bluuebunny/crossref_metadata_2025 huggingface dataset:
Factor analysis of the Korean version of the Illness Cognition Questionnaire for adolescents with chronic illness
Authors: Lee Dasuel , Jeong Dae‐Chul , Chung Nack‐Gyun , Lee Sunhee
Published: December 2020

Aim

The purpose of this study was to examine the reliability and validity of the Korean version of the Illness Cognition Questionnaire.

Methods

A total of 237 adolescent Participants ages 13–20 years were collected from two hospitals for purposes of the study. The participants were diagnosed with blood cancer, congenital heart disease, paediatric rheumatoid arthritis, multiple sclerosis and diabetes mellitus.

Results

The Illness Cognition Questionnaire is composed of three subscales and 18 items. Exploratory factor analysis and confirmatory factor analysis were performed for all 18 items. The data used in the exploratory factor analysis were obtained from 126 adolescents with blood cancer. The data used for confirmatory factor analysis were obtained from 111 adolescents who had chronic diseases. The three‐factor model of 18 items showed general fitness close to the standard but not a very good fit.

Conclusions

This study indicated that the Korean version of the Illness Cognition Questionnaire is reasonable to use for Korean adolescents with chronic illness. The authors recommend that the meaning of Item 10 be clarified from ‘I have learned to accept the limitations imposed by my illness’ to ‘I have learned to positively accept the limitations imposed by my illness’.
Recent advances in single‐cell multimodal analysis to study immune cells
Authors: Louie Raymond HY , Luciani Fabio
Published: December 2020

Recent advances in single‐cell technologies have enabled the profiling of the genome, epigenome, transcriptome and proteome, along with temporal and spatial information of individual cells. These technologies have provided unique opportunities to understand mechanisms underpinning the immune system, such as characterizations of the molecular cell state, how the cell state evolves along its lineage and the impact of spatial location on cell state. In this review, we discuss how these mechanisms have been studied through recent advances in single‐cell multimodal technologies.
Utility of 68Ga‐DOTA‐Exendin‐4 positron emission tomography–computed tomography imaging in distinguishing between insulinoma and nesidioblastosis in patients with confirmed endogenous hyperinsulinaemic hypoglycaemia
Authors: Kalff Victor , Iravani Amir , Akhurst Timothy , Pattison David A. , Eu Peter , Hofman Michael S. , Hicks Rodney J.
Published: December 2020

Background

Because management is very different, it is important to differentiate between small focal insulinomas and diffuse pancreatic dysplasia (nesidioblastosis) in patients with confirmed endogenous hyperinsulinaemic hypoglycaemia (EHH). Most insulinomas highly express glucagon‐like peptide‐1 receptors enabling positron emission tomography–computed tomography imaging with its radiolabelled analogue; 68Ga‐DOTA‐Exendin‐4 (Exendin).

Aim

To determine: (i) the utility of Exendin in EHH patients in a clinical setting; and (ii) whether the degree of Exendin uptake differentiates non‐insulinoma pancreatogenous hypoglycaemia syndrome (NIPHS) from post‐gastric bypass hypoglycaemia (PGBH).

Methods

This retrospective study reviewed the clinical, biochemistry and prior imaging findings in confirmed EHH patients referred for Exendin. Accuracy of Exendin was based on surgical findings and treatment outcomes. Finally, average Exendin uptake (SUVmax) of five PGBH studies was compared with the SUVmax of a key NIPHS case report.

Results

Twenty of 25 consecutive patients had confirmed EHH. Exendin located insulinomas in eight of nine patients enabling successful surgical excision with rapid and durable cure. Exendin correctly identified diffuse nesidioblastosis in two of three cases requiring partial pancreatectomy for hypoglycaemia control. All three relapsed within 1.7 years with one needing completion pancreatectomy. Establishing the cause in the remainder relied on other investigations, clinical correlation and response to empirical treatment. Finally, Exendin SUVmax could not distinguish between NIPHS and PGBH.

Conclusion

In EHH patients, Exendin accurately identifies the site of insulinoma and thereby differentiates it from nesidioblastosis but negative findings should not be ignored. Exendin is unlikely to differentiate between normal pancreatic uptake, NIPHS and PGBH.
Oral microbiome interactions with gingival gene expression patterns for apoptosis, autophagy and hypoxia pathways in progressing periodontitis
Authors: Ebersole Jeffrey L. , Kirakodu Sreenatha S. , Gonzalez Octavio A.
Published: December 2020

Oral mucosal tissues must react with and respond to microbes comprising the oral microbiome ecology. This study examined the interaction of the microbiome with transcriptomic footprints of apoptosis, autophagy and hypoxia pathways during periodontitis. Adult Macaca mulatta (n = 18; 12–23 years of age) exhibiting a healthy periodontium at baseline were used to induce progressing periodontitis through ligature placement around premolar/molar teeth. Gingival tissue samples collected at baseline, 0·5, 1 and 3 months of disease and at 5 months for disease resolution were analysed via microarray. Bacterial samples were collected at identical sites to the host tissues and analysed using MiSeq. Significant changes in apoptosis and hypoxia gene expression occurred with initiation of disease, while autophagy gene changes generally emerged later in disease progression samples. These interlinked pathways contributing to cellular homeostasis showed significant correlations between altered gene expression profiles in apoptosis, autophagy and hypoxia with groups of genes correlated in different directions across health and disease samples. Bacterial complexes were identified that correlated significantly with profiles of host genes in health, disease and resolution for each pathway. These relationships were more robust in health and resolution samples, with less bacterial complex diversity during disease. Using these pathways as cellular responses to stress in the local periodontal environment, the data are consistent with the concept of dysbiosis at the functional genomics level. It appears that the same bacteria in a healthy microbiome may be interfacing with host cells differently than in a disease lesion site and contributing to the tissue destructive processes.
Social participation of people with chronic wounds: A systematic review
Authors: Klein Toni Maria , Andrees Valerie , Kirsten Natalia , Protz Kerstin , Augustin Matthias , Blome Christine
Published: December 2020

Living with chronic ulcers can be burdensome and restrictive, with regard to not only physical and psychological but also social well‐being. This review aims to analyse social participation in patients with chronic wounds and to compare results across different wound types. A search string was applied in several electronic databases. Results were screened according to predefined inclusion and exclusion criteria. Data of eligible articles were extracted and synthesised narratively. The search revealed 42 eligible publications. Only minor differences across different ulcer types could be detected. Overall, family members were the main social contacts for patients; they often provided wound care and emotional support. Patients had few non‐family relations, but those existing were often very close. Patients felt guilty as their condition imposed burden on family and friends, as well. A close relationship with nurses was described. Restrictions were caused by direct and indirect consequences of the wound. Overall, social support and social connections were reduced in wound patients. Inconsistent results were found regarding social isolation. In summary, people with chronic wounds experience impairments in all aspects of social participation. Therefore, social participation deserves increased attention in routine care both as a trigger of burden and as an outcome of therapy.
Ultra‐fast, selective, non‐melting, laser sintering of alumina with anisotropic and size‐suppressed grains
Authors: Geng Xiao , Hong Yuzhe , Lei Jincheng , Ma Jianxing , Chen Jie , Xiao Hai , Tong Jianhua , Bordia Rajendra K. , Peng Fei
Published: December 2020

In this paper, we report an ultra‐fast sintering phenomenon of alumina achieved by the scanning laser irradiation method. Using CO2 laser irradiation, we found that micrometer‐sized alumina powder (d50 = 1.2 µm) can be sintered close to full density within a few tens of seconds. The microstructure of laser‐sintered alumina was different from that of the furnace‐sintered alumina. The relative density and grain size of the laser‐sintered alumina gradually decreased from the center of the laser beam to the edge. Anisotropy of the grain size was measured along and perpendicular to the scanning direction. This anisotropy decreased as the scanning speed decreased from 0.1 mm/s to 0.01 mm/s. The sintering master curve of grain size versus relative density, which reflects the sintering mechanism, was found to be affected by the laser scanning speed. When the laser scanning speed was 0.1 mm/s, grain size suppression was found for the almost fully dense alumina. However, at lower scanning speed (e.g., 0.01 mm/s), there was significant grain growth in the regions where the relative density was greater than 90%. These results clearly indicate that alumina can be sintered, in the solid‐state, to a high density in a short time using scanning laser and the microstructure is different from the furnace‐sintered alumina.
Together but Apart: Creating and Supporting Online Learning Communities in an Era of Distributed Studio Education
Authors: Marshalsey Lorraine , Sclater Madeleine
Published: December 2020

It would seem that technological campuses of tomorrow have manifested in 2020 as an essential spontaneous response to a world event. This article examines the current crisis in physical art and design studio learning in higher education as a consequence of the COVID‐19 outbreak and the sector’s response to the fast‐track conversion of blended learning to a distributed model. Universities are focusing on virtual community building where group work, ‘crits’ and presentations are being carried out online. Moving assessment and engagement to online formats has consequences for practice‐based art and design courses: distributed learning changes how we teach and learn. This article discusses the implications of art and design studio education in a time of distributed learning. It considers the loss of control over a physically based, practical curriculum and the repercussions for students unable to perform to the depth and rigour required for creative art and design practice. Studio education is considered a signature pedagogy, and has a distinct set of guiding principles such as facilitating critical play, thinking and making, and a pedagogy of ambiguity. This article examines the successes and challenges of moving these pedagogical principles into distributed spaces to support student engagement, using Cultural Historical Activity Theory (CHAT) as a research framework. The article also examines pedagogical strategies that support students to engage in physical forms of creative practice that enable them to connect their lived experience in a time of crisis.
Physical activity in the context of advanced breast cancer: An integrative review
Authors: Geng Zhaohui , Wang Jingting , Zhang Yingting , Wu Fulei , Yuan Changrong
Published: December 2020

Aims

To describe and synthesize diverse empirical evidence regarding physical activity (PA) in the context of advanced breast cancer (ABC).

Design

Integrative review guided by the work of Whittemore and Knafl (2005).

Data sources

Six electronic databases were systematically searched to identify relevant literature published between January 2007–June 2019.

Review methods

Abstracts of papers that met the inclusion criteria were reviewed by two researchers and full texts of eligible papers were assessed. Data were extracted by two independent researchers and inter‐rater reliability of data extraction established. Quality of papers was evaluated using the Mixed Methods Appraisal Tool. Data were organized according to comprehensive thematic analysis and the biobehavioural model for the study of exercise interventions.

Results

Of the 532 abstracts, 18 studies met the inclusion criteria which included six randomized controlled trials, one quantitative non‐randomized study, seven quantitative descriptive studies, three mixed method studies and one qualitative study. Results from studies enrolled fell into four domains: PA performance and its influence on survival; barriers and preferences for PA; interventions to enhance PA; perceived benefits of PA from qualitative feedback.

Conclusion

Evidence suggests that ABC patients are physically inactive. Main barriers of PA are less aerobic fitness and heavy symptom burden. Simple, tailored and specialist‐supervised PA is preferred by ABC patients. Form of joint self‐instructed and group accompanying is advocated as well. PA intervention programmes identified in this review vary on type, intensity, duration and frequency, while generally, are found to be feasible, safe and beneficial to patients’ physical and psychosocial well‐being.

Impact

The results propose tailored, supervised, group‐based PA programmes are in urgent need for ABC patients. Clinical professionals should manage more feasible and safer PA interventions to help improve patients’ overall health. More research with rigorous methodology design is warranted to explore PA’s effect on long‐term health outcomes.
Systematic evaluation, verification and comparison of tuberculosis‐related non‐coding RNA diagnostic panels
Authors: Lyu Mengyuan , Cheng Yuhui , Zhou Jian , Chong Weelic , Wang Yili , Xu Wei , Ying Binwu
Published: December 2020

We systematically summarized tuberculosis (TB)‐related non‐coding RNA (ncRNA) diagnostic panels, validated and compared panel performance. We searched TB‐related ncRNA panels in PubMed, OVID and Web of Science up to 28 February 2020, and available datasets in GEO, SRA and EBI ArrayExpress up to 1 March 2020. We rebuilt models and synthesized the results of each model in validation sets by bivariate mixed models. Specificity at 90% sensitivity, area under curve (AUC) and inconsistence index (I2) were calculated. NcRNA biofunctions were analysed. Nineteen models based on 18 ncRNA panels (miRNA, lncRNA, circRNA and snoRNA panels) and 18 datasets were included. Limited available datasets only allowed to evaluate miRNA panels further. Cui 2017 and Latorre 2015 exhibited specificity >70% at 90% sensitivity and AUC >80% in all validation sets. Cui 2017 showed higher specificity at 90% sensitivity (92%) and AUC (95%) and lower heterogeneity (I2 = 0%) in ethological‐confirmation validation sets. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis indicated that most ncRNAs in panels involved in immune cell activation, oxidative stress, and Wnt and MAPK signalling pathway. Cui 2017 outperformed other models in both all available and aetiological‐confirmed validation sets, meeting the criteria of target product profile of WHO. This work provided a basis for clinical choice of TB‐related ncRNA diagnostic panels to a certain extent.
The Lived Experience of Postpartum Women Attending Outpatient Substance Treatment for Opioid or Heroin Use
Authors: Proulx Donna , Fantasia Heidi Collins
Published: December 2020

Introduction

The current opioid crisis and associated heroin epidemic have exhausted the limited community services that are available to substance users, with only about 12% of substance use treatment facilities offering special programs for pregnant women. Little information is known about the lived experience of postpartum women in outpatient substance use treatment programs, who are working toward abstinence and caring for a newborn. The purpose of this phenomenological study was to explore the lived experience of postpartum women attending outpatient substance use treatment for illicit opioid or heroin use.

Methods

Individual interviews were conducted between December 2017 and November 2018, with 10 postpartum women with opioid use disorder (OUD) engaged in outpatient substance use treatment programs. A 4‐step conceptual framework as suggested by Moustakas was used to understand and synthesize the lived experiences shared by the women.

Results

Five themes emerged from the raw data: the presence of a stigma in providers of health care services, a fear of being reported to family services, children are primary motivators to remain engaged in treatment, concern for the welfare of the infant, and barriers to treatment.

Discussion

Postpartum women with OUD and their infants have complex needs that may best be served by treatment programs that offer comprehensive care. The fear of being reported to family services and possible loss of custody influenced all aspects of their decision‐making.
Importance of gynecological assessment for the treatment of vaginismus as a predictive value
Authors: Eserdağ Süleyman , Anğın Ali Dogukan
Published: December 2020

Aim

In this study, we aimed to analyze the impact of a detailed anamnesis and gynecological examination findings of women with vaginismus on its treatment success in a tertiary therapy center with 18 years of experience.

Methods

The socio‐demographical factors, gynecological examination notes and the treatment results of 281 vaginismus patients were analyzed between July 2018 and July 2019. The relationship with these parameters and the number of sessions for treatment were evaluated.

Results

The women with higher vaginismus grade had a longer duration of marriage (P < 0.001) and they needed more CBT sessions (P = 0.004). On the other hand, the age of the patient, duration of the relationship, education level, and surgical intervention (hymenotomy, hymenectomy) or presence of anatomically pathological hymen did not affect the outcomes regarding the number of sessions, duration of the treatment and the rate of successful penetration.

Conclusion

Gynecological evaluation and detailed anamnesis that is taken upon the first admission has an important impact on the management of therapy and the treatment success.
How can dementia and disability be prevented in older adults: where are we today and where are we going?
Authors: Lisko I. , Kulmala J. , Annetorp M. , Ngandu T. , Mangialasche F. , Kivipelto M.
Published: December 2020

Ageing of the population, together with population growth, has brought along an ample increase in the number of older individuals living with dementia and disabilities. Dementia is the main cause of disability in old age, and promoting healthy brain ageing is considered as a key element in diminishing the burden of age‐related disabilities. The World Health Organization recently launched the first risk reduction guidelines for cognitive impairment and dementia. According to recent estimates, approximately 40% of dementia cases worldwide could be attributable to 12 modifiable risk factors: low education; midlife hypertension and obesity; diabetes, smoking, excessive alcohol use, physical inactivity, depression, low social contact, hearing loss, traumatic brain injury and air pollution indicating clear prevention potential. Dementia and physical disability are closely linked with shared risk factors and possible shared underlying mechanisms supporting the possibility of integrated preventive interventions. FINGER trial was the first large randomized controlled trial indicating that multidomain lifestyle‐based intervention can prevent cognitive and functional decline amongst at‐risk older adults from the general population. Within the World‐Wide FINGERS network, the multidomain FINGER concept is now tested and adapted worldwide proving evidence and tools for effective and easily implementable preventive strategies. Close collaboration between researchers, policymakers and healthcare practitioners, involvement of older adults and utilization of new technologies to support self‐management is needed to facilitate the implementation of the research findings. In this scoping review, we present the current scientific evidence in the field of dementia and disability prevention and discuss future directions in the field.
A National Analysis of State Policies on Lesbian, Gay, Bisexual, Transgender, and Questioning/Queer Inclusive Sex Education
Authors: Garg Namrata , Volerman Anna
Published: December 2020

BACKGROUND

Many youth engage in risky sexual behaviors that are associated with adverse sexual health outcomes. Lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) youth are disproportionately affected. Comprehensive sex education is instrumental to minimize these outcomes; however, each state varies in the topics taught.

METHODS

This paper is a comprehensive review of all 50 states and the District of Columbia's policies, including laws and education standards, for LGBTQ inclusive material in school‐based sex education for youth in K‐12.

RESULTS

Overall, 48 states have policies that mandate sex education in the public schools. This review describes policy differences relevant to students who identify as LGBTQ, by comparing required topics, parental/guardian permission, LGBTQ inclusion, and normative language requirements.

CONCUSIONS

There is a lack of uniformity and presence of discrimination in school‐based sex education policies in the United States, particularly related to LGBTQ topics. Therefore, young people, especially LGBTQ students, face geographical barriers to accessing sexual health information and schools are limited in implementing curriculum essential for students to optimize sexual health outcomes. State policymakers, school administrators, child health advocates, and parents should work to eliminate barriers for comprehensive sex education.
Does detection of fetal growth restriction improve neonatal outcomes?
Authors: Selvaratnam Roshan J , Wallace Euan M , Treleaven Sophie , Hooper Stuart B , Davis Peter G , Davey Mary‐Ann
Published: December 2020

Aim

Timely delivery of fetal growth restriction (FGR) is a balance between avoiding stillbirth and minimising prematurity. We sought to assess the neonatal outcomes for babies suspected of FGR, both true and false positives.

Methods

This population cohort study examined all singleton births in Victoria, Australia from 2000 to 2017 (n = 1 231 415). Neonatal morbidities associated with neonatal intensive care unit (NICU) admission were assessed for babies born ≥32 weeks' with severe FGR (<3rd centile) and babies with birthweight ≥10th centile who were iatrogenically delivered for suspected FGR.

Results

Babies with severe FGR iatrogenically delivered for suspected FGR were more likely to require NICU admission than babies with severe FGR who were not detected (3.0% vs. 1.1%, P < 0.001). After adjusting for potential confounders, the odds of NICU admission were increased (adjusted odds ratio (aOR) = 3.00, 95% confidence interval = 2.45–3.67; P < 0.001). Rates of NICU admission were also higher in ≥10th centile babies iatrogenically delivered for suspected FGR than for ≥10th centile babies who entered labour spontaneously (1.8% vs. 0.5%, P < 0.001). After adjustments, the odds of NICU admission were increased (aOR = 3.91, 95% confidence interval = 3.40–4.49; P < 0.001). NICU admissions were associated with morbidities related to iatrogenic prematurity.

Conclusions

Detection and planned delivery of FGR reduces stillbirth but may be associated with increased neonatal morbidity related to iatrogenic prematurity.
The acute effects of sleep restriction therapy for insomnia on circadian timing and vigilance
Authors: Maurer Leonie F. , Ftouni Suzanne , Espie Colin A. , Bisdounis Lampros , Kyle Simon D.
Published: December 2020

Sleep‐restriction therapy (SRT) has been shown to improve insomnia symptoms by restricting sleep opportunity. Curtailment of time in bed affects the duration and consolidation of sleep, but also its timing. While recent work suggests that people with insomnia are characterised by misalignment between circadian and behavioural timing of sleep, no study has investigated if SRT modifies this relationship. The primary aim of the present study was to examine change in phase angle after 2 weeks of SRT. As a secondary aim, we also sought to assess the effect of SRT on psychomotor vigilance. Following a 1‐week baseline phase, participants implemented SRT for 2 consecutive weeks. Phase angle was derived from the difference between the decimal clock time of dim light melatonin onset (DLMO) and attempted sleep time. Secondary outcomes included vigilance (assessed via hourly measurement during the DLMO laboratory protocol), sleep continuity (assessed via sleep diary and actigraphy), and insomnia severity. Eighteen participants meeting insomnia criteria (mean [SD] age 37.06 [8.99] years) took part in the study. Consistent with previous research, participants showed robust improvements in subjective and objective sleep continuity, as well as reductions in insomnia severity. The primary outcome (phase angle) was measurable in 15 participants and revealed an increase of 34.8 min (~0.58 hr; 95% confidence interval [CI] 0.01–1.15) from baseline to post‐treatment (mean [SD] 2.27 [0.94] versus 2.85 [1.25] hr). DLMO remained relatively stable (20:49 versus 21:01 hours), while attempted sleep was 46.8 min later (~0.78 hr; 95%CI 0.41–1.15; 23:05 versus 23:52 hours). For psychomotor vigilance, reaction time was delayed (by 52.71 ms, 95% CI 34.44–70.97) and number of lapses increased (by 5.84, 95% CI 3.93–7.75) after SRT. We show that SRT increases phase angle during treatment, principally by delaying the timing of sleep attempt. Future studies are needed to test if an increase in phase angle is linked to clinical improvement. Finally, reduction in vigilance after SRT appears to be of similar magnitude to normal sleepers undergoing experimental sleep restriction, reinforcing the importance of appropriate safety advice during implementation.
Royal Free Hospital‐estimated glomerular filtration rate for prognostic stratification of first acute kidney injury in cirrhosis
Authors: Rodrigues Susana G. , Abraldes Juan G. , Tsochatzis Emmanouil , Bosch Jaime , Berzigotti Annalisa
Published: December 2020

Background & Aims

Renal function is a major determinant of prognosis in patients with cirrhosis. Current guidelines only contemplate serum creatinine (sCr) to assess kidney injury. However, there are formulas to estimate glomerular filtration rate (eGFR) which better measure renal function in patients listed for liver transplantation. There is no data available on whether these formulas predict prognosis in patients with acute kidney injury (AKI).

Methods

In 143 patients presenting with a first episode of AKI, we compared the prognostic value of renal function estimated using sCr or eGFR assessed with Modification of Diet in Renal Disease (MDRD‐6), chronic kidney disease epidemiology (CKD‐EPI) and Royal Free Hospital (RFH) for renal replacement therapy (RRT) within 30 days of AKI, and 30‐ and 90‐day transplant‐free survival.

Results

eGFR was calculated on values obtained before and at admission, at presentation of AKI (D0) and 48 hours after AKI (D2).15% of patients (more commonly in alcohol + metabolic etiology; P = .049 vs other) required RRT. Transplant‐free survival at 30‐and 90‐day were 77% and 63%. Among sCr, MDRD‐6, CKD‐EPI and RFH‐eGFR, the latter predicted best RRT (HR 0.937 95% CI 0.893‐0.982, P = .007), 30‐d (HR 0.936 95% CI 0.901‐0.972, P = .001) and 90‐d (HR 0.934 95% CI 0.908‐0.972, P < .001) mortality/OLT.

Conclusions

Renal function estimated using the RFH‐eGFR calculated at D2 after AKI diagnosis is a strong predictor of RRT and of 30‐d and 90‐d transplant‐free survival. Results suggest that in cirrhosis, RFH‐eGFR may be a better indicator of prognosis in AKI than sCr.
Stability issues in Kaleckian models driven by autonomous demand growth—Harrodian instability and debt dynamics
Authors: Hein Eckhard , Woodgate Ryan
Published: December 2020

Sraffian supermultiplier models, as well as Kaleckian distribution and growth models that make use of non‐capacity creating autonomous demand growth to cope with Harrodian instability, have paid little attention to the financial side of autonomous demand growth as the driver of the system. Therefore, we link the issue of Harrodian instability in Kaleckian models driven by non‐capacity creating autonomous demand growth with the associated financial dynamics. For a simple model with autonomous government expenditure growth, zero interest rates and no consumption out of wealth, we find that adding debt dynamics does not change the results obtained by Skott (2017) based on Lavoie's (2016) model without debt, each published in this journal. Hence, in this simple model, the long‐run equilibrium is stable if Harrodian instability is not too strong and the autonomous growth rate does not exceed a maximum given by the long‐run equilibrium saving rate. Introducing interest payments on government debt as well as consumption out of wealth into the model, however, changes the stability requirements: First, the autonomous growth rate of government expenditures should not fall short of the exogenous monetary interest rate. Second, this growth rate should not exceed a maximum given by the saving rate in the long‐run equilibrium net of the propensity to consume out of wealth. Third, Harrodian instability may be almost as strong as in the simple model without violating long‐run overall stability, particularly if the propensity to consume out of wealth is low. We claim that irrespective of the relevance or irrelevance of Harrodian instability, it is necessary to introduce financial variables into models driven by non‐capacity creating autonomous demand in order to assess the long‐run (in‐)stability and sustainability of growth.
The necessary indeterminacy of self‐determination: Politics, law and conflict in the Horn of Africa
Authors: de Waal Alex , Nouwen Sarah M.H.
Published: December 2020

This article frames a themed collection on Nationalism and Self‐determination in the Horn of Africa. It demonstrates how the praxis of self‐determination in the Horn of Africa has contributed to normative developments. On the basis of case studies of Eritrea, Ethiopia, Somalia and Sudan/South Sudan this article argues that nationalism and self‐determination have had different meanings in the political cultures across the different countries and have changed over time. We contend that such indeterminacy is unavoidable and should be welcomed. Nationalism is driven by historical circumstances that are contingent and often transitory. Self‐determination claims based on such nationalism are equally contingent and transitory. When the principle of self‐determination gets translated into concrete legal entitlements (for instance, a referendum on independence), it tends to solve one problem only by creating others. Instead, the pursuit and realization of self‐determination require constant political processes.
Inhibition of the P53/P21 Pathway Attenuates the Effects of Senescent Nucleus Pulposus Cell‐Derived Exosomes on the Senescence of Nucleus Pulposus Cells
Authors: Chen Chang‐chun , Chen Jing , Wang Wen‐liang , Xie Liang , Shao Chuan‐qiang , Zhang Yan‐xiang
Published: December 2020

Objective

The purpose of this paper is to investigate the effects of senescent nucleus pulposus cell (NPC)‐derived exosomes (SNPC‐Exo) and the roles of the P53/P21 pathway on the senescence of NPC.

Methods

The senescent phenotypes of NPC were induced by interleukin‐1β treatment. SNPC‐Exo was extracted from the culture medium of senescent NPC and purified by differential centrifugation. The structure of SNPC‐Exo was identified by transmission electron microscopy and western blot analysis was used to determine the exosomal marker proteins CD63 and Tsg101. Western blot analysis was performed to determine the relative expression levels of P16, P21, and P53 in NPC. Senescence‐associated β‐galactosidase (SA‐β‐gal) staining was used to stain the senescent NPC and a phase contrast microscope was used to observe and count the SA‐β‐gal staining of NPC. The proliferation of SNPC‐Exo‐treated NPC was assessed using growth curve analysis and the colony formation assay. The cell cycle of SNPC‐Exo‐treated NPC was determined by flow cytometry. NPC were transfected with siRNA to knock down P53 and P21 expression.

Results

Interleukin‐1β‐treated NPC had a higher percentage of SA‐β‐gal positive cells (45%) than the control group (20%) and showed an increase in the relative expression of P16, P21, and P53 (P < 0.05). SNPC‐Exo were positive for exosomal marker protein CD63 and Tsg 101 and negative for calnexin, and successfully internalized as previously described. SNPC‐Exo‐treated NPC showed an increase in the relative expression of P21 and P53 (P < 0.05). Compared with the control group, the SNPC‐Exo‐treated NPC showed a lower growth rate (3 times lower on the 5th day and 2 times lower on the 7th day), fewer colony‐forming units (12.0%), and a higher percentage of SA‐β‐gal‐positive NPC (50.0%). The SNPC‐Exo‐treated NPC contained more G1 phase cells (68.0%) and fewer S phase (15.5%) cells than the control group (53.0% in G1 phase, 33.5% in S phase). The expression of P21 and P53 significantly decreased in SNPC‐exo‐treated NPC after siRNA transfection (P < 0.05), followed by a higher growth rate (2 times higher on the 5th day and 1.5 times higher on the 7th day) and lower percentage of SA‐β‐gal‐positive NPC (22.5%). Moreover, the inhibition of the P53/P21 pathway promoted the SNPC‐Exo‐treated NPC to enter the S phase (from 15.5% to 25.3%).

Conclusion

The inhibition of the P53/P21 pathway attenuated the senescence of NPC induced by SNPC‐Exo.
Major Socioeconomic Driving Forces of Improving Population Health in China: 1978–2018
Authors: Zhao Zhongwei , Jia Hongbo , Chen Mengxue
Published: December 2020

China's post‐Cultural‐Revolution reform generated rapid economic growth. But it also brought about major negative changes, especially in the early stage, which jeopardized population health and mortality gains. Nonetheless, improvements continued. China had achieved the Millennium Development Goal target 4 of reducing under‐5 mortality by two‐thirds well before the target year of 2015. Life expectancy continued to rise and reached 76.6 years by 2018, notably higher than the world average and that recorded in many countries with similar per capita GDP. By describing China's recent economic growth, the rebuilding of nationwide health insurance systems, the development of medical financial assistance, and poverty alleviation programs, this paper shows how these improvements were achieved. Vulnerability to health and mortality risks has been reduced; the availability of, and people's access to, health insurance have increased; and better medical treatments and health services have become available and accessible. These macro‐socioeconomic determinants have played the central role in achieving further population health and mortality progress in China in the past four decades.
One‐time abscisic acid priming induces long‐term salinity resistance in Vicia faba: Changes in key transcripts, metabolites, and ionic relations
Authors: Sagervanshi Amit , Naeem Asif , Geilfus Christoph‐Martin , Kaiser Hartmut , Mühling Karl H.
Published: December 2020

Abscisic acid (ABA) priming is known to enhance plant growth and survival under salinity. However, the mechanisms mediating this long‐term acclimatization to salt stress are still obscure. Specifically, the long‐term transcriptional changes and their effects on ion relations were never investigated. This motivated us to study the long‐term (8 days) effect of one‐time 24 h root priming treatment with 10 μM ABA on transcription levels of relevant regulated key genes, osmotically relevant metabolites, and ionic concentrations in Vicia faba grown under 50 mM NaCl salinity. The novelty of this study is that we could demonstrate long‐term effects of a one‐time ABA application. ABA‐priming was found to prevent the salt‐induced decline in root and shoot dry matter, improved photosynthesis, and inhibited terminal wilting of plants. It substantially increased the mRNA level of AAPK and 14‐3‐3 ABA inducible kinases and ion transporters (PM H+‐ATPase, VFK1, KUP7, SOS1, and CLC1). These ABA‐induced transcriptional changes went along with altered tissue ion patterns. Primed plants accumulated less Na+ and Cl− but more K+, Ca2+, Zn2+, Fe2+, Mn2+, NO3−, and SO42−. Priming changed the composition pattern of organic osmolytes under salinity, with glucose and fructose being dominant in unprimed, whereas sucrose was dominant in the primed plants. We conclude that one‐time ABA priming mitigates salt stress in Vicia faba by persistently changing transcription patterns of key genes, stabilizing the ionic and osmotic balance, and improving photosynthesis and growth.
It is all relative: Contextual influences on boredom and neural correlates of regulatory processes
Authors: Perone Sammy , Anderson Alana J. , Weybright Elizabeth H.
Published: December 2020

Interest in the influences on and strategies to mitigate boredom has grown immensely. Boredom emerges in contexts in which people have difficulty paying attention, such as underchallenging relative to optimally challenging conditions. The current study probed contextual influences on peoples' experience of boredom by manipulating the order with which people performed easy and optimally challenging conditions of a task (N = 113). We measured frontal alpha asymmetry (FAA) and theta/beta as neural correlates of self‐regulatory and attentional control processes, respectively. Results showed self‐reported boredom was higher in the easy condition when the optimal condition was completed before it. Similarly, participant's FAA shifted rightward from the first to the second task when the optimal condition was completed prior to the easy condition, indicating that self‐regulatory processes were strongly engaged under these context‐specific conditions. Theta/beta was lower during the easy relative to the optimal condition, regardless of the task order, indicating that maintaining attention in the easy condition was more difficult. No relations between perceptions of the task and neural correlates were observed. Exploratory analyses revealed higher levels of variability in FAA and theta/beta were associated with less enjoyment and more boredom, respectively. We speculate these observations reflect the less consistent engagement of self‐regulatory and attentional control and, in turn, might play a role in peoples' subjective experience. We discuss the implications of our findings for our understanding of influences on and strategies to mitigate boredom, as well as how attentional and self‐regulatory processes operate under conditions boredom typically emerges.
Who said what? The effects of speech tempo on target detection and information extraction in a multi‐talker situation: An ERP and functional connectivity study
Authors: Szalárdy Orsolya , Tóth Brigitta , Farkas Dávid , Hajdu Botond , Orosz Gábor , Winkler István
Published: December 2020

People with normal hearing can usually follow one of the several concurrent speakers. Speech tempo affects both the separation of concurrent speech streams and information extraction from them. The current study varied the tempo of two concurrent speech streams to investigate these processes in a multi‐talker situation. Listeners performed a target‐detection and a content‐tracking task, while target‐related ERPs and functional brain networks sensitive to speech tempo were extracted from the EEG signal. At slower than normal speech tempo, building the two streams required longer processing times, and possibly the utilization of higher‐order, for example, syntactic and semantic cues. The observed longer reaction times and higher connectivity strength in a theta band network associated with frontal control over auditory/speech processing are compatible with this notion. With increasing tempo, target detection performance decreased and the N2b and the P3b amplitudes increased. These data suggest an increased need for strictly allocating target‐detection‐related resources at higher tempo. This was also reflected by the observed increase in the strength of gamma‐band networks within and between frontal, temporal, and cingular areas. At the fastest tested speech tempo, there was a sharp drop in recognition memory performance, while target detection performance increased compared to the normal speech tempo. This was accompanied by a significant increase in the strength of a low alpha network associated with the suppression of task‐irrelevant speech. These results suggest that participants prioritized the immediate target detection task over the continuous content tracking, likely due to some capacity limit reached the fastest speech tempo.
Blood group P1 prediction using multiplex PCR genotyping of A4GALT among Thai blood donors
Authors: Thinley Jigme , Nathalang Oytip , Chidtrakoon Sarisa , Intharanut Kamphon
Published: December 2020

Objectives

This study aimed to investigate single‐nucleotide variants (SNVs) associated with P1 expression among Thai blood donors and develop a genotyping method using multiplex polymerase chain reaction (PCR) to predict P1 blood group status.

Background

The α1,4‐galactosyltransferase (A4GALT), also called Gb3/CD77 synthase or P1/Pk synthase enzyme, is encoded by the A4GALT gene and catalyses the transfer of galactose from uridine diphosphate‐galactose to lactosylceramide, creating the Pk antigen (Gb3). The same enzyme synthesises the P1 antigen by adding terminal galactose to paragloboside. The A4GALT transcripts are elevated in P1, and different SNVs in transcription factor‐binding regions of A4GALT correlate with P1 and P2 phenotypes.

Material and Methods

A total of 218 blood samples from Thai blood donors at the Thammasat University Hospital were tested for the P1 antigen using the conventional tube technique. Genomic DNA was extracted, and non‐coding regions of A4GALT were sequenced and analysed. A multiplex PCR assay was developed and validated to identify P1‐associated SNVs and was subsequently tested on 1022 Thai DNA samples of unknown P1 antigen status.

Results

In the tested cohort (n = 218), P1 and P2 phenotypes were found in 24.77% and 75.23% of donors, respectively. Moreover, three SNVs—rs8138197 (C/T), rs2143918 (T/G) and rs5751348 (G/T)—correlated 100% with both phenotypes. Finally, findings agreed with serological phenotyping and DNA sequencing results, confirming their validity for predicting P1 antigen positivity.

Conclusions

This study confirmed that three SNVs also correlated with P1/P2 phenotypes among Thais, as expected. A multiplex PCR found that SNVs rs2143918 (T) and rs5751348 (G) predicted blood group P1 and is an accurate, reproducible, cost‐effective and less time‐consuming alternative to traditional methods.
Defining natural factors that stimulate and inhibit cellulose:xyloglucan hetero‐transglucosylation
Authors: Herburger Klaus , Franková Lenka , Pičmanová Martina , Xin Anzhou , Meulewaeter Frank , Hudson Andrew , Fry Stephen C.
Published: December 2020

Certain transglucanases can covalently graft cellulose and mixed‐linkage β‐glucan (MLG) as donor substrates onto xyloglucan as acceptor substrate and thus exhibit cellulose:xyloglucan endotransglucosylase (CXE) and MLG:xyloglucan endotransglucosylase (MXE) activities in vivo and in vitro. However, missing information on factors that stimulate or inhibit these hetero‐transglucosylation reactions limits our insight into their biological functions. To explore factors that influence hetero‐transglucosylation, we studied Equisetum fluviatile hetero‐trans‐β‐glucanase (EfHTG), which exhibits both CXE and MXE activity, exceeding its xyloglucan:xyloglucan homo‐transglucosylation (XET) activity. Enzyme assays employed radiolabelled and fluorescently labelled oligomeric acceptor substrates, and were conducted in vitro and in cell walls (in situ). With whole denatured Equisetum cell walls as donor substrate, exogenous EfHTG (extracted from Equisetum or produced in Pichia) exhibited all three activities (CXE, MXE, XET) in competition with each other. Acting on pure cellulose as donor substrate, the CXE action of Pichia‐produced EfHTG was up to approximately 300% increased by addition of methanol‐boiled Equisetum extracts; there was no similar effect when the same enzyme acted on soluble donors (MLG or xyloglucan). The methanol‐stable factor is proposed to be expansin‐like, a suggestion supported by observations of pH dependence. Screening numerous low‐molecular‐weight compounds for hetero‐transglucanase inhibition showed that cellobiose was highly effective, inhibiting the abundant endogenous CXE and MXE (but not XET) action in Equisetum internodes. Furthermore, cellobiose retarded Equisetum stem elongation, potentially owing to its effect on hetero‐transglucosylation reactions. This work provides insight and tools to further study the role of cellulose hetero‐transglucosylation in planta by identifying factors that govern this reaction.
New Interpretation of Extracurricular Activities via Social Networking Sites: A Case Study of Artificial Intelligence Learning at a Secondary School in Hong Kong
Authors: Ng Tsz Kit
Published: December 2020

During the COVID-19 pandemic, attending after-school activities now becomes a luxury to students, which used to establish interests, friendships and social networks in an informal setting. Students lost contact with peers and teachers and were forced to attend blended courses at home, which may constitute threats to their non-academic issues, especially social needs and mental health of the most vulnerable students. This article overviews a new interpretation of extracurricular activities (ECAs) to teach artificial intelligence (AI) via a social networking site (SNS) among junior secondary school students in Hong Kong. A three-stage action research with the use of semi-structured interviews, motivational surveys and lesson observation was conducted. Based on how students perceived such pedagogical changes, the teachers employed various strategies to transform the “after-school” activities online. The investigation presented the planning processes on how to transform the informal learning activities to an online mode via SNSs that can reach the roles of ECAs in schooling. Our study indicated that meaningful activities rely on teachers’ leading role to build a collaborative social media environment in order to facilitate social engagement among students.
A Novel Design for a Compliant Mechanism Based Variable Stiffness Grasper Through Structure Modulation
Authors: Chandrasekaran Karthik , Somayaji Adarsh , Thondiyath Asokan
Published: December 2020

Robots utilize graspers for interacting with an environment. Conventional robotic graspers have difficulty conforming to objects of varied shape and exerting varying grasping forces. Variable stiffness soft robotic graspers provide these features but face issues such as slow response time, the requirement of external power packs for operation and low variation of stiffness. A variable stiffness compliant robotic grasper that is simple in design and operation would improve end effectors used in assistive robotics and prostheses for handling a wide array of objects. In this paper, we present the design of a novel variable stiffness compliant robotic grasper that can change its stiffness through structural transformations. Current designs utilizing structural transformations do not provide shape conformance while grasping objects. We propose a design for a soft robotic grasper using the concept of stability of truss structures. This design is capable of partially conforming to the surface of an object being grasped and can rapidly vary its stiffness utilizing compliant rotating elements embedded in the grasper jaws. The grasper behavior is modeled using finite element analysis (FEA) and validated experimentally. Our results demonstrate that structural transformation of flexible elements is a potential solution for achieving variable stiffness in a grasper.