bluuebunny/crossref_metadata_2025 huggingface dataset:
Discomfort/pain due to periodontal and peri‐implant probing with/without platform switching
Authors: Parvini Puria , Saminsky Michael , Stanner Julia , Klum Matthias , Nickles Katrin , Eickholz Peter
Published: July 2019

Objective

To compare discomfort/pain following periodontal probing around teeth and peri‐implant probing around implants with or without platform switching.

Methods

Two dentists recruited and examined 65 patients, each of them exhibiting a dental implant with a contralateral tooth. Only two types of implants were included: one with and one without platform switching. Periodontal and peri‐implant probing depths (PPD) and probing attachment level (PAL) were assessed. Whether implant or tooth was measured first was randomly assigned. Immediately after probing, patients scored discomfort/pain using a visual analogue scale (VAS). The emergence profiles of implant crowns were assessed as angles between interproximal surfaces on radiographs.

Results

Sixty‐five patients (age 69; 63/76 years [median; lower/upper quartile]; 38 females, 11 smokers) were examined. With the exception of mean PPD and PAL (p < .05) clinical parameters (PPD, PAL, bleeding on probing, suppuration) were well balanced between implants and teeth. Peri‐implant probing (VAS: 10; 0.75/16.25) caused significantly (p < .001) more discomfort/pain than periodontal probing (4; 0/10). Logistic regression analysis identified a larger difference between discomfort/pain for peri‐implant and periodontal probing in the maxilla than the mandible (p = .003). Comparing discomfort/pain between implants maxilla (p = .006) and emergence profile (p = .015) were associated with discomfort/pain. Type of implant (with/without platform switching) had no significant effect on discomfort/pain.

Conclusions

Peri‐implant probing caused significantly more discomfort/pain than periodontal probing. Implant design with/without platform switching failed to have a significant effect on discomfort/pain.
The Role of Domestic and Foreign Knowledge Inflows on the Relationship between R&D Portfolio Mix and Innovation Outcomes: An Empirical Study of Manufacturing Firms in an Emerging Economy*
Authors: Choo Adrian S. , Chandrasekaran Aravind , Chinaprayoon Chinawut
Published: July 2019

Manufacturing firms in emerging economies face research and development (R&D) challenges that are quite different from firms in developed economies. Firms in emerging economies complement their internal R&D capabilities by accessing two forms of external knowledge: domestic knowledge from local partners and foreign knowledge from multinationals. Accessing these knowledge sources requires distinct organizational capabilities, and they may differently moderate the relationship between internal R&D investments on exploration and exploitation and innovation outcomes. Exploitation R&D investments refer to investments made on refining products and processes, while exploration R&D investments refer to investments made on designing new products and processes. We examine this issue by combining two waves of surveys from 155 manufacturing firms in Thailand. Results show that relative exploration (i.e., the ratio of R&D investments made toward exploration over sum of exploration and exploitation) exhibits an inverted U‐shaped relationship with the number of process and product innovations developed by the firm. This optimal mix, corresponding to the tipping point of an inverted U‐shaped curve, shifts toward a higher level of relative exploration (i.e., higher exploration and lower exploitation) when manufacturers have more access to domestic knowledge, and shifts toward a lower level of relative exploration (i.e., lower exploration and higher exploitation) when manufacturers have more access to foreign knowledge. Our findings are robust with similar effects on a firm's revenue generated from innovations. Taken together, these results demonstrate how external knowledge flows can moderate, in contrasting ways, the relationship between R&D portfolio mix and innovation outcomes. These findings also imply that inappropriately prioritizing R&D mix can lead to suboptimal innovation outcomes, offering further insights to both practicing managers and academics interested in emerging economy contexts.
Identification of human herpes virus 1 encoded microRNAs in biopsy samples of lower esophageal sphincter muscle during peroral endoscopic myotomy for esophageal achalasia
Authors: Ikebuchi Yuichiro , Kanda Tsutomu , Ikeda Haruo , Yoshida Akira , Sakaguchi Takuki , Urabe Shigetoshi , Minami Hitomi , Nakao Kazuhiko , Kuwamoto Satoshi , Inoue Haruhiro , Isomoto Hajime
Published: July 2019

Esophageal achalasia is a rare chronic debilitating disorder characterized by incomplete lower esophageal sphincter (LES) relaxation and abnormal peristalsis as a result of myenteric plexus degeneration. Although complex interactions among immunity, viruses and inheritance have been proposed, its causes remain unknown. MicroRNAs (miRs) play crucial roles in the regulation of gene expression during pathophysiological processes. Certain viruses such as herpes simplex virus (HSV) encode miRs derived from their own genomes. To determine the underlying relationship of miRNAs to achalasia, we analyzed the expression profile of miRNAs using biopsy samples obtained from LES muscle during peroral endoscopic myotomy. Peroral LES muscle biopsy sampling was uneventfully carried out in our case series of achalasia. Control biopsy tissues were also obtained from LES muscle of patients without symptoms relating to abnormal esophageal motility whose esophagogastric junction was surgically excised. RNA was extracted from biopsy specimens and analyzed using a microarray. Differentially expressed miRNAs in achalasia patients compared to controls were identified and analyzed using reverse transcription quantitative polymerase chain reaction. HSV‐1‐derived hsv1‐miR‐H1 and ‐H18 was significantly overexpressed in achalasia cohorts compared to controls. Correlations between the expression levels of viral miR and the patients’ clinical characteristics including achalasia morphological type, dilatation grading, and disease duration were not identified. Further studies with a larger sample size are needed to replicate the current heuristic identification of neurotropic viral miRs and unravel their functional significance in order to provide new insight linking neurodegenerative etiology in achalasia.
Cryptic species of a water hyacinth biological control agent revealed in South Africa: host specificity, impact, and thermal tolerance
Authors: Paterson Iain D. , Coetzee Julie A. , Weyl Philip , Griffith Tamzin C. , Voogt Nina , Hill Martin P.
Published: July 2019

The discovery that cryptic species are more abundant than previously thought has implications for weed biological control, as there is a risk that cryptic species may be inadvertently released with consequences for the safety of the practice. A cryptic species of a biological control agent released for the control of the invasive alien macrophyte, water hyacinth, Eichhornia crassipes (C. Mart.) Solms. (Pontederiaceae), was recently discovered in South Africa. The two species were considered a single species prior to genetic analysis and interbreeding experiments. The original biological control agent retains the name Eccritotarsus catarinensis (Carvalho) (Heteroptera: Miridae) whereas the new species has been described as Eccritotarsus eichhorniae Henry. In this study, we compared the host specificity, efficacy, and thermal physiologies of the two species. The host specificity of the two species within the Pontederiaceae was very similar and both are safe for release in South Africa. Comparison of the per capita impact of the two species indicated that E. eichhorniae was the more damaging species but this is likely to be influenced by temperature, with E. catarinensis being more effective under lower temperatures and E. eichhorniae being more effective under higher temperatures. Releasing the correct species for the thermal environment of each release site will improve the level of control of water hyacinth in South Africa. This example highlights the need to keep populations of biological control agents from different native range collection localities separate, and to screen for host specificity and efficacy.
Pathogenicity of fungi associated with ash dieback symptoms of one‐year‐old Fraxinus excelsior in Montenegro
Authors: Vemić Aleksandar , Tomšovský Michal , Jung Thomas , Milenković Ivan
Published: July 2019

In addition to Hymenoscyphus fraxineus, two fungi identified as Diaporthe eres aff. and Fusarium sambucinum aff. were also isolated from necrotic bark lesions on declining one‐year‐old Fraxinus excelsior in a forest stand in Montenegro. To examine their involvement in ash decline, a pathogenicity test was performed using under bark inoculations on one‐year‐old Fraxinus excelsior. Hymenoscyphus fraxineus was included as comparison. All three fungal species proved highly pathogenic towards one‐year‐old seedlings although lesion sizes differed significantly between the different species. Hymenoscyphus fraxineus was most aggressive, followed by F. sambucinum aff., while D. eres aff. caused the smallest lesions. This study demonstrates for the first time the ability of isolates in the D. eres and F. sambucinum species complexes to cause decline on one‐year‐old common ash seedlings.
Risk factors for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): antecedent events, lifestyle and dietary habits. Data from the Italian CIDP Database
Authors: Doneddu P. E. , Bianchi E. , Cocito D. , Manganelli F. , Fazio R. , Filosto M. , Mazzeo A. , Cosentino G. , Cortese A. , Jann S. , Clerici A. M. , Antonini G. , Siciliano G. , Luigetti M. , Marfia G. A. , Briani C. , Lauria G. , Rosso T. , Cavaletti G. , Carpo M. , Benedetti L. , Beghi E. , Liberatore G. , Santoro L. , Peci E. , Tronci S. , Cotti Piccinelli S. , Toscano A. , Piccolo L. , Verrengia E. P. , Leonardi L. , Schirinzi E. , Mataluni G. , Ruiz M. , Dacci P. , Nobile‐Orazio E. ,   the Italian CIDP Database Study Group
Published: July 2019

Background and purpose

The role of lifestyle and dietary habits and antecedent events has not been clearly identified in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

Methods

Information was collected about modifiable environmental factors and antecedent infections and vaccinations in patients with CIDP included in an Italian CIDP Database. Only patients who reported not having changed their diet or the lifestyle habits investigated in the study after the appearance of CIDP were included. The partners of patients with CIDP were chosen as controls. Gender‐matched analysis was performed with randomly selected controls with a 1:1 ratio of patients and controls.

Results

Dietary and lifestyle data of 323 patients and 266 controls were available. A total of 195 cases and 195 sex‐matched controls were used in the analysis. Patients eating rice at least three times per week or eating fish at least once per week appeared to be at decreased risk of acquiring CIDP. Data on antecedent events were collected in 411 patients. Antecedent events within 1–42 days before CIDP onset were reported by 15.5% of the patients, including infections in 12% and vaccinations in 1.5%. Patients with CIDP and antecedent infections more often had an acute onset of CIDP and cranial nerve involvement than those without these antecedent events.

Conclusions

The results of this preliminary study seem to indicate that some dietary habits may influence the risk of CIDP and that antecedent infections may have an impact on the onset and clinical presentation of the disease.
Report of a rapid pest risk analysis for Lambdina fiscellaria (Guenée, [1858]) (Lepidoptera: Geometridae) for the island of Ireland
Authors: Tuffen M. G. , Wisdom R. , Nolan S.
Published: July 2019

The hemlock looper, Lambdina fiscellaria (Guenée), is a serious forest pest in North America with three subspecies that vary in their geographical range and larval host preferences. Both broadleaved and coniferous trees are infested, though the largest impacts are on coniferous forestry where trees can be completely defoliated and killed. The pest was identified as a potential threat to forestry on the island of Ireland during a horizon‐scanning exercise to identify pests of Picea sitchensis (Bong.) Carr. (Sitka spruce) and was subject to a rapid pest risk analysis (PRA). Though judged to be unlikely, pathways identified were uncontrolled wood commodities and mosses and lichens harvested from forests in North America and exported for use in ornamental displays. Lambdina fiscellaria is found in a range of climate types, and is likely to be able to complete its lifecycle in the Irish climate – although there is uncertainty concerning its ability to adapt to European trees. Lambdina fiscellaria has only a limited capacity for spread, as virgin females are burdened by their eggs and are poor fliers. This was judged to reduce potential impacts in the PRA area – as the slow rate of spread would provide time to develop monitoring and control methods well ahead of the pest reaching its maximum extent on the island of Ireland. The pest still poses a considerable risk to coniferous forestry not only on the island of Ireland but across the EPPO region where climate is suitable for the pest to establish. Regulation and implementation of phytosanitary measures prevent introduction of the pest should be considered.
What’s ploidy got to do with it? Understanding the evolutionary ecology of macroalgal invasions necessitates incorporating life cycle complexity
Authors: Krueger‐Hadfield Stacy A.
Published: July 2019

Biological invasions represent grave threats to terrestrial, aquatic, and marine ecosystems, but our understanding of the role of evolution during invasions remains rudimentary. In marine environments, macroalgae account for a large percentage of invaders, but their complicated life cycles render it difficult to move methodologies and predictions wholesale from species with a single, free‐living ploidy stage, such as plants or animals. In haplodiplontic macroalgae, meiosis and fertilization are spatiotemporally separated by long‐lived, multicellular haploid and diploid stages, and gametes are produced by mitosis, not meiosis. As a consequence, there are unique eco‐evolutionary constraints that are not typically considered in invasions. First, selfing can occur in both monoicious (i.e., hermaphroditic) and dioicious (i.e., separate sexes) haplodiplontic macroalgae. In the former, fertilization between gametes produced by the same haploid thallus results in instantaneous, genome‐wide homozygosity. In the latter, cross‐fertilization between separate male and female haploids that share the same diploid parent is analogous to selfing in plants or animals. Separate sexes, therefore, cannot be used as a proxy for outcrossing. Second, selfing likely facilitates invasions (i.e., Baker's law) and the long‐lived haploid stage may enable purging of deleterious mutations, further contributing to invasion success. Third, asexual reproduction will result in the dominance of one ploidy and/or sex and the loss of the other(s). Whether or not sexual reproduction can be recovered depends on which stage is maintained. Finally, fourth, haplodiplontic life cycles are predicted to be maintained through niche differentiation in the haploid and diploid stages. Empirical tests are rare, but fundamental to our understanding of macroalgal invasion dynamics. By highlighting these four phenomena, we can build a framework with which to empirically and theoretically address important gaps in the literature on marine evolutionary ecology, of which biological invasions can serve as unnatural laboratories.
Mixed mode fatigue and fracture in planar geometries: Observations onKeqand crack path modelling
Authors: Tavares Sérgio M.O. , Reis Luis , de Freitas Manuel , de Castro Paulo M.S.T.
Published: July 2019

The mixed mode I‐II fatigue and fracture is briefly reviewed, addressing experimental and numerical modelling aspects, and focusing on planar specimens. One major challenge concerns the determination of equivalent stress intensity factor (Keq) in mixed mode situations. Several approaches were compared through the determination ofKeq/KIover a wide range of values ofKI/KIIorKII/KI. Whereas all different approaches converge to the same value asKI/KIIincreases, the same does not happen for largeKII/KI, where differences between values ofKeqpersist. In the regions of 0 < KI/KII < 2 and 0 < KII/KI < 2, no stable trend of results can be defined.

Experimental fatigue crack growth results are presented for Al alloy AA6082‐T6. Compact tension specimens, modified with holes, and four‐point bending specimens under asymmetrical loading promoting mixed mode situations, were subjected to fatigue crack growth tests, where crack path and crack growth rate were measured. The presentation of the fatigue crack growth data was made using a Paris law based uponKeq. Differences in the Paris law constants were found for the differentKeqcriteria.

Recent developments in numerical techniques, as the implementation of the extended finite element method (XFEM) in finite element software packages allows to determine accurately crack paths in mixed mode fracture. This article highlights concepts for mixed‐mode fatigue and fracture and supporting data, identifying challenges still to be overcome.
Estimation of the opening load under variable amplitude loading
Authors: Moreno Belen , Lopez‐Crespo Pablo , Cruces Alejandro S. , Dominguez Jaime
Published: July 2019

The crack opening/closure load concept is widely used to justify the fatigue crack growth behaviour with different load ratios and the load interaction effects. Many experimental techniques have been proposed to measure crack opening/closure load, and amongst them, compliance offset methods are widely used for their simplicity and consistency. In this paper, a modification of the ASTM method is proposed. The new method has a more general applicability as it can be applied to broadband variable amplitude loads. The method is described in detail and is applied on a 2024‐T351 aluminium alloy. The good correlation of the opening load estimated with the new method and the strip‐yield model implemented in Nasgro indicates that the new method could be used as an alternative for the cases where complex variable amplitude loads occur.
Facial skin mapping: from single point bio‐instrumental evaluation to continuous visualization of skin hydration, barrier function, skin surface pH, and sebum in different ethnic skin types
Authors: Voegeli R. , Gierschendorf J. , Summers B. , Rawlings A. V.
Published: July 2019

Dry skin is one of the most important concerns of consumers worldwide. Despite huge efforts over several decades, the personal care industry still does not offer a perfect solution to satisfy the unmet needs of consumers for moisturising treatments in different ethnic groups. The paucity of data for the underlying cellular and biochemical problems in, and the effects of moisturisers on photodamaged facial skin may partly explain this. Mainly, single point measurements are used to understand the effects of products on skin physiology even on surrogate skin sites such as the non‐photodamaged volar forearm. Some groups have developed discontinuous facial maps of skin biophysical properties, however, in 2014 a continuous facial analysis of bio‐instrumental evaluations was developed using a heat map approach. These maps enabled a continuous visualization of features that not only revealed an unexpected complexity of facial skin but also indicated that use of surrogate skin sites for facial skin is inappropriate. We have demonstrated that remarkable gradients of skin hydration, TEWL, skin surface pH and sebum exist within short distances across the face and the gradients are distinctive among different ethnic groups. In addition, these studies have demonstrated that darkly‐pigmented individuals do not necessarily have a better skin barrier function than their less‐pigmented counterparts and that Caucasians have a lower facial skin surface pH compared with more pigmented subjects. Overall, there are no correlations between capacitance, TEWL and skin surface pH including individual topology angle values. Novel 3D camera approaches have also been used to facilitate a more precise assignment of measurement sites and visualisation. The 3D facial colour mappings illustrated precisely the local moisturising effects of a moisturising cream. There were subtle ethnic differences in efficacy that may be related to underlying skin biochemistry and/or ethnic differences in product application. A placebo‐controlled study using conductance measurements in Chinese subjects is also reported. Finally, a new whole face statistical approach has been taken to prove differences in skin parameters but also of moisturiser treatment that adds further to our understanding of the ethnic differences in skin physiology and product application. This paper reviews the background of the development and application of this methodology.
Effect of doping and changing of the annealing temperature on the structural and optical properties of ZnS
Authors: Mohamed Mohamed Bakr
Published: July 2019

Nano ZnS doped with Co, Mn, or Fe have been synthesized via thermolysis technique at different annealing temperatures (300, 400, and 500°C). The effect of doping and annealing temperature on the lattice parameter and crystalline size of ZnS are studied in detail by Rietveld refinement method of X‐ray diffraction data. To confirm the formation of a zinc blend structure of annealed and doped ZnS, Fourier‐transform infrared are investigated. The energy gaps of doped and annealed ZnS are determined using ultraviolet spectroscopy technique. Undoped and doped ZnS with Fe emitted violet, blue, and green colors depend on the annealing temperature. Moreover, Mn‐doped ZnS exhibits blue‐green emission, while Co‐doped ZnS has a blue emission only.
Transfusion strategies in upper gastrointestinal bleeding management: a review of South Australian hospital practice
Authors: Hamarneh Zaki , Robinson Kathryn , Andrews Jane , Hunt Russell , Fraser Robert
Published: July 2019

Background

Upper gastrointestinal bleeding (UGIB) is a common cause of hospital admission and red cell transfusion is frequently required. A large single‐centre randomised study from 2013 showed that a restrictive transfusion strategy in UGIB management was associated with better outcomes compared to a liberal strategy. Subsequently multiple international guidelines favour a restrictive transfusion strategy. However, given the multiple exclusion criteria in the study, generalisation to everyday practice was unclear.

Aims

To assess applicability of the data to a non‐trial UGIB population and determine how often restrictive thresholds are used in clinical practice.

Methods

A retrospective case note review of patients with an UGIB admission during 2014 in three tertiary hospitals was undertaken. Information collected included demographics, comorbidities and factors associated with transfusion, such as apparent haemoglobin triggers and units transfused. The proportion of patients who would have met inclusion criteria of the study was calculated.

Results

Of 89 UGIB admissions reviewed, up to 70% would be suitable for a restrictive approach. Use of this approach was evident in only 26% of transfusion episodes in patients meeting inclusion criteria. However, assessment was, limited by rapidly changing clinical status and potential for overestimation of true haemoglobin level with fluid resuscitation and equilibration.

Conclusion

A restrictive transfusion strategy may be suitable for many patients presenting with UGIB; however, important exclusions were not uncommon. Opportunities for increased uptake of restrictive thresholds were identified. Ongoing improvement initiatives should address the risks of both over and under‐transfusion.
Mental health nurses’ attitudes towards consumer involvement in nursing handover pre and post an educational implementation
Authors: Olasoji Michael , Cross Wendy , Reed Fiona , Wang Wei , Jacob Sini , Plummer Virginia
Published: July 2019

Involving mental health consumers in nursing handover is a recent introduction to practise in acute mental health units. However, implementation must recognize that mental health care is complex and the approach needs to include recovery‐focused philosophies of practice. Evidence shows that nurses and other health professionals consider poor handover practices may be the source of adverse events; however, the views of mental health nurses about involving consumers in nursing handover have not been previously reported. The aim of this study was to identify nurses’ attitudes towards consumer involvement in handover and to measure the effect of a training programme upon these attitudes. A single‐group pre‐post‐test intervention study was undertaken. The study was conducted on the adult acute mental health inpatient unit of a major metropolitan hospital in Victoria, Australia, 2016–2017. Questionnaires were developed to capture the views of the nurses about proposed changes in the afternoon nursing handover process. A questionnaire was administered before and after the training intervention, an innovative, multi‐media education handover package. We found that training had a significant influence on mental health nurses’ attitudes towards involving consumers in the handover. Therapeutic engagement improved following training and miscommunication reduced when all players are informed and have the opportunity to engage with the information. This study has demonstrated that well‐planned education can influence nurses’ attitudes about involving consumers in the nursing handover processes.
Exploring the use of mobile information and communication technologies by people with mood disorders
Authors: Fulford Hamish , McSwiggan Linda , Kroll Thilo , MacGillivray Stephen
Published: July 2019

Information and communication technologies (ICTs) have become increasingly integrated into how care is delivered and received. However, no research has yet explored how people with mood disorders use mobile information and communication technologies (mICTs) in their everyday lives and, more specifically, how they might use mICTs to look after themselves. An exploratory qualitative study, within secondary and specialist mental health Services, was undertaken. Data generation involved in‐depth, semi‐structured interviews with 26 people with mood disorders. Participants’ data sets were analysed using constructivist grounded theory (CGT). The resultant theory explains how mICTs were used in daily life, and also, more specifically, how they were used to manage recovery from mood disorders. The findings reveal that people with mood disorders used their mICTs to centralize themselves within their on‐ and offline worlds and their importance of attachment were central in their continued use. These findings have the potential to inform and encourage the further incorporation of mICTs into the health and social care settings; spanning the therapeutic to systemic levels so that the full potential of these ubiquitous technologies can be harnessed to improve care and care delivery. Yet, without adequate resource and support, health and social care professionals’ efforts will be hampered, contributing to technology redundancy and high attrition rates in the use of this type of technology.
The top 100 most‐cited papers in Paediatric Dentistry journals: A bibliometric analysis
Authors: Perazzo Matheus França , Otoni Ana Luisa Caldas , Costa Matheus Silva , Granville‐Granville Ana Flávia , Paiva Saul Martins , Martins‐Júnior Paulo Antônio
Published: July 2019

Background

The most‐cited papers help to better understand important characteristics of this specific science field.

Objective

To analyse the 100 most‐cited papers in the field of Paediatric Dentistry.

Design

A search of the most‐cited papers in Paediatric Dentistry journals was performed using journals included in the category of ‘Dentistry, Oral Surgery & Medicine’ in the Thompson Reuters Web of Science citation indexing database up to December 2018. Two researchers performed the data extraction, which included: number of citations, title, authors, country, year, journals, study design, and thematic area.

Results

The number of citations of each paper included in the top 100 most‐cited ranged from 42 to 182 (mean: 64.51). Seven papers were cited more than 100 times. Most of the papers were published in the International Journal of Paediatric Dentistry (36%), between 2006 and 2015 (55%), with a cross‐sectional design (39%). Twenty‐six authors participated in two or more papers. The countries with the highest number of most‐cited papers were the United States (25%), Australia (11%), and Brazil (9%). Cariology was the most studied thematic area.

Conclusion

The evaluation of the top 100 most‐cited papers in Paediatric Dentistry journals allowed for a better understanding of the world scenario regarding this research field.
Bonding strength and thermal shock resistance of a novel bilayer (c‐AlPO4‐SiCw‐mullite)/SiC coated carbon fiber reinforced CMCs
Authors: Chen Pengju , Xiao Peng , Li Zhuan , Pan Ling , Li Jinwei , Liu Zeyan , Pu Dongmei , Li Yang
Published: July 2019

Mullite coating, SiC whiskers toughened mullite coating (SiCw‐mullite), and cristobalite aluminum phosphate (c‐AlPO4) particle modified SiCw‐mullite coating (c‐AlPO4‐SiCw‐mullite) were prepared on SiC coated C/SiC composites using a novel sol‐gel method combined with air spraying. Results show that molten SiO2 formed by the oxidation of SiC whiskers and molten c‐AlPO4 improved the bonding strength between mullite outer coating and SiC–C/SiC composites due to their high‐temperature bonding properties. The bonding strength between mullite, SiCw‐mullite, c‐AlPO4‐SiCw‐mullite outer coatings and SiC–C/SiC composites were 2.41, 4.31, and 7.38 MPa, respectively. After 48 thermal cycles between 1773 K and room temperature, the weight loss of mullite/SiC coating coated C/SiC composites was up to 11.61%, while the weight losses of SiCw‐mullite/SiC and c‐AlPO4‐SiCw‐mullite/SiC coatings coated C/SiC composites were reduced to 7.40% and 5.12%, respectively. The addition of appropriate SiC whiskers can considerably improve the thermal shock resistance of mullite coating owing to their excellent mechanical properties at high temperature. In addition, c‐AlPO4 particles can further improve the thermal shock resistance of SiCw‐mullite coating due to their high‐temperature bonding and sealing properties. No obvious micro‐pores and cracks were observed on the surface of c‐AlPO4‐SiCw‐mullite coating after 48 thermal cycles due to timely healing effect by formation of secondary mullite.
The global biogeography of lizard functional groups
Authors: Vidan Enav , Novosolov Maria , Bauer Aaron M. , Herrera Fernando Castro , Chirio Laurent , de Campos Nogueira Cristiano , Doan Tiffany M. , Lewin Amir , Meirte Danny , Nagy Zoltan T. , Pincheira‐Donoso Daniel , Tallowin Oliver J.S. , Torres Carvajal Omar , Uetz Peter , Wagner Philipp , Wang Yuezhao , Belmaker Jonathan , Meiri Shai
Published: July 2019

Aim

Understanding the mechanisms determining species richness is a primary goal of biogeography. Richness patterns of sub‐groups within a taxon are usually assumed to be driven by similar processes. However, if richness of distinct ecological strategies respond differently to the same processes, inferences made for an entire taxon may be misleading. We deconstruct the global lizard assemblage into functional groups and examine the congruence among richness patterns between them. We further examine the species richness – functional richness relationship to elucidate the way functional diversity contributes to the overall species richness patterns.

Location

Global.

Methods

Using comprehensive biological trait databases we classified the global lizard assemblage into ecological strategies based on body size, diet, activity times and microhabitat preferences, using Archetypal Analysis. We then examined spatial gradients in the richness of each strategy at the one‐degree grid cell, biome, and realm scales.

Results

We found that lizards can best be characterized by seven “ecological strategies”: scansorial, terrestrial, nocturnal, herbivorous, fossorial, large, and semi‐aquatic. There are large differences among the global richness patterns of these strategies. While the major richness hotspot for lizards in general is in Australia, several strategies exhibit highest richness in the Amazon Basin. Importantly, the global maximum in lizard species richness is achieved at intermediate values of functional diversity and increasing functional diversity further result in a slow decline of species richness.

Main conclusions

The deconstruction of the global lizard assemblage along multiple ecological axes offers a new way to conceive lizard diversity patterns. It suggests that local lizard richness mostly increases when species belonging to particular ecological strategies become hyper‐diverse there, and not because more ecological types are present in the most species rich localities. Thus maximum richness and maximum ecological diversity do not overlap. These results shed light on the global richness pattern of lizards, and highlight previously unidentified spatial patterns in understudied functional groups.
Long‐term performance and lead failure analysis of the Durata defibrillation lead compared to its previous model, the recalled Riata defibrillation lead
Authors: Kleemann Thomas , Nonnenmacher Florian , Strauss Margit , Kouraki Kleopatra , Werner Nicolas , Fendt Andràs , Zahn Ralf
Published: July 2019

Introduction

Data on long‐term durability of St Jude Medical Durata defibrillation leads compared to its previous model, the St Jude Medical Riata leads in clinical practice are missing. Aim of the study was to analyze the long‐term performance of the Durata defibrillation leads compared to the Riata leads in clinical practice.

Methods and Results

A total of 1407 consecutive patients of a prospective single‐centre implantable cardioverter defibrillator (ICD)‐registry were analyzed who underwent ICD implantation with a Durata (n = 913) or Riata (n = 494) ICD lead between 2002 and 2017. Most of the leads were implanted via a subclavian vein access. The estimated lead defect rates after 5 and 10 years were not different between the Durata (11% and 36%) and Riata leads (13% and 38%). Among Durata leads single coil and DF‐4 connector ICD leads had a lower incidence of lead failure. Major causes of lead failure were compression of the lead in the clavicular region, generator to lead friction and distal fatigue fracture whereas lead defect due to externalization was a rare cause of lead defect in Riata leads (3%).

Conclusion

Among ICD leads implanted via the subclavian vein access the lead defect rate of Durata leads after 10 years is similar to that of Riata leads. Single coil and DF‐4 ICD leads are associated with a lower lead failure rate. Mechanical stress represents a major cause of lead failure mechanism whereas externalization might only play a minor role in clinical practice.
Inter‐rater reliability of the BIOCHIP indirect immunofluorescence dermatology mosaic in bullous pemphigoid and pemphigus patients
Authors: Yang A. , Xuan R.R. , Melbourne W. , Hashimoto T. , Uzun S. , Daneshpazhooh M. , Yamagami J. , Di Zenzo G. , Mascaro J.M. , Mahmoudi H. , Patsatsi A. , Drenovska K. , Vassileva S. , Murrell D.F.
Published: July 2019

Background

The BIOCHIP (Dermatology Mosaic 7; EUROIMMUN, Lubeck, Germany) is a novel multiplex indirect immunofluorescence (IIF) technique used in the serological diagnosis of bullous pemphigoid (BP) and pemphigus.

Objective

To validate the accuracy and inter‐rater reliability (IRR) of the BIOCHIP in the diagnosis of BP, pemphigus foliaceus (PF) and pemphigus vulgaris (PV).

Methods

Sera from patients with BP (n = 38), PF (n = 8), PV (n = 23), control patients (n = 64) and healthy control volunteers (n = 39) were tested. Sera were collected and analysed during the course of the disease at 1–5 different time points. The BIOCHIP was performed for all patients, digital images were captured of each incubated field, and the images were shared with 10 dermatologists experienced in reading IF from around the world to report. There were 312 BIOCHIP slides consisting of 1872 photos in total. All patients were de‐identified. Fleiss Kappa was used to estimate the IRR.

Results

Fleiss Kappa was computed for each category (Oesophagus, Oesophagus immunofluorescence pattern, Salt‐Split Skin (SSS), SSS immunofluorescence location, BP180, BP230, Dsg 1 and Ds3). The inter‐rater agreement between the 10 raters varied between fair and moderate for all categories. Those that demonstrated fair concordance included monkey oesophagus (k = 0.257, P < 0.0001), oesophagus pattern (k = 0.357, P < 0.0001), Dsg1 (k = 0.390, P < 0.0001) and BP230 (k = 0.281, P < 0.0001). Moderate agreement was demonstrated for SSS (k = 0.416, P < 0.0001), SSS immunofluorescence location (k = 0.505, P < 0.0001), Dsg3 (k = 0.437, P < 0.0001) and BP180 (k = 0.559, P < 0.0001).

Conclusion

The BIOCHIP mosaic‐based immunofluorescence test is a simple, time and effort saving test that can aid in the diagnosis and screening of BP, PV and PF. However, the level of agreement was relatively low. The authors found the most common causes to be variable levels of training, indicating the presence of a learning curve in the interpretation of the results and ambiguous staining patterns leading to incongruent results.
Listeria monocytogenes and enterotoxigenic Staphylococcus aureus in dry fermented sausages belonging to “Traditional Agri‐Food Product” produced in Southern Italy
Authors: Quaglia Nicoletta C. , Storelli MariaMaddalena , Ioanna Federica , Celano Giuseppe , Celano Gaetano V. , Conversano Chiara , De Rosa Michele , Dambrosio Angela
Published: July 2019

The aim of this study was to assess the microbiological quality and safety of typical dry fermented sausages produced in Apulia region, Southern Italy, classified as “Traditional Agri‐Food Products” (T.A.P.). A total of 106 samples were collected and analyzed. Two samples of Soppressata di maiale nero dei Monti Dauni (1.89%) were positive to Listeria monocytogenes. Nevertheless, the loads were <100 cfu/g hence all samples had a satisfactory microbiological quality. According to Gilbert's guidelines, 9.43% of the analyzed samples showed unsatisfactory microbiological quality since Staphylococcus aureus was between 100 and <104 cfu/g. Moreover, 7.54% of the dry fermented sausages analyzed had unacceptable microbiological quality since S. aureus loads were >104 cfu/g. Five isolated strains of S. aureus were enterotoxigenic. Based on findings, it is essential to apply and maintain good hygiene practices throughout the food chain, especially for T.A.P., which are often produced in small family processing plants using production protocols based on the experience handed down from father to son.

Practical Application

The Traditional Agri‐Food Products (T.A.P.) are foodstuffs much appreciated by consumers because of their organoleptic qualities and taste that brings back to the genuine flavors of the past. The results of this study can contribute to the risk analysis for these particular products, and underline the need to apply and maintain good hygiene practices throughout the production chain.
Generation of magnifying endoscopic images of gastric neoplasms based on an all‐in‐focus algorithm
Authors: Matsui Kenichi , Funasaka Kohei , Miyahara Ryoji , Furukawa Kazuhiro , Matsushita Masanobu , Yamamura Takeshi , Ishikawa Takuya , Ohno Eizaburo , Nakamura Masanao , Kawashima Hiroki , Watanabe Osamu , Ohara Kenichi , Hirooka Yoshiki , Goto Hidemi
Published: July 2019

Background and Aim

Magnifying endoscopy is useful for diagnosis of early gastrointestinal neoplasms by visualizing microvascular (MV) and microsurface (MS) structures of the mucosa when combined with image‐enhanced endoscopy. However, precise control of the endoscope is needed because the depth of focus is narrow and the target may move. These problems may be overcome by the all‐in‐focus (AIF) technique, which was developed in the engineering field. The aim of the study was to evaluate magnifying endoscopic image with AIF algorithm.

Methods

Twenty gastric neoplasms were examined. Images were acquired at 80× magnification and converted to endoscopic images with an AIF algorithm (EI‐AIF). The focus area and MV and MS patterns in the original image and the EI‐AIF were compared on a 5‐point Likert scale, where 5 indicates that the EI‐AIF was superior. Intraclass correlation coefficients (ICCs) were used to assess the inter‐evaluator reliability. An image quality measurement value was calculated for each image as an indicator of the degree of focus.

Results

The scores for focus area, MV, and MS were 4.78 ± 0.45 (ICC = 0.63), 4.12 ± 0.76 (ICC = 0.70), and 4.72 ± 0.52 (ICC = 0.45), respectively, with the EI‐AIF significantly superior for all three items (P < 0.05 by Student's t‐test). ICCs for the focus area and MV were > 0.60, indicating strong inter‐evaluator reliability. Image quality measurement was higher for the EI‐AIF compared with the original image in every case.

Conclusions

Endoscopic observation with AIF algorithm gives a better image quality that allows easier evaluation of MV and MS patterns. This technique may resolve the difficulties with magnifying endoscopic observation.
Geriatric Education Programs for Emergency Department Professionals: A Systematic Review
Authors: Hesselink Gijs , Demirbas Mehmet , Rikkert Marcel Olde , Schoon Yvonne
Published: July 2019

OBJECTIVES

To evaluate geriatric education programs for emergency department (ED) professionals based on: content and teaching methods and learning outcome effects and factors promoting or hindering program implementation.

DESIGN

Systematic review.

SETTING

ED.

PARTICIPANTS

Physicians, nurses, and medical residents working in the ED.

METHODS AND MEASUREMENT

Five major biomedical databases were searched for (quasi) experimental studies, published between 1990 and April 2018, evaluating geriatric education programs for ED professionals. Data were synthesized around study quality, learning participants, teaching content and methods, and Kirkpatrick learning outcomes.

RESULTS

Nine before‐after studies were included. Learners were mostly ED residents and, to a smaller extent, ED nurses and physicians. Study quality was moderate, with the lowest scores on sampling and instrument validity. Programs varied from a 1‐day workshop to a 2‐year curriculum, mostly combining didactic lectures with active and experiential learning formats. Topics commonly addressed included managing: geriatric syndromes, trauma and falls, medication, atypical presentations, and care transitions. Statistically significant improvements were mostly found in learners' knowledge acquisition (six studies). Significant improvements were also found in single studies on: self‐reported geriatric screening, documentation of geriatric care, and appropriate urinary catheter placement. Factors promoting program implementation included: solving competing educational demands and busy work schedules, embedding the program in preexisting curricula, and close collaboration between emergency and geriatric medicine faculties.

CONCLUSIONS

Various geriatric education programs improve the geriatric knowledge of ED professionals and seem to positively impact their clinical practice. However, more program evaluations with larger study samples, and use of valid and reliable outcome measures, are needed to provide robust evidence on the effectiveness of such programs. J Am Geriatr Soc, 1–8, 2019. J Am Geriatr Soc 67:2402–2409, 2019
Statins in Older Danes: Factors Associated With Discontinuation Over the First 4 Years of Use
Authors: Thompson Wade , Jarbøl Dorte Ejg , Haastrup Peter , Nielsen Jesper Bo , Pottegård Anton
Published: July 2019

BACKGROUND AND OBJECTIVE

Use of statins is considerable among older persons. We investigated factors associated with statin discontinuation in new statin users aged 70 years or older within the first 4 years of use.

DESIGN

Register‐based descriptive drug utilization study using data from 2008 to 2016.

POPULATION/SETTING

All Danish persons, aged 70 years or older, initiating statin treatment.

MEASUREMENTS

Rates and predictors of statin discontinuation after 1 year (early), 2 years, and 4 years. Predictors of discontinuation were estimated using logistic regression.

RESULTS

We included 83 788 statin initiators. At 1 year, 13% had discontinued their treatment, while another 12% and 13% discontinued after 2 and 4 years, respectively. The overall discontinuation rate over 4 years was 32%. Increasing age was associated with discontinuation at all time points (adjusted odds ratio [OR] = 2.06 [95% confidence interval {CI} = 1.35‐3.16] at 1 year, adjusted OR = 3.94 [95% CI, 1.83‐8.49] at 4 years, comparing those aged >95 years to those aged 70‐74 years). Further, higher comorbidity scores and use of more than 10 medications were modestly associated with discontinuation. Use of statins for secondary prevention was associated with decreased odds of discontinuation compared to primary prevention at 1 year (adjusted OR = 0.74; 95% CI, 0.65‐0.83) and at 4 years (adjusted OR = 0.83; 95% CI, 0.72‐0.95), along with concomitant use of cardiovascular (CV) therapies. The annual proportion of early discontinuers ranged from 14% to 17% for primary prevention and from 9% to 12% for secondary prevention between 2008 and 2015.

DISCUSSION

Statin discontinuation within the first 4 years after initiation appeared to be influenced most strongly by age, and may also be influenced by comorbidity, polypharmacy, use for secondary prevention, and concomitant CV medication use. Future research should clarify reasons for, and discussions about, statin discontinuation and initiation among older persons, to provide additional insight on this topic. J Am Geriatr Soc 67:2050–2057, 2019
Spinophilin regulates phosphorylation and interactions of the GluN2B subunit of the N‐methyl‐d‐aspartate receptor
Authors: Salek Asma B. , Edler Michael C. , McBride Jonathon P. , Baucum Anthony J.
Published: July 2019

N‐methyl‐d‐Aspartate receptors (NMDARs) are abundant postsynaptic proteins that are critical for normal synaptic communication. NMDAR channel function is regulated by multiple properties, including phosphorylation. Inhibition of protein phosphatase 1 (PP1) in hippocampal neurons increases NMDAR activity, an effect abrogated by loss of spinophilin, the major PP1‐targeting protein in the postsynaptic density. However, how spinophilin regulates PP1‐dependent NMDAR function is unclear. We hypothesize that spinophilin regulates PP1 binding to the NMDAR to alter NMDAR phosphorylation. Our data demonstrate that spinophilin interacts with the GluN2B subunit of the NMDAR. In human embryonic kidney 293 FT cells, activation and/or overexpression of protein kinase A increased the association between spinophilin and the GluN2B subunit of the NMDAR. Functionally, we found that spinophilin overexpression decreased PP1 binding to the GluN2B subunit of the NMDAR and attenuated the PP1‐dependent dephosphorylation of GluN2B at Ser‐1284. Moreover, in P28 hippocampal lysates isolated from spinophilin KO compared to WT mice, there was increased binding of GluN2B to PP1, decreased phosphorylation of GluN2B at Ser‐1284, and altered GluN2B protein interactions with postsynaptic density‐enriched proteins. Together, our data demonstrate that spinophilin decreases PP1 binding to GluN2B and concomitantly enhances the phosphorylation of GluN2B at Ser‐1284. The putative consequences of these spinophilin‐dependent alterations in GluN2B phosphorylation and interactions on synaptic GluN2B localization and function are discussed.

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