score in patients with dementia. Subgroup analysis based on fracture pattern (femoral neck and intertrochanteric) demonstrated a significant decrease in preoperative MME consumption in femoral neck fractures only, 12.0 (interquartile range = 5.0–24.0) versus 29.0 (interquartile range = 12.0–59.0) (P < .001).

CONCLUSION

FIBs reduce preoperative opioid intake and have low rates of opioid‐related adverse events in geriatric hip fracture patients.

LEVEL OF EVIDENCE

The level of evidence was II.
Moderators of Cognitive Outcomes from an Exercise Program in People with Mild to Moderate Dementia
Authors: Smith Toby O. , Mistry Dipesh , Lee Hopin , Dosanji Sukhdeep , Finnegan Susanne , Fordham Bethany , Nichols Vivien P. , Sheehan Bart , Lamb Sarah E.
Published: May 2020

BACKGROUND/OBJECTIVES

Our aim was to estimate whether baseline participant variables were able to moderate the effect of an exercise intervention on cognition in patients with mild to moderate dementia.

DESIGN

Subgroup analysis of a multicenter pragmatic randomized controlled trial.

SETTING

Community‐based gym/rehabilitation centers.

PARTICIPANTS

A total of 494 community‐dwelling participants with mild to moderate dementia.

INTERVENTION

Participants were randomized to a moderate‐ to high‐intensity aerobic and strength exercise program or a usual care control group. Experimental group participants attended twice weekly 60‐ to 90‐minute gym sessions for 4 months. Participants were prescribed home exercises for an additional hour per week during the supervised period and 150 minutes each week after the supervised period.

MEASUREMENTS

Multilevel regression model analyses were undertaken to identify individual moderators of cognitive function measured through the Alzheimer Disease Assessment Scale‐Cognitive Subscale score at 12 months.

RESULTS

When tested for a formal interaction effect, only cognitive function assessed by the baseline number cancellation test demonstrated a statistically significant interaction effect (−2.7 points; 95% confidence interval = −5.14 to −0.21).

CONCLUSION

People with worse number cancellation test scores may experience greater progression of cognitive decline in response to a moderate‐ to high‐intensity exercise program. Further analyses to examine whether these findings can be replicated in planned sufficiently powered analyses are indicated.
A Hospital Partnership with a Nursing Home Experiencing a COVID‐19 Outbreak: Description of a Multiphase Emergency Response in Toronto, Canada
Authors: Stall Nathan M. , Farquharson Carolyn , Fan‐Lun Chris , Wiesenfeld Lesley , Loftus Carla A. , Kain Dylan , Johnstone Jennie , McCreight Liz , Goldman Russell D. , Mahtani Ramona
Published: May 2020

Nursing homes have become “ground zero” for the coronavirus disease 2019 (COVID‐19) epidemic in North America, with homes experiencing widespread outbreaks, resulting in severe morbidity and mortality among their residents. This article describes a 371‐bed acute‐care hospital's emergency response to a 126‐bed nursing home experiencing a COVID‐19 outbreak in Toronto, Canada. Like other healthcare system responses to COVID‐19 outbreaks in nursing homes, this hospital–nursing home partnership can be characterized in several phases: (1) engagement, relationship, and trust building; (2) environmental scan, team building, and immediate response; (3) early‐phase response; and (4) stabilization and transition period. J Am Geriatr Soc 68:1376‐1381, 2020.
Dynamic range and background filtering in raster image correlation spectroscopy
Authors: DE METS R. , DELON A. , BALLAND M. , DESTAING O. , WANG I.
Published: May 2020

Raster‐scan image correlation spectroscopy (RICS) enables researchers to measure molecular translational diffusion constants and concentrations from standard confocal laser scanning microscope images and is suitable for measuring a wide range of mobility, especially fast‐diffusing molecules. However, as RICS analysis is based on the spatial autocorrelation function of fluorescence images, it is sensitive to the presence of fluorescent structures within the image. In this study, we investigate methods to filter out immobile or slow moving background structures and their impact on RICS results. Both the conventional moving‐average subtraction‐based method and cross‐correlation subtraction‐based method are rationalized and quantified. Simulated data and experimental measurements in living cells stress the importance of optimizing the temporal resolution of background filtering for reliable RICS measurements. Finally, the capacity of RICS analysis to separate two species is studied.
Relationship between sleep characteristics and markers of inflammation in Swedish women from the general population
Authors: Ghilotti Francesca , Bellocco Rino , Trolle Lagerros Ylva , Thorson Anna , Theorell‐Haglöw Jenny , Åkerstedt Torbjörn , Lindberg Eva
Published: May 2020

Systemic inflammation is thought to mediate the link between sleep and cardiovascular outcomes, but previous studies on sleep habits and inflammation markers have found inconsistent results. This study investigated the relationship between sleep characteristics and C‐reactive protein (CRP), interleukin‐6 (IL‐6) and tumor necrosis factor α (TNFα). A representative sample of 319 Swedish women was randomly selected from the general population for in‐home polysomnography, sleep questionnaire and blood samples. As variables were highly correlated, principal component analysis was used to reduce the number of original variables. Linear regression with log‐transformation of the outcomes (lnCRP, lnIL‐6 and lnTNFα) and quantile regression were fitted to estimate cross‐sectional relationships. Multivariable linear regression models suggested a significant association of insomnia symptoms (self‐reported) with higher lnCRP levels (β = 0.11; 95% confidence interval [CI] = 0.02; 0.21), but not with lnIL‐6 and lnTNFα. From quantile regression analysis we found that a high non‐restorative index (subjective) and insomnia symptoms (self‐reported) were associated with higher values of CRP, especially in the highest quantiles of the CRP distribution (90th percentile: β = 0.71; 95% CI = 0.17; 1.24. β = 1.23; 95% CI = 0.44; 2.02, respectively). Additionally, higher amounts of rapid eye movement (REM) sleep were associated with lower CRP values (90th percentile: β = −0.80; 95% CI = −0.14; −1.46). In conclusion, sleep disturbances (self‐reported), specifically difficulties maintaining sleep and early morning awakenings, but not sleep duration (neither subjective nor objective), were associated with higher CRP levels. No association was found with IL‐6 or TNFα. Elevated REM sleep was associated with lower CRP levels. The results suggest that inflammation might be an intermediate mechanism linking sleep and health in women.
Impact financing and aquaculture: Maryland oyster aquaculture profitability
Authors: Parker Matt , Lipton Douglas , Harrell Reginal M.
Published: May 2020

Aquaculture production of oysters has been carried out in the state of Maryland since the 1890s, with limited success because of restrictive regulations and opposition from the commercial wild industry. After revision of the aquaculture leasing regulations in 2009, the Maryland oyster aquaculture industry expanded more than 10‐fold. In 2010, Maryland Agricultural & Resource Based Industry Development Corporation (MARBIDCO) started the Maryland Shellfish Aquaculture Loan fund, which features a below‐market interest rate, interest‐only repayment period, and partial principle forgiveness. This study evaluated differences in farm‐accounting metrics when comparing self‐financed operations, conventionally funded operations, and operations with MARBIDCO funding on water‐column and bottom‐culture oyster aquaculture operations in Maryland. Bottom‐culture and water‐column operations had significantly higher net present value and internal rates of return when they were MARBIDCO‐financed compared to other sources of capital. This research suggests that oyster aquaculture operations which make use of MARBIDCO financing or similar options should have the best chance of success and highest financial return. The research also suggests that if significant funds could be identified or obtained (i.e., federal, provincial, or private company disaster payments), establishing programs similar to the MARBIDCO Shellfish Aquaculture Loan Fund could help improve the financial profitability of aquaculture operations in other areas of the world.
Developmentally regulated Arabidopsis thaliana susceptibility to tomato spotted wilt virus infection
Authors: Huang Ying , Hong Hao , Xu Min , Yan Jiaoling , Dai Jing , Wu Jianyan , Feng Zhike , Zhu Min , Zhang Zhongkai , Yuan Xuefeng , Ding Xinshun , Tao Xiaorong
Published: May 2020

Tomato spotted wilt virus (TSWV) is one of the most devastating plant viruses and often causes severe crop losses worldwide. Generally, mature plants become more resistant to pathogens, known as adult plant resistance. In this study, we demonstrated a new phenomenon involving developmentally regulated susceptibility of Arabidopsis thaliana to TSWV. We found that Arabidopsis plants become more susceptible to TSWV as plants mature. Most young 3‐week‐old Arabidopsis were not infected by TSWV. Infection of TSWV in 4‐, 5‐, and 6‐week‐old Arabidopsis increased from 9%, 21%, and 25%, respectively, to 100% in 7‐ to 8‐week‐old Arabidopsis plants. Different isolates of TSWV and different tospoviruses show a low rate of infection in young Arabidopsis but a high rate in mature plants. When Arabidopsis dcl2/3/4 or rdr1/2/6 mutant plants were inoculated with TSWV, similar results as observed for the wild‐type Arabidopsis plants were obtained. A cell‐to‐cell movement assay showed that the intercellular movement efficiency of TSWV NSm:GFP fusion was significantly higher in 8‐week‐old Arabidopsis leaves compared with 4‐week‐old Arabidopsis leaves. Moreover, the expression levels of pectin methylesterase and β‐1,3‐glucanase, which play critical roles in macromolecule cell‐to‐cell trafficking, were significantly up‐regulated in 8‐week‐old Arabidopsis leaves compared with 4‐week‐old Arabidopsis leaves during TSWV infection. To date, this mature plant susceptibility to pathogen infections has rarely been investigated. Thus, the findings presented here should advance our knowledge on the developmentally regulated mature host susceptibility to plant virus infection.
Start me up; harnessing natural variation in photosynthetic induction to improve crop yields
Authors: McAusland Lorna , Murchie Erik H.
Published: May 2020

This article is a Commentary on Acevedo‐Siaca et al. (2020), 227: 1097–1108.
An empiricist's guide to modern coexistence theory for competitive communities
Authors: Godwin Casey M. , Chang Feng‐Hsun , Cardinale Bradley J.
Published: May 2020

While many ecological theories have historically invoked niche differences as the primary mechanism allowing species coexistence, we now know that coexistence in competitive communities depends on the balance of two opposing forces: niche differences (ND) that determine how species limit their own growth rate versus that of their competitor, and relative fitness differences (RFD) that establish competitive hierarchies among species. Several different empirical methods have been proposed for quantifying ND and RFD in order to make predictions about coexistence between pairs of species, yet it remains unclear which method(s) are appropriate for a given empirical study and whether or not those methods yield the same information. Here we compare six different empirical methods and provide a practical guide to help empiricists determine which method(s) are best for their study system. We show that there are important tradeoffs between mechanistic methods, which require detailed understanding of species’ resource use and physiology but are more tractable experimentally, and phenomenological methods which do not require this detailed information but can be impractical for some study designs. Finally, we show that the methods do not always yield the same values and therefore we caution against future syntheses that compile these estimates from different empirical studies.
An Intensional Theory of Truth: An Informal Report
Authors: Cook Roy T.
Published: May 2020

Saul Kripke’s theory of truth suffers from expressive limitations – in particular, there are no extensional operators within that framework that allow one to characterize those sentences that fail to receive a truth value within the framework. Especially worrisome is the fact that there is no operator that outputs true on exactly the paradoxical sentences. In this paper I extend Kripke’s approach via the addition of extensional operators, which allows us to characterize many (but not all) such sentences, including the paradoxical ones.
New post‐ACA insurance data highlights health insurer spending on health care quality
Authors: Tice Sirmans E. , Steinorth Petra
Published: May 2020

Following the Patient Protection and Affordable Care Act (ACA), annual financial reports by commercial health insurers include more detailed information on a Supplemental Health Care Exhibit. In this new exhibit, insurers illustrate spending on the provision of medical services and associated expenses. These expenses, which were commonly reported as “claims adjustment” and “general administrative” expenses, can now be allocated to several new categories of expenses associated with combatting fraud and improving patient health care quality. This article illustrates that quality improvement expenses have increased significantly in the individual, small group, and large group markets following implementation of the ACA. Of the five types of quality expenses reported, the greatest proportion of spending has been toward the improvement of health outcomes and the most pronounced increase from 2011 to 2017 has been spending toward increased wellness and health promotion activities, which include activities such as wellness assessments and coaching programs for patients with chronic diseases. Given that the ACA was designed not only to broaden access to health insurance but also to improve health, analysis of the allocations to various types of quality improvement activities highlights the private market's contribution to improving the health of the US population.
A Hybrid Approach for The Stratified Mark-Specific Proportional Hazards Model with Missing Covariates and Missing Marks, with Application to Vaccine Efficacy Trials
Authors: Sun Yanqing , Qi Li , Heng Fei , Gilbert Peter B.
Published: May 2020

Deployment of the recently licensed tetravalent dengue vaccine based on a chimeric yellow fever virus, CYD-TDV, requires understanding of how the risk of dengue disease in vaccine recipients depends jointly on a host biomarker measured after vaccination (neutralization titre—neutralizing antibodies) and on a ‘mark’ feature of the dengue disease failure event (the amino acid sequence distance of the dengue virus to the dengue sequence represented in the vaccine). The CYD14 phase 3 trial of CYD-TDV measured neutralizing antibodies via case–cohort sampling and the mark in dengue disease failure events, with about a third missing marks. We addressed the question of interest by developing inferential procedures for the stratified mark-specific proportional hazards model with missing covariates and missing marks. Two hybrid approaches are investigated that leverage both augmented inverse probability weighting and nearest neighbourhood hot deck multiple imputation. The two approaches differ in how the imputed marks are pooled in estimation. Our investigation shows that nearest neighbourhood hot deck imputation can lead to biased estimation without properly selected neighbourhoods. Simulations show that the hybrid methods developed perform well with unbiased nearest neighbourhood hot deck imputations from proper neighbourhood selection. The new methods applied to CYD14 show that neutralizing antibody level is strongly inversely associated with the risk of dengue disease in vaccine recipients, more strongly against dengue viruses with shorter distances.
Solitary wave solutions to the Isobe‐Kakinuma model for water waves
Authors: Colin Mathieu , Iguchi Tatsuo
Published: May 2020

We consider the Isobe‐Kakinuma model for two‐dimensional water waves in the case of a flat bottom. The Isobe‐Kakinuma model is a system of Euler‐Lagrange equations for a Lagrangian approximating Luke's Lagrangian for water waves. We show theoretically the existence of a family of small amplitude solitary wave solutions to the Isobe‐Kakinuma model in the long wave regime. Numerical analysis for large amplitude solitary wave solutions is also provided and suggests the existence of a solitary wave of extreme form with a sharp crest.