bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward discovering a national identity for millennials: Examining their personal value orientations for regional, institutional, and demographic similarities or variations
Authors: Weber James , Loewenstein Jeffrey , Lewellyn Patsy , Elm Dawn R. , Hill Vanessa , Warnell Jessica McManus
Published: August 2019

Millennials are a powerful workforce group and are quickly becoming established business leaders, consumers, and investors. Yet, millennials are often described as a uniformly homogeneous generation, despite mounting evidence of variances across their private and workplace behaviors, attitudes and preferences, and personal values. This article examines the personal value orientations of millennials in the Unites States, reporting consistencies, variations, and contrasts based on a large sample drawn from seven diverse universities. Results of this article suggest more similarities across a national population of millennials than differences, suggesting a national identity among American millennials. Practical implications of our findings and future research are discussed.
Social media monitoring on the perceived safety of medication use during pregnancy: A case study from the Netherlands
Authors: van Gelder Marleen M.H.J. , Rog Annemarije , Bredie Sebastian J.H. , Kievit Wietske , Nordeng Hedvig , van de Belt Tom H.
Published: August 2019

Aims

An increasing number of women trust the Internet for information about medication safety during pregnancy. This study aimed to evaluate the availability and accuracy of social media content on the perceived safety of medication use in pregnancy.

Methods

We performed a systematic search of posts related to medication safety during pregnancy in the Dutch language published on social media, blogs and forums between May 2011 and April 2016 using Coosto, a tool for social media monitoring. The perceived safety in the posts was compared with the Dutch Teratology Information Service (TIS) safety classifications.

Results

We included 1224 online posts, which described 1441 scenarios about medication safety in pregnancy. A total of 820 (57%) scenarios were in line with the TIS classification. Incorrect perception was higher for prescription medication compared to medication available over‐the‐counter (60 vs 25%). Furthermore, the safety classification of medications with a TIS classification on strict indication or second‐line drugs (93%) and medications with insufficient knowledge on their safety during pregnancy (76%) was more likely to be incorrectly perceived by the public compared to medications with the TIS classification safe (24%).

Conclusions

Social media monitoring may be useful for surveillance of potentially unsafe use of medications in pregnancy. Many social posts related to medication safety during pregnancy provide inaccurate information. As this information may affect women's perceptions and decisions, accurate communication between healthcare providers and pregnant women regarding the benefits and risks of medications is vital.
The ellagitannin metabolite urolithin C is a glucose‐dependent regulator of insulin secretion through activation of L‐type calcium channels
Authors: Bayle Morgane , Neasta Jérémie , Dall'Asta Margherita , Gautheron Guillaume , Virsolvy Anne , Quignard Jean‐François , Youl Estelle , Magous Richard , Guichou Jean‐François , Crozier Alan , Del Rio Daniele , Cros Gérard , Oiry Catherine
Published: August 2019

Background and Purpose

The pharmacology of polyphenol metabolites on beta‐cell function is largely undetermined. We sought to identify polyphenol metabolites that enhance the insulin‐secreting function of beta‐cells and to explore the underlying mechanisms.

Experimental Approach

INS‐1 beta‐cells and rat isolated islets of Langerhans or perfused pancreas preparations were used for insulin secretion experiments. Molecular modelling, intracellular Ca2+ monitoring, and whole‐cell patch‐clamp recordings were used for mechanistic studies.

Key Results

Among a set of polyphenol metabolites, we found that exposure of INS‐1 beta‐cells to urolithins A and C enhanced glucose‐stimulated insulin secretion. We further characterized the activity of urolithin C and its pharmacological mechanism. Urolithin C glucose‐dependently enhanced insulin secretion in isolated islets of Langerhans and perfused pancreas preparations. In the latter, enhancement was reversible when glucose was lowered from a stimulating to a non‐stimulating concentration. Molecular modelling suggested that urolithin C could dock into the Cav1.2 L‐type Ca2+ channel. Calcium monitoring indicated that urolithin C had no effect on basal intracellular Ca2+ but enhanced depolarization‐induced increase in intracellular Ca2+ in INS‐1 cells and dispersed cells isolated from islets. Electrophysiology studies indicated that urolithin C dose‐dependently enhanced the L‐type Ca2+ current for levels of depolarization above threshold and shifted its voltage‐dependent activation towards more negative potentials in INS‐1 cells.

Conclusion and Implications

Urolithin C is a glucose‐dependent activator of insulin secretion acting by facilitating L‐type Ca2+ channel opening and Ca2+ influx into pancreatic beta‐cells. Our work paves the way for the design of polyphenol metabolite‐inspired compounds aimed at ameliorating beta‐cell function.
“You Always Remain Slightly an Outsider”: Workplace Experiences of Academics from Working‐Class or Impoverished Backgrounds
Authors: Waterfield Bea , Beagan Brenda L. , Mohamed Tameera
Published: August 2019

Debates surrounding class inequality and social mobility often highlight the role of higher education in reducing income inequality and promoting equity through upward social mobility. We explore the lived experience of social mobility through an analysis of 11 semistructured interviews with Canadian academics who self‐identified as having working‐class or impoverished family origins. While economic capital increased substantially, cultural capital and habitus left many feeling like cultural outsiders. Isolation—both chosen and imposed—reduced professional networks, diminishing social capital. Caught between social worlds, participants mobilized symbolic capital in moral boundary marking, aligning themselves strategically with either their current class status or their working‐class roots. While upward social mobility is a path toward reducing economic inequality, the lived experience of social mobility suggests it may exact a high emotional cost.
When the Solution Is on the Doorstep: Better Solving Performance, but Diminished Aha! Experience for Chess Experts on the Mutilated Checkerboard Problem
Authors: Bilalić Merim , Graf Mario , Vaci Nemanja , Danek Amory H.
Published: August 2019

Insight problems are difficult because the initially activated knowledge hinders successful solving. The crucial information needed for a solution is often so far removed that gaining access to it through restructuring leads to the subjective experience of “Aha!”. Although this assumption is shared by most insight theories, there is little empirical evidence for the connection between the necessity of restructuring an incorrect problem representation and the Aha! experience. Here, we demonstrate a rare case where previous knowledge facilitates the solving of insight problems but reduces the accompanying Aha! experience. Chess players were more successful than non‐chess players at solving the mutilated checkerboard insight problem, which requires retrieval of chess‐related information about the color of the squares. Their success came at a price, since they reported a diminished Aha! experience compared to controls. Chess players’ problem‐solving ability was confined to that particular problem, since they struggled to a similar degree to non‐chess players to solve another insight problem (the eight‐coin problem), which does not require chess‐related information for a solution. Here, chess players and non‐chess players experienced the same degree of insight.
Gricean Expectations in Online Sentence Comprehension: An ERP Study on the Processing of Scalar Inferences
Authors: Augurzky Petra , Franke Michael , Ulrich Rolf
Published: August 2019

There is substantial support for the general idea that a formalization of comprehenders' expectations about the likely next word in a sentence helps explaining data related to online sentence processing. While much research has focused on syntactic, semantic, and discourse expectations, the present event‐related potentials (ERPs) study investigates neurolinguistic correlates of pragmatic expectations, which arise when comprehenders expect a sentence to conform to Gricean Maxims of Conversation. For predicting brain responses associated with pragmatic processing, we introduce a formal model of such Gricean pragmatic expectations, using an idealized incremental interpreter. We examine whether pragmatic expectancies derived from this model modulate the amplitude of the N400, a component that has been associated with predictive processing. As part of its parameterization, the model distinguishes genuine pragmatic interpreters, who expect maximally informative true utterances, from literal interpreters, who only expect truthfulness. We explore the model's non‐trivial predictions for an experimental setup which uses picture‐sentence verification with ERPs recorded at several critical positions in sentences containing the scalar implicature trigger some. We find that Gricean expectations indeed affect the N400, largely in line with the predictions of our model, but also discuss discrepancies between model predictions and observations critically.
Keratinocytes maintain compartmentalization between dermal papilla and fibroblasts in 3D heterotypic tri‐cultures
Authors: Tan Justin J. Y. , Common John E. , Wu Chunyong , Ho Paul C. L. , Kang Lifeng
Published: August 2019

Objectives

Reproducing human hair follicles in vitro is often limited by various reasons such as the lack of a systematic approach to culture distinct hair follicle cell types to reproduce their spatial relationship. Here, we reproduce hair follicle‐like constructs resembling the spatial orientation of different cells in vivo, to study the role of keratinocytes in maintaining cellular compartmentalization among hair follicle‐related cells.

Materials and methods

Dermal papilla (DP) cells, HaCaT keratinocytes and human dermal fibroblast (HDF) cells were seeded sequentially into three‐dimensional (3D) microwells fabricated from polyethylene glycol diacrylate hydrogels. Quantitative polymerase chain reaction was used to compare inductive gene expression of 3D and two‐dimensional (2D) DP. DP and HaCaT cells were transfected with green fluorescent protein and red fluorescent protein lentivirus, respectively, to enable cell visualization using confocal microscopy.

Results

The 3D DP cultures showed significantly enhanced expression of essential DP genes as compared 2D cultures. Core‐shell configurations containing keratinocytes forming the outer shell and DP forming the core were observed. Migratory polarization was mediated by cell‐cell interaction between the keratinocytes and HDF cells, while preserving the aggregated state of the DP cells.

Conclusions

Keratinocytes may play a role in maintaining compartmentalization between the DP and the surrounding HDF residing in the dermis, and therefore maintains the aggregative state of the DP cells, necessary for hair follicle development and function.
Post‐scabietic nodules: Mimicker of infantile indeterminate cell histiocytosis and potential diagnostic pitfall
Authors: Ruby Kristen N. , Loo Eric Y. , Mann Julianne A. , LeBlanc Robert E.
Published: August 2019

Indeterminate cell histiocytosis (ICH) is an extremely rare disease and little is known about its etiology. Patients usually present with nodular, dermal proliferations of indeterminate cells, which characteristically resemble Langerhans cells but lack Birbeck granules. The clinical course is highly variable, ranging from spontaneous regression to rapid progression with reports of extracutaneous involvement, subsequent acute myeloid leukemias, and associated B‐cell lymphomas. Rare cases of ICH‐like reactions have been reported in the setting of scabies infestations as well as in patients who had been bitten by ticks and mosquitos. We present a successfully treated case of indeterminate cell‐rich post scabietic nodules in an otherwise healthy 8‐month‐old boy and review the literature on similar cases. Clinical context is essential for correct interpretation of these indolent ICH‐mimicking lesions, and to avert unnecessary patient anxiety and aggressive management.
Pitx2c inhibition increases atrial fibroblast activity: Implications in atrial arrhythmogenesis
Authors: Kao Yu‐Hsun , Chung Cheng‐Chih , Cheng Wan‐Li , Lkhagva Baigalmaa , Chen Yi‐Jen
Published: August 2019

Background

A Pitx2c deficiency increases the risk of atrial fibrillation (AF). Atrial structural remodelling with fibrosis blocks electrical conduction and leads to arrhythmogenesis. A Pitx2c deficiency enhances profibrotic transforming growth factor (TGF)‐β expression and calcium dysregulation, suggesting that Pitx2c may play a role in atrial fibrosis. The purposes of this study were to evaluate whether a Pitx2c deficiency modulates cardiac fibroblast activity and study the underlying mechanisms.

Materials and Methods

A migration assay, proliferation analysis, Western blot analysis and calcium fluorescence imaging were conducted in Pitx2c‐knockdown human atrial fibroblasts (HAFs) using short hairpin (sh)RNA or small interfering (si)RNA.

Results

Compared to control HAFs, Pitx2c‐knockdown HAFs had a greater migration but a similar proliferative ability. Pitx2c‐knockdown HAFs had a higher calcium influx with enhanced phosphorylation of calmodulin kinase II (CaMKII), α‐smooth muscle actin and matrix metalloproteinase‐2. In the presence of a CaMKII inhibitor (KN‐93, 0.5 μmol/L), control and Pitx2c‐knockdown HAFs exhibited similar migratory abilities.

Conclusion

These findings suggest that downregulation of Pitx2c may regulate atrial fibrosis through modulating calcium homeostasis, which may contribute to its role in anti‐atrial fibrosis, and Pitx2c downregulation may change the atrial electrophysiology and AF occurrence through modulating fibroblast activity.
Preparing the Next Generation of Educational Measurement Specialists: A Call for Programs With an Integrated Scope and Sequence
Authors: Russell Mike , Ludlow Larry , O'Dwyer Laura
Published: August 2019

The field of educational measurement has evolved considerably since the first doctoral programs were established. In response, programs have typically tacked on courses that address newly developed theories, methods, tools, and techniques. As our review of current programs evidences, this approach produces artificial distinctions among topics and techniques that are in fact a tightly coupled whole. This position paper advocates a redesign of the scope and sequence for doctoral programs focused on the preparation of the next generations of educational measurement specialists; a redesign that reflects the full life‐cycle of instrument development and use.
Hemodialysis without anticoagulation: Less clotting in conventional hemodialysis than in predilution hemodiafiltration
Authors: Krummel Thierry , Cellot Etienne , Thiery Alicia , De Geyer Géraldine , Keller Nicolas , Hannedouche Thierry
Published: August 2019

Introduction

Hemodialysis patients with contraindication to systemic anticoagulation require a heparin‐free hemodialysis technique. Among several alternatives to heparin, predilution hemodiafiltration (HDF) is often used, albeit without any confirmation of its effectiveness.

Methods

Patients hospitalized in a nephrology ICU and hemodialysed for stage 5 CKD or AKI and with contraindication to systemic anticoagulation were randomized to either standard HD with a polysulfone membrane, or to predilution HDF with the same membrane. Coagulation activation was evaluated clinically by the need for premature termination and by the measurement of D‐dimers.

Findings

Two hundred dialysis sessions were performed in 155 patients. Survival curves showed better circuit survival in HD (P = 0.046). In HD, 12% of sessions were interrupted for coagulation versus 23% in predilution HDF (P = 0.04).

Discussion

Predilution HDF was associated with more premature clotting than conventional HD without improvement in dialysis duration or performance epuration indices. When aiming for a 4‐hour duration session, conventional heparin‐free hemodialysis can be safely proposed in most patients with high bleeding risk.
Current status of countermeasures for infectious diseases and resistant microbes in the field of urology
Authors: Kitano Hiroyuki , Teishima Jun , Shigemura Katsumi , Ohge Hiroki , Fujisawa Masato , Matsubara Akio
Published: August 2019

A worldwide increase in antimicrobial‐resistant microbes due to the improper use of antimicrobial agents, along with a lack of progress in developing new antimicrobials, is becoming a societal problem. Although carbapenem‐resistant Enterobacteriaceae, which are resistant to carbapenem antimicrobials, first appeared in 1993, treatment options remain limited. Mechanisms behind antimicrobial resistance involve changes to microbial outer membranes, drug efflux pump abnormalities, β‐lactamase production and the creation of biofilms around cell bodies. Genetic information related to these forms of antimicrobial resistance exists on chromosomes and plasmids, and when located on the latter can easily be transmitted to other strains, no matter the species, which creates a risk of antimicrobial resistance spreading exceptionally rapidly. To prevent the spread of antimicrobial resistance, the World Health Organization in 2015 published an action plan on antimicrobial resistance, based on which World Health Organization member countries have laid out specific policies and targets. Urinary tract infections are a type of healthcare‐associated infection, and the sexually transmitted disease pathogen, Neisseria gonorrhoeae, has been included in a list of microbes that pose a risk to human health published by the US Centers for Disease Control and Prevention. Urologists face numerous problems when attempting to use antimicrobials properly, which is one method of dealing with antimicrobial resistance. Therefore, this article describes the current state of resistant microbes associated with urinary tract infections and countermeasures for antimicrobial resistance, including new antimicrobials.
Can policy deviance reduce poverty? A critical analysis of self‐return migration in Cameroon
Authors: Balgah Roland Azibo , Kimengsi Jude Ndzifon
Published: August 2019

The general focus of policy is to achieve pre‐designed goals considered by policy‐makers to be of interest to societies or targeted groups. Policy research has, therefore, witnessed a significant tilt towards improving scientific knowledge and understanding policy enactment processes, and the extent to which they achieve desired goals. Policy deviance – the tendency for members of society to ignore or disrespect laid‐down policy guidelines – has often been considered a crucial determinant for poor policy outcomes. However, the benefits of policy deviance, and the conditions under which societal groups register such benefits currently account for only a negligible number of studies. This article reduces this existing knowledge gap by examining the nexus between policy deviance and poverty reduction, based on a case study of deviant migrant households who relocated to settle around the Lake Nyos area in Cameroon. The empirical analysis through a livelihoods lens revealed a positive relationship between deviance and poverty reduction. The conclusion suggests that not all policy deviance situations lead to negative outcomes. It emphasises the need for a constant analysis of the policy outcome nexus, as opposed to the assumption that deviance leads to negative outcomes. Further research is needed to ground this contention.
Design of carbonated r‐MgO‐PC binder system: Effect of r‐MgO replacement level and water‐to‐binder ratio
Authors: Zhang Runxiao , Panesar Daman K.
Published: August 2019

This study investigates the influence of reactive MgO (r‐MgO) replacement levels and water‐to‐binder (w/b) ratios on the compressive strength, carbonation front, and pore structure of mortars with r‐MgO and Portland cement (r‐MgO‐PC) as binder. The experimental results reveal that an increase in the w/b ratio decreases the carbonation degree for mortars with 20% r‐MgO, but increases the carbonation degree for mortars with 60% r‐MgO. The r‐MgO replacement level together with the w/b ratio and carbonation degree impacts the type and quantity of the carbonation products, namely Mg‐calcite, nesquehonite and the hydrated amorphous Mg carbonate, which affects the pore structure and compressive strength of the matrix. The maximum strength for mortars with 20% r‐MgO occurs at the lowest w/b ratio (0.45), while the maximum strength for mortars with 60% r‐MgO occurs at the intermediate w/b ratio (0.65). A design of r‐MgO replacement level, w/b ratio in conjunction with the drying and carbonation curing regimes is needed for further advancement and application r‐MgO‐PC system.
Liquid and amorphous states of boron subarsenide
Authors: Durandurdu Murat
Published: August 2019

Ab initio molecular dynamics simulations are executed to probe the short‐range order and the electrical features of the liquid and amorphous boron subarsenide (B12As2). A drastic volume swelling of ~40% is witnessed for the liquid state, relative to the crystal. The density of the melt is found to be close to that of liquid boron. As the temperature applied is gradually decreased, the volume progressively decreases and a glass‐transition zone at around 1400 K is observed. About 14% volume expansion is perceived for the amorphous phase. Due to the drastic density (volume) difference between the liquid and amorphous forms, their atomic structure is found to be different from each other. In the liquid phase at 2500 K, the mean coordination number (CN) of B and As atoms is 4.4 and 2.5, correspondingly. During the solidification process, both average CNs steadily increase and reach values of 5.5 (B‐atom) and 4.14 (As‐atom) at 300 K. The pentagonal pyramid‐like motifs barely survive at 2500 K but during the quenching process they develop progressively and some of which lead to the formation of B12 clusters. In the amorphous state, the chain‐like and A7‐like As‐As clusters are observed. Nonetheless, the noncrystalline state is proposed to be partially similar to the crystalline structure. The liquid state shows a metallic character while the amorphous form presents a semiconducting nature having an energy band gap much smaller than that of the crystalline phase.
Spotting the pests of tomorrow—Sampling designs for detection of species associations with woody plants
Authors: Eschen René , De Groot Maarten , Glavendekić Milka , Lacković Nikola , Matosević Dinka , Morales‐Rodriguez Carmen , O Hanlon Richard , Oskay Funda , Papazova Irena , Prospero Simone , Franić Iva
Published: August 2019

Aim

Early warning against potentially harmful organisms of woody plant species can be achieved by sampling sentinel plants in exporting countries. However, it is unclear where sentinel plants can best be located, and how many samples are required and when and how often sampling optimally should take place for the adequate assessment of the biodiversity associated with the target plant species. We aimed to review spatial and temporal factors affecting associate biodiversity of single woody plant species and to develop guidance for the design of global biodiversity sampling studies.

Location

Worldwide.

Taxon

Insects and Fungi.

Methods

Literature about factors affecting the diversity of insects and fungi in association with single plant species on global, regional, local and different temporal scales was reviewed. Case studies of insect and fungal diversity, primarily collected on single plant species, and the cost of collecting and analysing samples from locations around the world were analysed.

Results

The review of the literature illustrated various factors affecting diversity, and the case studies allowed quantification of the relative impact of some spatial, temporal and financial aspects on captured biodiversity and, thus, illustrate the need to consider all possible factors that may affect the result of the sampling when deciding on a sampling design.

Main conclusions

Our study illustrates the factors that should be considered when deciding on the location and timing of sampling for sentinel plants, which is important because of the trade‐off between the number of samples and sampling locations needed to detect many of the species which may be potential pests, and the cost of (repeated) sampling in many locations. Decisions about the sampling design must be based on the objective of the sampling, but our recommendations apply irrespective of the targeted plant species or country.
Older People's Loneliness in Clinical Work
Authors: Pitkala Kaisu H. , Jansson Anu , Savikko Niina
Published: August 2019

See the Reply by Perissinotto et al.
Reply to: Older People's Loneliness in Clinical Work
Authors: Perissinotto Carla , Holt‐Lunstad Julianne , Periyakoil Vyjeyanthi S. , Covinsky Ken
Published: August 2019

This letter comments on the letter by Pitkala et al.
The Experience and Motivations of Midwives of Color in Minnesota: Nothing for Us Without Us
Authors: Almanza Jennifer , Karbeah J'Mag , Kozhimannil Katy B. , Hardeman Rachel
Published: August 2019

Introduction

Racial disparities in birth outcomes originate with a confluence of factors including social determinants of health, toxic stress, structural racism, and barriers to engaging, high‐quality perinatal care. Historically and currently, midwives are disproportionately white, and attention to the racial and ethnic diversity of midwives is an increasing focus in birth equity efforts. This qualitative study helps fill the gap in literature by assessing the perspectives and motivations of midwives of color.

Methods

Building on concepts from critical race theory, semistructured interviews (30‐90 minutes long) were used to elicit an authentic voice from midwives of color, who primarily identified as African American. Participants (N = 7) were midwives who were affiliated with an African American‐owned birth center in north Minneapolis, Minnesota. Participants represented an estimated 58% of all midwives of color in the state of Minnesota. Emergent themes were identified using a grounded theory, inductive approach. Three rounds of coding were conducted, and key themes were identified and analyzed.

Results

Three primary themes emerged as motivations for midwives of color: 1) offering racially concordant care to the community, 2) racial justice as a primary motivation in their work, and 3) providing physically and emotionally safe care. Racially concordant care was identified both as a motivating factor and as a way of providing physically and emotionally safe care.

Discussion

Findings suggest that midwives of color maintain a critical analysis of and commitment to eliminating racial perinatal inequities. Their motivation to provide racially concordant care elicits an urgency in current efforts to recruit and train more midwives of color, recognizing the current lack of racial and ethnic diversity in the field. Understanding how to support the work of equity‐minded midwives of color may help to improve access to racially concordant health care providers and care that better meets the unique needs of African American individuals.
Amniotic epithelial cells damage by oxidative stress in cases of diffuse chorioamniotic hemosiderosis
Authors: Iizuka Takashi , Ono Masanori , Masumoto Sakiko , Mitani Yusuke , Yamazaki Rena , Fujiwara Hiroshi
Published: August 2019

The amniotic membrane plays an important role in the physiological maintenance and protection of the embryo. Indeed, dysfunction of the amniotic membrane is thought to have an adverse effect on the continuation of pregnancy. In this report, we examined the pathological changes in the amniotic epithelium in three cases of diffuse chorioamniotic hemosiderosis (DCH) and investigated the cause of necrosis of the amniotic epithelial cells and its relationship with oligohydramnios. Diffuse chorioamniotic hemosiderosis was confirmed in all three cases. More extensive amniotic epithelial necrosis led to more severe hemosiderosis. Immunostaining for 8‐hydroxy‐2′‐deoxyguanosine, a marker of oxidative stress, was positive in the amniotic epithelial cells. We speculate that oxidative DNA damage of the amniotic epithelium occurs by decomposition products of blood cells in cases accompanying subchorionic hematomas and pathological DCH. Furthermore, disorder of the amniotic epithelium may disrupt the balance of the amniotic fluid volume and cause oligohydramnios.
What to look for during constant observations: Expert consensus and a tool for observations recording
Authors: Chu Simon , Lambert Katie , Baker Alison
Published: August 2019

Accessible summary

What is known on the subject?

Supportive observations is the practice of closely monitoring patients who are acutely unwell in order to keep them safe.

There are no formal guidelines for nursing staff on what to observe during observations.

What this paper adds to existing knowledge?

A consensus of expert opinion suggests that the clinically meaningful behaviours in supportive observations focus on six factors: agitation, self‐harm and suicide, violence, negative influence, disengagement and positive behaviour.

What are the implications for practice?

These aspects of patient presentation should be a part of the decision‐making discussions about observations. The Mersey Care Supportive Observations Recording Tool that emerged from this consensus may assist with recording the relevant information.

Introduction

Supportive observations are common in mental health care but there are no guidelines on best practice or what should be documented in observations records.

Aim

To develop expert consensus on the important aspects of patient presentation that inform clinical decision‐making about observations and to develop a recording tool from this consensus.

Method

A Delphi methodology was used to consult an expert panel of mental health clinicians and academics to agree on what aspects of patient presentation during constant observations are important in informing clinical decisions. Thematic analysis was applied to the agreed item set to extract common aspects of presentation and behaviour.

Results

The panel considered 118 individual items across three rounds of consultation and agreed that 51 items were important to clinical decisions about observations. Thematic analysis found six man themes: agitation, self‐harm and suicide, violence, negative influence, disengagement and positive behaviour. Subthemes were used to create the MerseyCare Supportive Observations Recording Tool (MSORT).

Discussion

These data represent the first expert consensus on the aspects of patient presentation that are important to clinical decisions.

Implications for practice

Consensus items should be recorded in observations records and be considered in decision‐making about observations. The MSORT may aid observations recording.
Clinical application of mesenchymal stem cells in periodontal regeneration: A systematic review and meta‐analysis
Authors: Novello Solen , Debouche Alexandre , Philippe Marie , Naudet Florian , Jeanne Sylvie
Published: August 2019

Objective

To evaluate the potential efficacy of mesenchymal stem cells (MSCs) in periodontal regeneration in humans on the following main outcomes: clinical attachment level (CAL), probing depth (PD), and gingival recession (GR).

Background

The clinical application of stem cells in periodontal regeneration has begun in recent years, but clinical practices are not yet standardized and no recommendations are available at this time.

Methods

Electronic database searches and hand searches were conducted. All types of studies, case series, and case reports were qualitatively described. Double‐blind randomized controlled trials (RCTs) evaluating MSCs in periodontal regeneration were included in a meta‐analysis if they compared administration of MSCs vs application of stem cell‐free therapy in the control group, in healthy patients with periodontal defects, with a minimum of three mo of follow‐up.

Results

Fifteen reports were included in qualitative analysis, involving 123 patients and 158 periodontal defects. Only two small RCTs at high risk of bias, with a total of 59 patients and 70 periodontal defects, were included in the meta‐analysis. A small but significant difference between test and control groups was found for CAL at three mo (−0.90 mm, 95% CI [−1.51; −0.29]), but not for PD and GR.

Conclusion

Low‐quality evidence suggests that MSC‐based therapy may have a small impact on periodontal regeneration. However, due to the monocentric character, the small sample size, and potential heterogeneity across the two included RCTs, these results must not be considered as definitive. High‐quality RCTs are needed before any clinical use of MSCs in periodontal regeneration.
Diagnostic features, treatment, and outcome of dogs with inflammatory protein‐losing enteropathy
Authors: Salavati Schmitz Silke , Gow Adam , Bommer Nick , Morrison Linda , Mellanby Richard
Published: August 2019

Background

Protein‐losing enteropathy (PLE) because of chronic inflammatory enteropathy (CIE) in dogs is often treated with a combination of glucocorticoids and second‐line immunosuppressant (SLI). This combined approach might not be necessary in all dogs.

Hypothesis/objectives

To describe diagnostic features and outcomes of dogs with PLE treated with glucocorticoids alone (group P) or with glucocorticoids and SLI (group S).

Animals

Thirty‐one dogs with PLE.

Material and methods

Retrospective analysis of signalment data from diagnostic procedures, treatment, and outcome of dogs with CIE/PLE (from 2015 to 2017), using the hospital's digital case database. Dogs with hypoalbuminemia and CIE were included. Because of a stepwise treatment algorithm, dogs were allocated to group P or S. Time to serum albumin concentrations ≥20 g/L and survival data were collected. Dogs were additionally categorized by their albumin and cobalamin serum concentrations. Multivariate and univariate analysis as well as Pearson's correlation and Kaplan‐Maier survival analysis were performed.

Results

Seventeen dogs were included in group P and 14 in group S. World Small Animal Veterinary Association score of the duodenum was different between groups (P = .05), but none of the other examined data. Median time until serum albumin reached >20 g/L was 13 days. Median survival time after start of treatment was 85 days (range, 13‐463 days) in group P and 166 days (range, 8‐390 days) in group S.

Conclusion and Clinical Importance

No routine diagnostic test was predictive of clinical response, treatment group, or outcome. Glucocorticoid treatment alone can be appropriate in dogs with PLE.
Videofluoroscopic swallow study features of lower esophageal sphincter achalasia‐like syndrome in dogs
Authors: Grobman Megan E. , Schachtel James , Gyawali C. Prakash , Lever Teresa E. , Reinero Carol R.
Published: August 2019

Background

Megaesophagus (ME) carries a poor long‐term prognosis in dogs. In people, lower esophageal sphincter (LES) disorders causing functional obstruction are rare causes of ME that may respond to targeted treatment. Functional LES disorders are reported rarely in dogs because of challenges in diagnostic methodologies.

Hypothesis/Objectives

To identify dogs with videofluoroscopic swallow study (VFSS) features of LES achalasia‐like syndrome (LES‐AS). We hypothesized that dogs with LES‐AS could be distinguished from normal dogs using standardized VFSS criteria.

Animals

Dogs with LES‐AS by VFSS (n = 19), healthy normal dogs (n = 20).

Methods

Retrospective study. One‐hundred thirty dogs presented to the University of Missouri Veterinary Health Center (MU‐VHC) between April 2015 and December 2017 for a free‐feeding VFSS; 20 healthy dogs were included as controls. Swallow studies were evaluated for failure of the LES to relax during pharyngeal swallow (LES‐AS). Affected dogs subsequently were evaluated using standardized criteria to identify metrics important for identifying and characterizing dogs with LES‐AS.

Results

Nineteen dogs with LES‐AS were identified out of 130 VFSS. Megaesophagus was present in 14 of 19 (73.7%) dogs with LES‐AS. A baseline esophageal fluid‐line and “bird beak” were present in 68.4% (95% confidence interval [CI], 47.5%‐89.3%) and 63.2% (95% CI, 41.5%‐84.8%) of affected dogs, respectively. The esophagus was graded as acontractile (8/19), hypomotile (8/19), or hypermotile (3/19).

Conclusions and Clinical Importance

Dogs with LES‐AS may successfully be identified by VFSS using a free‐feeding protocol. These data are of critical clinical importance because a subpopulation of dogs with functional LES obstruction may be candidates for targeted intervention.
Combined interventional procedure and cardiopulmonary bypass surgery in a dog with cor triatriatum dexter, patent foramen ovale, and pulmonary stenosis
Authors: Marchesotti Federica , Rondelli Vincenzo , Pesaresi Marco , Nicoli Stefano , Vezzosi Tommaso , Auriemma Edoardo , Lanzillo Guido , Cuccio Andrea , Khouri Toufic , Dejong Annette , Domenech Oriol
Published: August 2019

A 2‐year‐old American Pit Bull dog was presented for surgical evaluation of imperforate cor triatriatum dexter (CTD) and patent foramen ovale (PFO). Echocardiography identified an imperforate CTD associated with a right‐to‐left shunting PFO and valvular pulmonary stenosis. A 2‐step interventional and surgical approach was used. Initially, a pulmonary balloon valvuloplasty was performed, and subsequently the dog underwent a surgical correction of the atrial anomaly under cardiopulmonary bypass.
Use of video capsule endoscopy to identify gastrointestinal lesions in dogs with microcytosis or gastrointestinal hemorrhage
Authors: Mabry Kasey , Hill Tracy , Marks Stanley L. , Hardy Brian T.
Published: August 2019

Background

Video capsule endoscopy (VCE) is a noninvasive imaging modality that can identify mucosal lesions not detected with traditional endoscopy or abdominal sonography. In people, VCE is used in diagnostic and management protocols of various gastrointestinal (GI) disorders, particularly in GI bleeding of obscure origin or unexplained iron deficiency anemia (IDA).

Objective

To evaluate the utility of VCE in the identification of mucosal lesions in dogs with evidence of GI hemorrhage.

Animals

Sixteen client‐owned dogs that underwent VCE.

Methods

Retrospective case‐control study. Medical records were reviewed to include dogs with microcytosis, low normal mean corpuscular volume, or clinical GI bleeding that received VCE.

Results

Median age of dogs was 8.7 years (range, 8 months to 15 years) with a median weight of 21.7 kg (range, 6.9‐62.5 kg). Abdominal ultrasound (16), abdominal radiography (4), and abdominal CT (1) did not identify a cause for GI blood loss. Gastric mucosal lesions were identified by VCE in 15 of 16 dogs and small intestinal lesions in 12 of 14 dogs, with 2 capsules remaining in the stomach. Endoscopy was performed in 2 dogs before VCE; 1 dog had additional small intestinal lesions identified through the use of VCE.

Conclusions and Clinical Importance

Video capsule endoscopy is a minimally invasive diagnostic tool that can identify GI lesions in dogs presenting with microcytosis with or without GI hemorrhage when ultrasonography is inconclusive; however, the majority of lesions identified would have been apparent with conventional endoscopy.
Predicting HBsAg clearance in genotype A chronic hepatitis B using HBsAg epitope profiling: A biomarker for functional cure
Authors: Walsh Renae , Hammond Rachel , Yuen Lilly , Deerain Joshua , O’Donnell Tanya , Leary Thomas , Cloherty Gavin , Gaggar Anuj , Kitrinos Kathryn , Subramanian Mani , Wong Darren , Locarnini Stephen
Published: August 2019

Background and Aim

Functional cure is the major goal of chronic hepatitis B (CHB) therapy though few biomarkers predict this outcome. HBsAg epitope occupancy can be influenced by therapeutic and immune pressure. The aim of this study was to map the HBsAg epitope profiles during long‐term nucleos(t)ide analogue therapy in patients with genotype A CHB, in the context of HBsAg loss (SL)/seroconversion.

Methods

We evaluated 25 genotype A CHB patients in the GS‐US‐174‐0103 trial of HBeAg‐positive CHB patients treated with tenofovir or adefovir for 4 years, 14 who achieved SL whilst 11 had no change. We epitope mapped the major domains of HBsAg to identify those patients with HBsAg clearance profile (CP) (loss of binding at both loops 1 and 2 epitopes of the ‘a’ determinant) vs non‐clearance profile (no change in epitope recognition, or loss of epitope binding at one loop only), correlating this to on‐treatment HBsAg responses. Complexed anti‐HBs was also measured.

Results

Analysis of the HBsAg epitope profiles of the 25 patients at baseline identified no predictive correlation with SL. In contrast, analysis at week 48 and end of study (week 192) or prior to SL identified significant predictive associations between development of HBsAg CPs and outcome of functional cure. The detection of a CP also correlated with the development of an alanine aminotransferase flare and detection of anti‐HBs complexed with HBsAg.

Conclusion

The detection of HBsAg CPs by epitope mapping represents a novel viral biomarker, reflecting an emerging anti‐HBs selection pressure prior to functional cure.
The Desirable Difficulty Framework as a Theoretical Foundation for Optimizing and Researching Second Language Practice
Authors: SUZUKI YUICHI , NAKATA TATSUYA , DEKEYSER ROBERT
Published: August 2019

This coda article offers unified theoretical accounts of the major findings of the empirical studies in this special issue ofOptimizing Second Language Practice in the Classroom: Perspectives from Cognitive Psychology. We present a theoretical framework from cognitive psychology (desirable difficulty framework) and link it to the ideas of second language (L2) difficulty. We argue that practice condition, linguistic difficulty, and individual differences need to be taken into account for creating optimal, deliberate, and systematic L2 practice. The desirable difficulty framework may serve as a theoretical foundation to better understand the role of practice on L2 acquisition, as well as to gain insights into effective L2 teaching. Future directions for research are presented to further develop this emerging field of L2 practice.
Transcending history
Authors: Stone Lois
Published: August 2019

The missing trans history on museum walls
Coronectomy of mandibular third molar teeth with caries or resorption ‘at‐risk' of inferior dentoalveolar nerve injury
Authors: Patel N. , Patel D. , Sproat C. , Beneng K. , Patel V.
Published: August 2019

Aim

Coronectomy is an elective surgical technique designed to reduce the risk of morbidity to the inferior dental nerve for those mandibular third molars (M3M) deemed to pose such risk. Successful coronectomy relies on the retention of a vital root with non‐inflamed pulpal tissue and healthy surrounding bone. For this reason coronectomy in teeth with disease affecting the pulp has been widely contraindicated based on theoretical presumption rather than evidence. The current case series challenges this common supposition and highlights evidence in other dental specialties to support the use of coronectomy in selected cases of teeth with pulpal involvement.

Methods

Over a 5‐year period, 22 M3M teeth closely related to the IDN canal with either caries or internal resorption were treated with coronectomy. Preoperative assessment included both 2D and 3D imaging which helped determine risk assessment.

Results

All patients had a minimum of 1 year post‐coronectomy review. No patients reported persistent symptoms or required root retrieval. Radiographically, there were no suggestions of apical radiolucency to indicate associated apical disease.

Conclusion

This small case series provides an early insight and potential scope for considering coronectomy in selective carious or internally resorbing M3M deemed at having an elevated risk of IDN injury.
Soil carbon dioxide venting through rice roots
Authors: Kirk Guy J.D. , Boghi Andrea , Affholder Marie‐Cecile , Keyes Samuel D. , Heppell James , Roose Tiina
Published: August 2019

The growth of rice in submerged soils depends on its ability to form continuous gas channels—aerenchyma—through which oxygen (O2) diffuses from the shoots to aerate the roots. Less well understood is the extent to which aerenchyma permits venting of respiratory carbon dioxide (CO2) in the opposite direction. Large, potentially toxic concentrations of dissolved CO2 develop in submerged rice soils. We show using X‐ray computed tomography and image‐based mathematical modelling that CO2 venting through rice roots is far greater than thought hitherto. We found rates of venting equivalent to a third of the daily CO2 fixation in photosynthesis. Without this venting through the roots, the concentrations of CO2 and associated bicarbonate (HCO3−) in root cells would have been well above levels known to be toxic to roots. Removal of CO2 and hence carbonic acid (H2CO3) from the soil was sufficient to increase the pH in the rhizosphere close to the roots by 0.7 units, which is sufficient to solubilize or immobilize various nutrients and toxicants. A sensitivity analysis of the model showed that such changes are expected for a wide range of plant and soil conditions.
Thioredoxin h2 contributes to the redox regulation of mitochondrial photorespiratory metabolism
Authors: da Fonseca‐Pereira Paula , Souza Paulo V.L. , Hou Liang‐Yu , Schwab Saskia , Geigenberger Peter , Nunes‐Nesi Adriano , Timm Stefan , Fernie Alisdair R. , Thormählen Ina , Araújo Wagner L. , Daloso Danilo M.
Published: August 2019

Thioredoxins (TRXs) are important proteins involved in redox regulation of metabolism. In plants, it has been shown that the mitochondrial metabolism is regulated by the mitochondrial TRX system. However, the functional significance of TRX h2, which is found at both cytosol and mitochondria, remains unclear. Arabidopsis plants lacking TRX h2 showed delayed seed germination and reduced respiration alongside impaired stomatal and mesophyll conductance, without impacting photosynthesis under ambient O2 conditions. However, an increase in the stoichiometry of photorespiratory CO2 release was found during O2‐dependent gas exchange measurements in trxh2 mutants. Metabolite profiling of trxh2 leaves revealed alterations in key metabolites of photorespiration and in several metabolites involved in respiration and amino acid metabolism. Decreased abundance of serine hydroxymethyltransferase and glycine decarboxylase (GDC) H and L subunits as well as reduced NADH/NAD+ ratios were also observed in trxh2 mutants. We further demonstrated that the redox status of GDC‐L is altered in trxh2 mutants in vivo and that recombinant TRX h2 can deactivate GDC‐L in vitro, indicating that this protein is redox regulated by the TRX system. Collectively, our results demonstrate that TRX h2 plays an important role in the redox regulation of mitochondrial photorespiratory metabolism.