bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of cumulative language exposure on heritage and majority language skills
Authors: Tao Lily , Cai Qing , Gollan Tamar H.
Published: March 2019

This study investigated the effects of the amount of cumulative heritage language (HL) exposure during three time periods, on heritage and majority language performance in young adulthood, among two distinct groups of immigrant populations in the USA. Within each time period, exposure from three different sources were examined, and amount of cumulative exposure was calculated encompassing exposure from preceding periods. Factors that may modulate exposure effects were also assessed. Results showed that greater cumulative HL exposure from people at home during all three time periods significantly predicted HL skills for both language groups. For effects on English skills, only the Spanish group showed any influences of exposure. These effects were modulated by parental English proficiency. Input from other sources had less impact. The present findings support the role of parental input throughout childhood, adolescence, and early adulthood in improving HL skills, with less noticeable consequences for the majority language.
Comparable parallel corpora
Authors: Hareide Lidun
Published: March 2019

Are papers presented in corpus-based translation studies truly scientific? These are normally done on only one language pair, often on purpose-made parallel corpora, and can normally not be replicated. Therefore their value is limited in a strictly scientific sense. The use of comparable parallel corpora allows both for the replication of studies, and the testing of complex hypotheses like Halverson’s Gravitational Pull hypothesis. This chapter defines and discusses the concept of comparable parallel corpora, and exemplifies their value by illustrating their use. The chapter also presents hopes for the future, as new groundbreaking technology that will allow the linguist to create her own parallel corpora without the aid of computer scientists is currently being launched at the University of León in Spain.
Expression, purification, and in vitro mitochondrial interaction analysis of full-length and truncated human tumor suppresser p53
Authors: Wang Lingyao , Zhao Tong , Wang Song , Jin Jingji , Cai Yong , Wang Fei
Published: March 2019

p53 is a potent tumor suppressor which can prevent the propagation of cells carrying oncogenic lesions via a multitude of pathways. Besides the transactivation of downstream genes encoding proapoptotic proteins, p53 is also able to physically interact with mitochondria and induce apoptosis through a so called transcriptional-independent pathway. In this study, we described a quick method for the expression and purification of soluble recombinant p53 and its different truncations in E. coli. These proteins are able to interact with mitochondria and induce mitochondrial outer membrane permeabilization and associated downstream apoptotic events in a cell-free apoptosis analysis system.
Production of Glucose from Waste Bark Acacia Mangium Using Delifnification and Chemical Hydrolysis Process
Authors: Arita S , Hadiah F , Amalia R , Rosmalisa E , Andalia W
Published: March 2019

The bark of Acacia mangium is lignocellulosic biomass from waste pulp which can be recovered by means of hydrolyse to produce simple sugar called glucose. To produce glucose, there are two stages of the process performed is process using solvent delignification NaOH and KOH. The parameters analyzed were the biomass with a solvent ratio (1:6, 1:8, 1:10, 1:12). The second stage cellulose is then hydrolyzed to see the influence of sulfuric acid concentration of the resulting glucose content (0.1; 0.25; 0.40; 0.55% (v/v)).Lignin removal efficiency using NaOH and KOH solvent that is almost equal to 62.39%. Decrease hemicellulose using KOH solvent (36%) are more efficient than solvent only 29.3% NaOH. Efficiency increased levels of cellulose using NaOH or KOH solvent almost equal approximately 85.5%, but with KOH the lower alkaline properties provide a more stable rise. Solvent delignification process with NaOH provide large enough glucose content at a ratio of 1: 6 and 1: 8 with sulfuric acid concentration in the range of 0.1 to 0.4 and 0.5% v/v. Increased glucose content in the solvent of NaOH at a ratio of 1:6 reached 69.88 ppm for sulfuric acid concentration of 0.55% v/v, whereas the content of glucose degradation products of cellulose with delignification process using KOH solvent is in the range of 3.25 ppm to 77.67 ppm. The highest value is produced by the hydrolysis of cellulose to the sulfuric acid concentration of 0.4% v/v, and the KOH solvent ratio is 1:10. The higher the ratio, the lower the KOH solvent content of glucose produced.
Carbon isotope minima in the South Atlantic during the last deglaciation: evaluating the influence of air-sea gas exchange
Authors: Lund D , Hertzberg J , Lacerra M
Published: March 2019

Carbon isotope minima were a ubiquitous feature in the mid-depth (1.5–2.5 km) Atlantic during Heinrich Stadial 1 (HS1, 14.5–17.5 kyr BP) and the Younger Dryas (YD, 11.6–12.9 kyr BP), with the most likely driver being collapse of the Atlantic Meridional Overturning Circulation (AMOC). Negative carbon isotope anomalies also occurred throughout the surface ocean and atmosphere, but their timing relative to AMOC collapse and the underlying drivers have remained unclear. Here we evaluate the lead-lag relationship between AMOC variability and surface ocean δ
13C signals using high resolution benthic and planktonic stable isotope records from two Brazil Margin cores (located at 1.8 km and 2.1 km water depth). In each case, the decrease in benthic δ
13C during HS1 leads planktonic δ
13C by 800 ± 200 years. Because the records are based on the same samples, the relative timing is constrained by the core stratigraphy. Our results imply that AMOC collapse initiates a chain of events that propagates through the oceanic carbon cycle in less than 1 kyr. Direct comparison of planktonic foraminiferal and atmospheric records implies a portion of the surface ocean δ
13C signal can be explained by temperature-dependent equilibration with a 13C-depleted atmosphere, with the remainder due to biological productivity, input of carbon from the abyss, or reduced air-sea equilibration.
Ocean warming pattern effects on future changes in East Asian atmospheric rivers
Authors: Kamae Youichi , Mei Wei , Xie Shang-Ping
Published: March 2019

Atmospheric rivers (ARs), intense water vapor transports associated with extra-tropical cyclones, frequently bring heavy rainfalls over mid-latitudes. Over East Asia, landfalling ARs result in major socio-economic impacts including widespread floods and landslides; for example, western Japan heavy rainfall in July 2018 killed more than 200 people. Using results of high-resolution atmospheric model ensemble simulations, we examine projected future change in summertime AR frequency over East Asia. Different sea surface temperature (SST) warming patterns derived from six atmosphere–ocean coupled model simulations were assumed to represent uncertainty in future SST projections. The rate of increase in the frequency of landfalling ARs over summertime East Asia is on average 0.9% K–1 and is dependent on SST warming patterns. Stronger warming over the North Indian Ocean and South China Sea or weaker warming over the tropical central Pacific produce more frequent landfalling ARs over East Asia. These patterns are similar to the co-variability of SST, atmospheric circulation, and ARs over the western North Pacific found on the interannual time scale. The results of this study suggest that the natural disaster risk related to landfalling ARs should increase over East Asia under global warming and SSTs over the Indo-Pacific region holds the key for a quantitative projection.
D-optimal design of b-values for precise intra-voxel incoherent motion imaging
Authors: Sansone Mario , Fusco Roberta , Petrillo Antonella
Published: March 2019

The aim of this paper is to optimally design the set of b-values for diffusion weighted MRI with the aim of precise estimation of intra-voxel incoherent motion (IVIM) parameters (f perfusion fraction, D

s
slow diffusion, D

f
 fast diffusion) according to the model developed by Le Bihan. Previous studies have addressed the design in a Monte Carlo fashion; however, due to huge computation times, this approach is practical only for a limited number of values of the parameters (local design): however, as the parameters of a specific patient are not known a priori, it would be desirable to optimise b-values over a region of parameters. In order to address this issue, we propose to use a D-optimal design approach. Our study has two key results: first, under fairy general conditions, the optimal design does not depend on perfusion fraction: this allow to perform a search over a 2D parameter space instead of 3D; second, as an exhaustive search over all possible designs would still be time consuming, we proposed an algorithm to find an approximate solution very quickly.
Assessing molecular simulation for the analysis of lipid monolayer reflectometry
Authors: McCluskey A R , Grant J , Smith A J , Rawle J L , Barlow D J , Lawrence M J , Parker S C , Edler K J
Published: March 2019

Using molecular simulation to aid in the analysis of neutron reflectometry measurements is commonplace. However, reflectometry is a tool to probe large-scale structures, and therefore the use of all-atom simulation may be irrelevant. This work presents the first direct comparison between the reflectometry profiles obtained from different all-atom and coarse-grained molecular dynamics simulations. These are compared with a traditional model layer structure analysis method to determine the minimum simulation resolution required to accurately reproduce experimental data. We find that systematic limits reduce the efficacy of the MARTINI potential model, while the Berger united-atom and Slipids all-atom potential models agree similarly well with the experimental data. The model layer structure gives the best agreement, however, the higher resolution simulation-dependent methods produce an agreement that is comparable. Finally, we use the atomistic simulation to advise on possible improvements that may be offered to the model layer structures, creating a more realistic monolayer model.  Usage: Electronic Supplementary Information (ESI) including all analysis/plotting scripts and figure files, allowing for a fully reproducible, and automated, analysis workflow for the work presented is available at https://github.com/arm61/sim_vs_trad (DOI: 10.5281/zenodo.3254719) under a CC BY-SA 4.0 license. Reduced experimental datasets are available at DOI: 10.15125/BATH-00586, under a CC-BY 4.0 license.
From Epidemiologic Knowledge to Improved Health: A Vision for Translational Epidemiology
Authors: Windle Michael , Lee Hojoon D , Cherng Sarah T , Lesko Catherine R , Hanrahan Colleen , Jackson John W , McAdams-DeMarco Mara , Ehrhardt Stephan , Baral Stefan D , D’Souza Gypsyamber , Dowdy David W
Published: March 2019

Epidemiology should aim to improve population health; however, no consensus exists regarding the activities and skills that should be prioritized to achieve this goal. We performed a scoping review of articles addressing the translation of epidemiologic knowledge into improved population health outcomes. We identified 5 themes in the translational epidemiology literature: foundations of epidemiologic thinking, evidence-based public health or medicine, epidemiologic education, implementation science, and community-engaged research (including literature on community-based participatory research). We then identified 5 priority areas for advancing translational epidemiology: 1) scientific engagement with public health; 2) public health communication; 3) epidemiologic education; 4) epidemiology and implementation; and 5) community involvement. Using these priority areas as a starting point, we developed a conceptual framework of translational epidemiology that emphasizes interconnectedness and feedback among epidemiology, foundational science, and public health stakeholders. We also identified 2–5 representative principles in each priority area that could serve as the basis for advancing a vision of translational epidemiology. We believe an emphasis on translational epidemiology can help the broader field to increase the efficiency of translating epidemiologic knowledge into improved health outcomes and to achieve its goal of improving population health.
Through the eyes of young EFL learners: learning with student teachers
Authors: Yildirim Rana , Orsdemir Esra
Published: March 2019

The importance of the practicum for pre-service teachers is well documented in the teacher education literature. A considerable amount of research has investigated various dimensions of the student teaching experience, from student teachers’ beliefs and perceptions to the problems and challenges they face within the process. However, one important dimension, namely what pupils in the classroom think about working with student teachers, has not been given much attention. Hence, the purpose of this study was to investigate how young EFL learners construe their learning experience with student teachers. Data were collected from the drawings of 35 primary school EFL pupils, and we conducted follow-up interviews in which volunteering pupils described what they had drawn. The findings revealed not only pupils’ classroom experiences with student teachers but also various aspects of mentoring practices carried out in the schools.
Proximal aorta longitudinal strain predicts aortic root dilation rate and aortic events in Marfan syndrome
Authors: Guala Andrea , Teixidó-Tura Gisela , Rodríguez-Palomares Jose , Ruiz-Muñoz Aroa , Dux-Santoy Lydia , Villalva Nicolas , Granato Chiara , Galian Laura , Gutiérrez Laura , González-Alujas Teresa , Sanchez Violeta , Forteza Alberto , García-Dorado David , Evangelista Artur
Published: March 2019

Aims

Life expectancy in Marfan syndrome patients has improved thanks to the early detection of aortic dilation and prophylactic aortic root surgery. Current international clinical guidelines support the use of aortic root diameter as a predictor of complications. However, other imaging markers are needed to improve risk stratification. This study aim to ascertain whether proximal aorta longitudinal and circumferential strain and distensibility assessed by cardiac magnetic resonance (CMR) predict the aortic root dilation rate and aortic events in Marfan syndrome.

Methods and results

One hundred and seventeen Marfan patients with no previous aortic dissection, cardiac/aortic surgery, or moderate/severe aortic regurgitation were prospectively included in a multicentre protocol of clinical and imaging follow-up. At baseline, CMR was performed and proximal aorta longitudinal strain and ascending aorta circumferential strain and distensibility were obtained. During follow-up (85.7 [75.0–93.2] months), the annual growth rate of aortic root diameter was 0.62 ± 0.65 mm/year. Fifteen patients underwent elective surgical aortic root replacement and four presented aortic dissection. Once corrected for baseline clinical and demographic characteristics and aortic root diameter, proximal aorta longitudinal strain, but not circumferential strain and distensibility, was an independent predictor of the aortic root diameter growth rate (P = 0.001, P = 0.823, and P = 0.997, respectively), z-score growth rate (P = 0.013, P = 0.672, and P = 0.680, respectively), and aortic events (P = 0.023, P = 0.096, and P = 0.237, respectively).

Conclusion

Proximal aorta longitudinal strain is independently related to the aortic root dilation rate and aortic events in addition to aortic root diameter, clinical risk factors, and demographic characteristics in Marfan syndrome patients.
A randomized controlled trial of metformin on left ventricular hypertrophy in patients with coronary artery disease without diabetes: the MET-REMODEL trial
Authors: Mohan Mohapradeep , Al-Talabany Shaween , McKinnie Angela , Mordi Ify R , Singh Jagdeep S S , Gandy Stephen J , Baig Fatima , Hussain Muhammad S , Bhalraam U , Khan Faisel , Choy Anna-Maria , Matthew Shona , Houston John Graeme , Struthers Allan D , George Jacob , Lang Chim C
Published: March 2019

Aim

We tested the hypothesis that metformin may regress left ventricular hypertrophy (LVH) in patients who have coronary artery disease (CAD), with insulin resistance (IR) and/or pre-diabetes.

Methods and results

We randomly assigned 68 patients (mean age 65 ± 8 years) without diabetes who have CAD with IR and/or pre-diabetes to receive either metformin XL (2000 mg daily dose) or placebo for 12 months. Primary endpoint was change in left ventricular mass indexed to height1.7 (LVMI), assessed by magnetic resonance imaging. In the modified intention-to-treat analysis (n = 63), metformin treatment significantly reduced LVMI compared with placebo group (absolute mean difference −1.37 (95% confidence interval: −2.63 to −0.12, P = 0.033). Metformin also significantly reduced other secondary study endpoints such as: LVM (P = 0.032), body weight (P = 0.001), subcutaneous adipose tissue (P = 0.024), office systolic blood pressure (BP, P = 0.022) and concentration of thiobarbituric acid reactive substances, a biomarker for oxidative stress (P = 0.04). The glycated haemoglobin A1C concentration and fasting IR index did not differ between study groups at the end of the study.

Conclusion

Metformin treatment significantly reduced LVMI, LVM, office systolic BP, body weight, and oxidative stress. Although LVH is a good surrogate marker of cardiovascular (CV) outcome, conclusive evidence for the cardio-protective role of metformin is required from large CV outcomes trials.
MYRF haploinsufficiency causes 46,XY and 46,XX disorders of sex development: bioinformatics consideration
Authors: Hamanaka Kohei , Takata Atsushi , Uchiyama Yuri , Miyatake Satoko , Miyake Noriko , Mitsuhashi Satomi , Iwama Kazuhiro , Fujita Atsushi , Imagawa Eri , Alkanaq Ahmed N , Koshimizu Eriko , Azuma Yoshiki , Nakashima Mitsuko , Mizuguchi Takeshi , Saitsu Hirotomo , Wada Yuka , Minami Sawako , Katoh-Fukui Yuko , Masunaga Yohei , Fukami Maki , Hasegawa Tomonobu , Ogata Tsutomu , Matsumoto Naomichi
Published: March 2019

Disorders of sex development (DSDs) are defined as congenital conditions in which chromosomal, gonadal or anatomical sex is atypical. In many DSD cases, genetic causes remain to be elucidated. Here, we performed a case–control exome sequencing study comparing gene-based burdens of rare damaging variants between 26 DSD cases and 2625 controls. We found exome-wide significant enrichment of rare heterozygous truncating variants in the MYRF gene encoding myelin regulatory factor, a transcription factor essential for oligodendrocyte development. All three variants occurred de novo. We identified an additional 46,XY DSD case of a de novo damaging missense variant in an independent cohort. The clinical symptoms included hypoplasia of Müllerian derivatives and ovaries in 46,XX DSD patients, defective development of Sertoli and Leydig cells in 46,XY DSD patients and congenital diaphragmatic hernia in one 46,XY DSD patient. As all of these cells and tissues are or partly consist of coelomic epithelium (CE)-derived cells (CEDC) and CEDC developed from CE via proliferaiton and migration, MYRF might be related to these processes. Consistent with this hypothesis, single-cell RNA sequencing of foetal gonads revealed high expression of MYRF in CE and CEDC. Reanalysis of public chromatin immunoprecipitation sequencing data for rat Myrf showed that genes regulating proliferation and migration were enriched among putative target genes of Myrf. These results suggested that MYRF is a novel causative gene of 46,XY and 46,XX DSD and MYRF is a transcription factor regulating CD and/or CEDC proliferation and migration, which is essential for development of multiple organs.
Going Out on a Limb: How Investigation of the Anoline Adhesive System Can Enhance Our Understanding of Fibrillar Adhesion
Authors: Garner Austin M , Wilson Michael C , Russell Anthony P , Dhinojwala Ali , Niewiarowski Peter H
Published: March 2019

The remarkable ability of geckos to adhere to a wide-variety of surfaces has served as an inspiration for hundreds of studies spanning the disciplines of biomechanics, functional morphology, ecology, evolution, materials science, chemistry, and physics. The multifunctional properties (e.g., self-cleaning, controlled releasability, reversibility) and adhesive performance of the gekkotan adhesive system have motivated researchers to design and fabricate gecko-inspired synthetic adhesives of various materials and properties. However, many challenges remain in our attempts to replicate the properties and performance of this complex, hierarchical fibrillar adhesive system, stemming from fundamental, but unanswered, questions about how fibrillar adhesion operates. Such questions involve the role of fibril morphology in adhesive performance and how the gekkotan adhesive apparatus is utilized in nature. Similar fibrillar adhesive systems have, however, evolved independently in two other lineages of lizards (anoles and skinks) and potentially provide alternate avenues for addressing these fundamental questions. Anoles are the most promising group because they have been the subject of intensive ecological and evolutionary study for several decades, are highly speciose, and indeed are advocated as squamate model organisms. Surprisingly, however, comparatively little is known about the morphology, performance, and properties of their convergently-evolved adhesive arrays. Although many researchers consider the performance of the adhesive system of Anolis lizards to be less accomplished than its gekkotan counterpart, we argue here that Anolis lizards are prime candidates for exploring the fundamentals of fibrillar adhesion. Studying the less complex morphology of the anoline adhesive system has the potential to enhance our understanding of fibril morphology and its relationship to the multifunctional performance of fibrillar adhesive systems. Furthermore, the abundance of existing data on the ecology and evolution of anoles provides an excellent framework for testing hypotheses about the influence of habitat microstructure on the performance, behavior, and evolution of lizards with subdigital adhesive pads.
Richardson extrapolation allows truncation of higher-order digital nets and sequences
Authors: Goda Takashi
Published: March 2019

We study numerical integration of smooth functions defined over the $s$-dimensional unit cube. A recent work by Dick et al. (2019, Richardson extrapolation of polynomial lattice rules. SIAM J. Numer. Anal., 57, 44–69) has introduced so-called extrapolated polynomial lattice rules, which achieve the almost optimal rate of convergence for numerical integration, and can be constructed by the fast component-by-component search algorithm with smaller computational costs as compared to interlaced polynomial lattice rules. In this paper we prove that, instead of polynomial lattice point sets, truncated higher-order digital nets and sequences can be used within the same algorithmic framework to explicitly construct good quadrature rules achieving the almost optimal rate of convergence. The major advantage of our new approach compared to original higher-order digital nets is that we can significantly reduce the precision of points, i.e., the number of digits necessary to describe each quadrature node. This finding has a practically useful implication when either the number of points or the smoothness parameter is so large that original higher-order digital nets require more than the available finite-precision floating-point representations.
Comparative Prey Spectra Analyses on the Endangered Aquatic Carnivorous Waterwheel Plant (Aldrovanda vesiculosa, Droseraceae) at Several Naturalized Microsites in the Czech Republic and Germany
Authors: Horstmann M , Heier L , Kruppert S , Weiss L C , Tollrian R , Adamec L , Westermeier A , Speck T , Poppinga S
Published: March 2019

Synopsis

The critically endangered carnivorous waterwheel plant (Aldrovanda vesiculosa, Droseraceae) possesses underwater snap traps for capturing small aquatic animals, but knowledge on the exact prey species is limited. Such information would be essential for continuing ecological research, drawing conclusions regarding trapping efficiency and trap evolution, and eventually, for conservation. Therefore, we performed comparative trap size measurements and snapshot prey analyses at seven Czech and one German naturalized microsites on plants originating from at least two different populations. One Czech site was sampled twice during 2017. We recorded seven main prey taxonomic groups, that is, Cladocera, Copepoda, Ostracoda, Ephemeroptera, Nematocera, Hydrachnidia, and Pulmonata. In total, we recorded 43 different prey taxa in 445 prey-filled traps, containing in sum 461 prey items. With one exception, prey spectra did not correlate with site conditions (e.g. water depth) or trap size. Our data indicate that A. vesiculosa shows no prey specificity but catches opportunistically, independent of prey species, prey mobility mode (swimming or substrate-bound), and speed of movement. Even in cases where the prey size exceeded trap size, successful capture was accomplished by clamping the animal between the traps’ lobes. As we found a wide prey range that was attracted, it appears unlikely that the capture is enhanced by specialized chemical- or mimicry-based attraction mechanisms. However, for animals seeking shelter, a place to rest, or a substrate to graze on, A. vesiculosa may indirectly attract prey organisms in the vicinity, whereas other prey capture events (like that of comparably large notonectids) may also be purely coincidental.
Changes in liver stiffness after ART initiation in HIV-infected Nigerian adults with and without chronic HBV
Authors: Grant Jennifer L , Agaba Patricia , Ugoagwu Placid , Muazu Auwal , Okpokwu Jonathan , Akpa Samuel , Machenry Stephen , Imade Godwin , Agbaji Oche , Thio Chloe L , Murphy Robert , Hawkins Claudia
Published: March 2019

Background

There are limited data from sub-Saharan Africa on long-term liver fibrosis changes in HIV- and HIV/HBV-infected individuals.

Objectives

To assess the effects of ART on liver stiffness measurement (LSM) using transient elastography (TE) in HIV- and HIV/HBV-infected Nigerian adults and examine factors associated with fibrosis regression.

Methods

We included ART-naive HIV- and HIV/HBV-infected adults (≥18 years) enrolled in a prospective, longitudinal study of liver disease between July 2011 and February 2015 at Jos University Teaching Hospital HIV Care and Treatment Centre in Nigeria. Patients initiated ART and had TE at baseline and follow-up (year 3). LSM cut-offs for Metavir scores were 5.9, 7.6 and 9.4 kPa for moderate fibrosis, advanced fibrosis and cirrhosis, respectively. We used multivariable regression to identify factors associated with TE (≥1 Metavir) stage decline.

Results

A total of 106 HIV- and 71 HIV/HBV-infected patients [70.5% female and median age = 34 years (IQR = 29–42 years)] were studied. Baseline LSM and median LSM decline were significantly higher in HIV/HBV- versus HIV-infected patients; 41% of HIV/HBV-infected patients regressed ≥1 Metavir stage versus 17% of HIV-infected patients (P < 0.01); LSM scores at year 3 were not significantly different between HIV- and HIV/HBV-infected patients. In multivariable analyses, patients with baseline CD4+ T cells ≥200 (versus <200) cells/mm3 and lower BMIs were more likely to experience LSM stage decline.

Conclusions

HBV coinfection does not attenuate LSM declines in HIV-infected patients after ART initiation despite being a risk factor for more advanced liver disease prior to therapy. The inverse association between BMI and TE stage decline needs further investigation.
Factors associated with antibiotic prescribing for adults with acute conditions: an umbrella review across primary care and a systematic review focusing on primary dental care
Authors: Thompson W , Tonkin-Crine S , Pavitt S H , McEachan R R C , Douglas G V A , Aggarwal V R , Sandoe J A T
Published: March 2019

Introduction

One way to slow the spread of resistant bacteria is by improved stewardship of antibiotics: using them more carefully and reducing the number of prescriptions. With an estimated 7%–10% of antibiotic prescriptions globally originating from dental practices and up to 80% prescribed unnecessarily, dentistry has an important role to play. To support the design of new stewardship interventions through knowledge transfer between contexts, this study aimed to identify factors associated with the decision to prescribe antibiotics to adults presenting with acute conditions across primary care (including dentistry).

Methods

Two reviews were undertaken: an umbrella review across primary healthcare and a systematic review in dentistry. Two authors independently selected and quality assessed the included studies. Factors were identified using an inductive thematic approach and mapped to the Theoretical Domains Framework (TDF). Comparisons between dental and other settings were explored. Registration number: PROSPERO_CRD42016037174.

Results

Searches identified 689 publications across primary care and 432 across dental care. Included studies (nine and seven, respectively) were assessed as of variable quality. They covered 46 countries, of which 12 were low and middle-income countries (LMICs). Across the two reviews, 30 factors were identified, with ‘patient/condition characteristics’, ‘patient influence’ and ‘guidelines & information’ the most frequent. Two factors were unique to dental studies: ‘procedure possible’ and ‘treatment skills’. No factor related only to LMICs.

Conclusions

A comprehensive list of factors associated with antibiotic prescribing to adults with acute conditions in primary care settings around the world has been collated and should assist theory-informed design of new context-specific stewardship interventions.
Gamma-Ray Irradiation Control of Whiteflies Bemisia tabaci (Hemiptera: Aleyrodidae) and Trialeurodes vaporariorum in the Exportation of Fresh Strawberries
Authors: Cho Sun-Ran , Koo Hyun-Na , Shin Soeun , Kim Hyun Kyung , Park Jong-Heum , Yoon Yeong Seok , Kim Gil-Hah
Published: March 2019

Whitefly pests, including the sweetpotato whitefly, Bemisia tabaci (Gennadius), and the greenhouse whitefly, Trialeurodes vaporariorum (Westwood), are economically important in agriculture. With the annual growth of the domestic fresh fruit export market, various quarantine treatment methods are being used to export strawberries of better quality. The objective of the present study was to evaluate the effects of gamma rays on the development and reproductive sterility of B. tabaci and T. vaporariorum. In both species, the eggs were completely inhibited from hatching at 50 Gy, and the emergence of third-instar nymphs was completely suppressed at 150 Gy. Some adult B. tabaci and T. vaporariorum spawning occurred at 100 and 70 Gy, respectively; however, at these irradiation levels, F1 hatchability was completely inhibited. Dosimetry results showed that the penetrating power of gamma ray in the strawberry-filled box was the lowest at the mid-box position. Therefore, B. tabaci and T. vaporariorum were placed in the middle of the strawberry-filled box and irradiated. A gamma-ray irradiation of 100 Gy suppressed the development and reproduction of eggs and adults in both B. tabaci and T. vaporariorum. Our data suggest that at least 100 Gy should be used for the control of these two species of whitefly for strawberry export.
Treatment Patterns Among De Novo Metastatic Cancer Patients Who Died Within 1 Month of Diagnosis
Authors: Sineshaw Helmneh M , Jemal Ahmedin , Ng Kimmie , Osarogiagbon Raymond U , Robin Yabroff K , Ruddy Kathryn J , Freedman Rachel A
Published: March 2019

Background

Little is known about patterns of and factors associated with treatment for de novo metastatic cancer patients who die soon after diagnosis. In this study, we examine treatment patterns for patients newly diagnosed with metastatic lung, colorectal, breast, or pancreatic cancer who died within 1 month of diagnosis.

Methods

We identified 100 848 adult patients in the National Cancer Database with de novo metastatic lung, colorectal, breast, and pancreatic cancer, diagnosed between 2004 and 2014 and who died within 1 month. We performed descriptive and multivariable logistic regression analyses to examine receipt of surgery, chemotherapy, radiation, and hormonal therapy by cancer type, adjusting for sociodemographic and clinical variables.

Results

Treatment substantially varied by cancer type, over time, age, insurance, and facility type. Surgery ranged from 0.4% in pancreatic to 28.3% in colorectal cancer (CRC) patients, chemotherapy from 5.8% among CRC to 11% in lung and breast cancer patients, and radiotherapy from 1.3% in pancreatic to 18.7% in lung cancer patients. Use of some treatments (eg, surgery for CRC and breast cancer) progressively declined between 2004 and 2014. Compared with lung cancer patients treated at National Cancer Institute-designated cancer centers, those treated at community cancer centers had 48% lower odds of radiation.

Conclusions

Treatment of patients diagnosed with imminently fatal de novo metastatic cancer varied markedly by cancer type and patient/facility characteristics. These variations warrant more research to better identify patients with imminently fatal de novo metastatic cancer who may not benefit from aggressive and expensive therapies.
La Formation Des Conjugaisons Passives En Syriaque
Authors: Aïm Emmanuel
Published: March 2019

The present study provides a synchronic morphophonological analysis of the passive verbal stems in Syriac. As is well known, Syriac passive stems are directly derived from their corresponding active stems by addition of the preformative ’et- and ablaut (vowel mutation). Oddly enough, ablaut always involves the final-stem vowel but never the first one, e.g. pa “el > ’etpa “al. We aim to show that the concept of Prosodic Circumscription developed by John McCarthy and his colleagues explains not only the asymmetry between the two vowels but also how the various internal modes of formation (gemination, infixation, ablaut) are distributed within the syllabic structure of the patterns, both active and passive.
A Note on ‘Arabic’
Authors: Oliver Kahl
Published: March 2019

This short article proposes an explanation of the opaque term (variant ), which is recorded three times in medieval Arabic literature but not yet identified.
The Short-Form of the Phoenician First-Person, Independent Pronoun Reassessed
Authors: Loder Charles W
Published: March 2019

The majority consensus concerning the first-person, singular, independent pronoun in Phoenician-Punic is that the language/s possessed only one form of the pronoun - 'nk. Krahmalkov in his dictionary of Phoenician-Punic lists two instances of a short-form of the pronoun and in his grammar adds two more instances. He regards the existence of the short-form as a dialectal variant of ‘Western Phoenician’ (i.e. Punic). Although this proposal is attractive, especially since it gives greater consideration to dialectal variation, the evidence is not convincing on the basis of epigraphic and phonological considerations.
A Pitfall in HbA1c Testing Caused by Hb Long Island Hemoglobin Variant
Authors: Wei Luo , Nan Yao , Ying Bian , Zuoliang Dong
Published: March 2019

Background

Although many factors may interfere with hemoglobin (Hb)A1c measurement, Hb variants are among the most important factors.

Methods

We tested the HbA1c levels of the patient, a 32 year old Manchu Chinese woman, during a routine health check. We used different methods, including high-performance liquid chromatography (HPLC) and capillary electrophoresis, to test specimens from the patient. Next, we tested the specimen further using polymerase chain reaction (PCR) and sequencing.

Results

We discovered that our patient, who had an HbA1c value of 0, also has an Hb variant, Hb Long Island, which we found during the HbA1c analysis as part of her routine health check at the Health Management Center in the General Hospital of Tianjin Medical University, Tianjin, China. Also, we discovered that the exon 1 of β gene contained transversion mutations, with 1 heterozygous and 1 homozygous variant (HBB:c.8A > C, 9T > C). These gene mutations resulted in an amino-acid change (His to Pro) and a decrease in HbA1c value.

Conclusions

When there is no correlation between the clinical signs, glycemic status, and glycated Hb levels of the patient, the chromatogram of HbA1c should be carefully checked to detect possible variants that cause interference in the measurement.
Sweating the Little Things: Tourniquet Application Efficacy in Two Models of Pediatric Limb Circumference
Authors: El- Sherif Nibras , Lowndes Bethany , Franz Walter , Hallbeck M Susan , Belau Steven , Sztajnkrycer Matthew D
Published: March 2019

Background

Current military recommendations include the use of tourniquets (TQ) in appropriate pediatric trauma patients. Although the utility of TQs has been well documented in adult patients, the efficacy of TQ application in pediatric patients is less clear. The current study attempted to identify physical constraints for TQ use in two simulated pediatric limb models.

Methods

Five different TQ (Combat Application Tourniquet (CAT) Generation 6 and Generation 7, SOFTT (SOF Tactical Tourniquet), SOFTT-W (SOF Tactical Tourniquet – Wide), SWAT-T (Stretch Wrap and Tuck – Tourniquet) and a trauma dressing were evaluated in two simulated pediatric limb models. Model one employed four cardiopulmonary resuscitation (CPR) manikins simulating infant (Simulaids SaniBaby), 1 year (Gaumard HAL S3004), and 5 years (Laerdal Resusci Junior, Gaumard HAL S3005). Model two utilized polyvinyl chloride (PVC) piping with circumferences ranging from 4.25” to 16.5”. Specific end-points included tightness of the TQ and ability to secure the windlass (where applicable).

Results

In both models, the ability to successfully apply and secure the TQ depended upon the simulated limb circumference. In the 1-year-old CPR manikin, all windlass TQs failed to tighten on the upper extremity, while all TQs successfully tightened at the high leg and mid-thigh. With the exception of the CAT7 and the SOFTT-W at the mid-thigh, no windlass TQ was successfully tightened at any extremity location on the infant. The SWAT-T was successfully tightened over all sites of all CPR manikins except the infant. No windlass TQ was able to tighten on PVC pipe 5.75” circumference or smaller (age < 24 months upper extremity). All windlass TQs were tightened and secured on the 13.25” and 15.5” circumference PVC pipes (age 7–12 years lower extremity, age >13 years upper extremity). The SWAT-T was tightened on all PVC pipes.

Discussion

The current study suggests that commercial windlass TQs can be applied to upper and lower extremities of children aged 5 years and older at the 50%th percentile for limb circumference. In younger children, windlass TQ efficacy is variable. Further study is required to better understand the limitations of TQs in the youngest children, and to determine actual hemorrhage control efficacy.
Naval Health Research Center Surveillance for Meningococcal Disease
Authors: Broderick Michael , Myers Christopher
Published: March 2019

Historically, meningococcal disease has had a devastating impact on U.S. military personnel, but since the introduction of a vaccine in the 1970s, rates have dropped over 90%.1 Department of Defense instructions mandate a meningococcal vaccine for all service personnel. In the last 5 years, rates of meningococcal disease in the military are similar to the U.S. general population. The active duty incidence was 0.21 cases per 100,000 person-years from 2013–2017. Six cases occurred in the 6 months between September 2016 and February 2017; of these, only one was determined to be a vaccine-covered strain. Ongoing surveillance shows vaccination has resulted in a dramatic reduction in meningococcal cases in the military; however, it also demonstrates cases continue to occur sporadically. The recent emergence of new cases reminds us that surveillance and accompanying research are important for evaluating changes in the disease and informing new vaccine development and policy.
Females Engaged in Elite Training Previously Only Open to Males: Exploring the Variables of Successful Outcomes
Authors: Givens Melissa L , Eklund Kathryn
Published: March 2019

To date, there has been no analysis of the skills or attributes predicting success in female trainees who undergo traditionally male elite military training. This retrospective case control study characterized variables specific to females in the Special Operations Combat Medic course. 20/39 males and 15/38 females successfully completed the course. Several objective variables of interest including height and body weight, marital status, dependents, and physical fitness scores revealed trends but marital status and dependents were the only variables that achieved statistical significance. Exploration of subjective measures also highlighted potential trends in upper body strength and personal versus behavioral issues. These variables should be explored further for applicability to altering selection criteria or adjusting training conditions to mitigate sex disparities without altering standards of performance or creating an imbalance of resource investment for intended returns. The variables identified in this sample can be explored in other populations as females are integrated in other previously closed realms of military service.
Prominent Injury Types in Vehicle Underbody Blast
Authors: Loftis Kathryn L , Mazuchowski Edward L , Clouser Mary C , Gillich Patrick J
Published: March 2019

Background

To fully understand the injury mechanisms during an underbody blast (UBB) event with military vehicles and develop new testing standards specific to military vehicles, one must understand the injuries sustained by the occupants.

Methods

Injury data from Service Members (SM) involved in UBB theater events that occurred from 2010 to 2014 were analyzed. Analysis included the investigation of prominent skeletal and visceral torso injuries. Results were categorized by killed-in-action (n = 132 SM) and wounded-in-action (n = 1,887 SM).

Results

Over 90% (553/606 SM) of casualties in UBB events with Abbreviated Injury Scale (AIS) 2+ injury sustained at least one skeletal fracture, when excluding concussion. The most frequent skeletal injuries from UBB were foot fractures (13% of injuries) for wounded-in-action and tibia/fibula fractures (10% of injuries) for killed-in-action. Only 1% (11/1037 SM) of all casualties with AIS 2+ injuries had visceral torso injuries without also sustaining skeletal fractures. In these few casualties, the coded injuries were likely due to trauma from a loading path other than direct UBB loading.

Conclusion

Skeletal fractures are the most frequent AIS 2+ injury resulting from UBB events. Visceral torso injuries are infrequent in individuals that survive and they generally occur in conjunction with skeletal injuries.
4-Aminopyridine as a Single Agent Diagnostic and Treatment for Severe Nerve Crush Injury
Authors: Noble Mark , Tseng Kuang-Ching (Chris) , Li Haiyan , Elfar John C
Published: March 2019

Background

Traumatic peripheral nerve injury (TPI) is a major medical problem without effective treatment options. There is no way to diagnose or treat an incomplete injury and delays contribute to morbidity. We examined 4-aminopyridine (4-AP), a potassium-channel blocker as a possible treatment for TPI.

Methods

We used standard mouse models of TPI with functional outcomes including sciatic-functional-index, sensory indices, and electrodiagnostics; in addition to standard immunohistochemical, and electron microscopic correlates of axon and myelin morphology.

Results

Sustained early 4-AP administration increased the speed and extent of behavioral recovery too rapidly to be explained by axonal regeneration. 4-AP also enhanced recovery of nerve conduction velocity, promoted remyelination, and increased axonal area post-injury. 4-AP treatment also enabled the rapid distinction between incomplete and complete nerve lesions.

Conclusion

4-AP singularly provides both a new potential therapy to promote durable recovery and remyelination in acute peripheral nerve injury and a means of identifying lesions in which this therapy would be most likely to be of value. The ability to distinguish injuries that may respond to extended therapy without intervention can offer benefit to wounded soldiers.
Anticipating the Sun’s heavy-element abundance
Authors: Gough D O
Published: March 2019

Much of our understanding of the internal structure of the Sun derives from so-called standard theoretical solar models. Unfortunately, none of those models agrees completely with observations. The discrepancy is commonly associated with chemical abundance, and has led to what is now called the solar abundance problem, the resolution of which has previously been out of sight. But now the Borexino Collaboration, which recently announced measurements of the pp-chain solar neutrinos, are optimistic that they will be able to measure the flux ΦCNO of the neutrinos emitted by the relatively weak CNO cycle. Since C, N, and O constitute the majority of the heavy elements, that measurement will permit a crucial determination of the heavy-element abundance Zc in the Sun’s energy-generating core, thereby shedding important light on the problem. To accomplish that determination, a robust relation between Zc and ΦCNO will be required. That relation is $Z_{\rm c}= 0.400\, \Phi _{\rm CNO}$, where ΦCNO is in units of 1010 cm−2 s−1.
Pain Intensity, Pressure Pain Hypersensitivity, Central Sensitization, and Pain Catastrophizing Related to Vascular Alterations in Raynaud’s Phenomenon: A Preliminary Case–Control Study
Authors: Tapia-Haro Rosa María , Guisado-Barrilao Rafael , García-Ríos María del Carmen , Raya-Álvarez Enrique , Pérez-Mármol José Manuel , Aguilar-Ferrándiz María Encarnación
Published: March 2019

Objective

To evaluate pain intensity, widespread pressure pain, central sensitization (CS), and catastrophizing between subjects with primary and secondary Raynaud’s phenomenon (RP) and healthy controls and to compare the relationships between vascular impairment and pain perception.

Methods

A preliminary case–control study was performed with a total sample of 57 participants (37 with RP). Sociodemographic data, clinical/vascular data, and pain variables (pain intensity, pressure pain sensitivity, pain magnitude and threshold, CS, and catastrophizing) were registered. Results were analyzed by analysis of covariance and Pearson correlation.

Results

Participants with RP had a lower basal temperature (more vasoconstriction) in their hands (P ≤ 0.012), higher pain intensity (P ≤ 0.001), higher electrical pain magnitude (P < 0.001), and lower pressure pain (P ≤ 0.05) and electrical pain (P < 0.001) thresholds in comparison with healthy controls. Secondary RP participants showed a significantly higher level of CS compared with controls and primary RP participants (P = 0.001). Catastrophizing was higher in the primary and secondary RP (P ≤ 0.001) groups than in controls. No correlations were observed between severity of vasoconstriction and pain variables.

Conclusions

RP participants showed bilateral hypersensitivity to pressure pain. However, the severity of vascular alterations seems not to be related to central pain experiences. Additional mechanisms such as catastrophizing may influence pain in RP; nevertheless, central sensitization only appears to be involved in the secondary form of RP.