bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and management of drug–drug interactions with antiretroviral treatment in 2069 people living with HIV in rural Tanzania: a prospective cohort study
Authors: Schlaeppi C , Vanobberghen F , Sikalengo G , Glass TR , Ndege RC , Foe G , Kuemmerle A , Paris DH , Battegay M , Marzolini C , Weisser M ,   the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) study group
Published: September 2019

Objectives

Widespread access to antiretroviral therapy (ART) has substantially increased life expectancy in sub‐Saharan African countries. As a result, the rates of comorbidities and use of co‐medications among people living with HIV are increasing, necessitating a sound understanding of drug–drug interactions (DDIs). We aimed to assess the prevalence and management of DDIs with ART in a rural Tanzanian setting.

Methods

We included consenting HIV‐positive adults initiating ART in the Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) between January 2013 and December 2016. DDIs were classified using www.hiv-druginteractions.org as red (contra‐indicated), amber (potential clinical relevance requiring dosage adjustment/monitoring), yellow (weak clinical significance unlikely to require further management) or green (no interaction). We assessed management of amber DDIs by evaluating monitoring of laboratory or clinical parameters, or changes in drug dosages.

Results

Of 2069 participants, 1945 (94%) were prescribed at least one co‐medication during a median follow‐up of 1.8 years. Of these, 645 (33%) had at least one potentially clinically relevant DDI, with the highest grade being red in nine (< 1%) and amber in 636 (33%) participants. Of the 23 283 prescriptions, 19 (< 1%) and 1745 (7%) were classified as red and amber DDIs, respectively. Overall, 351 (2%) prescriptions were red DDIs or not appropriately managed amber DDIs.

Conclusions

Co‐medication use was common in this rural sub‐Saharan cohort. A third of participants had DDIs requiring further management. Of the 9% of participants with not appropriately managed DDIs, most were with cardiovascular and analgesic drugs. This highlights the importance of physicians’ awareness of DDIs for their recognition and management.
Controlling depth of electrosurgery after curettage of skin tumors—an in vitro study
Authors: Taheri Arash , Green Courtney , Mansoori Parisa
Published: September 2019

Background

Depth of tissue injury in electrosurgery depends on generator power, electrode size, speed of electrode movement on tissue, and current delivery method. We sought to evaluate the depth of tissue injury associated with different methods of electrocoagulation in an effort to make electrocoagulation more reproducible.

Methods

A knife‐shaped electrode was used to apply an electrosurgical current to the surface of a piece of bovine liver. Different electrosurgical methods were performed. Cross sections of the liver were then studied for tissue effect.

Results

Fulguration provided only superficial coagulation. Contact electrocoagulation and electrodesiccation using the flat side of the electrode provided significantly deeper levels of coagulation and were associated with less smoke than fulguration. Desiccation provided the deepest tissue effect.

Conclusions

Electrofulguration can be used for superficial tissue destruction. For deeper coagulation, a relatively larger electrode can be used in contact mode. Slower movement of the electrode on tissue in contact mode is associated with desiccation and the deepest level of tissue destruction.
Changes in serum TNF‐like weak inducer of apoptosis (TWEAK) levels and Psoriasis Area Severity Index (PASI) scores in plaque psoriasis patients treated with conventional versus anti‐TNF treatments
Authors: Engin Burhan , Tanakol Ali , Bulut Huri , Songür Abdullah , Vehid Hayriye E. , Gökalp Eral , Kutlubay Zekayi , Özkoca Defne , Tüzün Yalçın , Serdaroğlu Server
Published: September 2019

Background

Psoriasis is a chronic dermatologic disease affecting 2% of the general population. Tumour necrosis factor (TNF)‐like weak inducer of apoptosis (TWEAK) is a newly defined member of the TNF family. Increased serum levels of TWEAK were reported in inflammatory diseases. The relationship between serum TWEAK levels and severity of psoriasis has not yet been proven. Our aim was to clarify the change in serum TWEAK levels in response to conventional and anti‐TNF treatments.

Material and methods

Blood samples were collected from 103 moderate or severe chronic plaque psoriasis patients with or without arthritis who were referred to the Department of Dermatology, Istanbul University Cerrahpasa Medical Faculty between the years 2016 and 2018. Psoriasis Area and Severity Index (PASI) scores were calculated, and serum TWEAK levels were assessed with TWEAK ELISA kit. SPSS 20 was used for statistics.

Results

Serum TWEAK levels increased significantly and PASI scores decreased significantly after both conventional and anti‐TNF treatments, but the two variables were not correlated. There was no significant difference between conventional and anti‐TNF treatments, between patients with or without comorbid arthritis and between genders.

Conclusions

Lower serum TWEAK levels induce psoriasis and higher levels of TWEAK are observed after treatment. It is important to determine a threshold value. Such a cutoff value of serum TWEAK levels could not be calculated in our study similar to previous studies. If its serum levels were to be standardized in further studies, TWEAK can be used as a follow‐up marker in psoriasis patients with the PASI score.
Mixed 3D/2D dimensional TiO2 nanoflowers/MoSe2 nanosheets for enhanced photoelectrochemical hydrogen generation
Authors: Li Hongxia , Yang Chao , Wang Xiaoyang , Zhang Jun , Xi Junhua , Du Gang , Ji Zhenguo
Published: September 2019

Recently, various kinds of methods have been implemented to broaden the visible light response and fasten the carrier's separation of TiO2‐based photoanodes. As a promising hydrogen evolution reaction catalyst, MoSe2 is rarely investigated especially combined with TiO2 photoanode. In this study, we report a composite photoanode of MoSe2 nanosheets (with 1T and 2H phase)‐modified 3D TiO2 nanoflowers (NFs).The hybrid of 3D TiO2 NFs/2D MoSe2 holds great promise in boosting the PEC water splitting performance. TiO2 NFs/MoSe2‐15 showed the largest photocurrent density of 1.40 mA/cm2, which was five times higher than that of pure TiO2 NFs under AM1.5G illumination. Moreover 10 times improvement in current density was observed for the TiO2 NFs/MoSe2‐15 under visible light. This increase could be ascribed to synergistic effects of light absorption enhancement and more efficient carrier separation after MoSe2 modification. This study not only provides a reference to boost the photoelectrochemical performance of photoelectrodes but also renders a perspective on the potential applications of MoSe2 nanosheets.
Great spotted cuckoo eggshell microstructure characteristics can make eggs stronger
Authors: Soler Manuel , Rodríguez‐Navarro Alejandro B. , Pérez‐Contreras Tomás , García‐Ruiz Juan Manuel , Soler Juan José
Published: September 2019

Obligate avian brood parasites lay stronger eggs than their hosts or non‐parasitic relatives because they are rounder and have a thicker eggshell. Additionally, some other characteristics of the brood parasitic eggshells related to their microstructure such as size and orientation of calcite crystal units could also contribute to generating even stronger shells. An eggshell microstructure formed by small randomly oriented calcite crystal units can increase the robustness of the eggshells of birds. Here, the eggshell microstructure of avian brood parasites as well as their hosts have been characterized in detail, using X‐ray diffraction analyses to estimate the size and degree of orientation of calcite crystal units making the eggshell. Specifically, the brood parasitic great spotted cuckoo Clamator glandarius and two hosts (jackdaws Corvus monedula and magpie Pica pica) and one non‐host species (the pigeon, Columba livia domestica) were considered. Calcite crystal of the eggshell of the brood parasitic species was smaller and more randomly oriented than those of the eggshells of non‐parasitic species, which suggest that eggshell microstructure would contribute to explain why parasitic eggs are more resistant to breakage than those of their hosts.
Ignoring biotic interactions overestimates climate change effects: The potential response of the spotted nutcracker to changes in climate and resource plants
Authors: Engelhardt Eva Katharina , Neuschulz Eike Lena , Hof Christian
Published: September 2019

Aim

Projecting future distributions of species under climate change remains a particular challenge for species that are trophically interacting. Interaction partners are often assumed to react differently to climate change, causing spatial mismatches in future distributions and increased extinction risks. We compare potential direct effects of climate change with combined direct and indirect effects mediated via food plants on a highly specialized bird species.

Location

Europe.

Taxon

European spotted nutcracker (Nucifraga caryocatactes).

Methods

We used climate‐based species distribution models to project probabilities of occurrence of European spotted nutcrackers and their main food sources, Swiss stone pine (Pinus cembra) and common hazel (Corylus avellana) under climate change. We combined direct climate change effects on the bird and indirect effects via the food plants by calculating the probabilities of plants and nutcrackers occurring together.

Results

We find considerable projected northward shifts in future occurrences of nutcrackers under climate change and similar effects on hazel. In contrast, projections for Swiss stone pine indicate minor altitudinal upward shifts. Combined projections of direct and indirect effects of climate change indicate less pronounced shifts of nutcrackers’ occurrences, due to relatively small changes in pine's occurrences and to suitable hazel occurrence shifts.

Main conclusions

Our study suggests that potential effects of climate change on the future distribution of the nutcracker might be overestimated when ignoring trophically interacting plants in future projections. Models of direct effects of climate change on nutcrackers’ occurrence probabilities project greater range losses than models of combined direct and indirect effects via resource plants. Therefore, considering biotic interactions does not necessarily increase the risks that climate change may impose on species distributions, but could reduce overestimation of potential range losses in rapidly changing environments.
Exploring nursing students’ use of the Fundamentals of Care framework in case‐based work
Authors: Voldbjerg Siri Lygum , Lyng Larsen Karen , Nielsen Gitte , Laugesen Britt
Published: September 2019

Aims and objectives

To explore how nursing students perceive and use the conceptual Fundamentals of Care framework in case‐based work in nursing education and furthermore to describe influencing factors on perceptions and use of the framework.

Background

The Fundamentals of Care framework has been integrated in core courses in two Schools of Nursing in Region North Denmark in response to studies reporting that nursing students and newly graduated nurses lack the knowledge, skills and competencies to meet the challenges of delivering fundamental care in clinical practice. An integration of the framework in case‐based work in nursing education has not previously been studied.

Design and methods

The study design was focused ethnography. Data were collected using participant observations, focus group interviews and individual interviews. Four groups of four to five nursing students participating in case‐based work sessions and three faculty members from two Schools of Nursing were included. The study adhered to COREQ.

Results

The results show an uncertainty among the students about how to understand and use the conceptual framework in case‐based work. The uncertainties derive from diversities in faculty members’ perceptions and curricular planning among others. However, the framework appears to support the students’ learning about what nursing is and requires.

Conclusions

The study indicates that integrating Fundamentals of Care framework in case‐based work may be one way of teaching nursing students the complexities of integrated fundamental nursing care. However, there is a need to consider how to support students in articulating Fundamentals of Care, and to draw attention to the influence of role models and curricular planning.

Relevance to educational practice

The study provides knowledge relevant when customising future educational interventions regarding the integration of Fundamentals of Care in nursing education and may provide valuable knowledge of evaluation strategies.
Psychological effects and brain correlates of a rose‐based scented cosmetic cream
Authors: David Oana A. , David Daniel O. , Mogoase Cristina , Popescu Lavinia C. , Giosan Cezar , Pellegrino Arthur
Published: September 2019

In the present study, we investigated the effects of a cosmetic cream with a rose based formula scent on mood, in a sample of 26 female participants, with a mean age of 27.42 years of age. We looked at psychological measures (e.g., mood‐based self‐reports scales) and brain‐related correlates (e.g., brain activation patterns) of stress/relaxation in the scented versus an odorless skin care cream with the same physical characteristics. We employed a mood induction procedure using a face‐processing task based on positive, neutral, and negative faces. Results showed that the scented cream led to more happiness no matter the sequence of presentation and was associated to more relaxation, satisfaction, happiness, and less stress if presented after the odorless cream. The use of scented cream also increased the discharge in the brain area related to the task of face perception, and also modulated the discharge of the area involved in pleasure perception and reward.

Practical applications

Results of the present study provide important data on the scent formulas that can be effectively used in cosmetics in order to boost their effects on mood.
Melatonin exerts oncostatic capacity and decreases melanogenesis in human MNT‐1 melanoma cells
Authors: Kleszczyński Konrad , Kim Tae‐Kang , Bilska Bernadetta , Sarna Michal , Mokrzynski Krystian , Stegemann Agatha , Pyza Elżbieta , Reiter Russel J. , Steinbrink Kerstin , Böhm Markus , Slominski Andrzej T.
Published: September 2019

Melanogenesis is a key parameter of differentiation in melanocytes and melanoma cells; therefore, search for factors regulating this pathway are strongly desired. Herein, we investigated the effects of melatonin, a ubiquitous physiological mediator that is found throughout animals and plants. In mammals, the pineal gland secretes this indoleamine into the blood circulation to exert an extensive repertoire of biological activities. Our in vitro assessment indicates an oncostatic capacity of melatonin in time‐dependent manner (24, 48, 72 hours) in highly pigmented MNT‐1 melanoma cells. The similar pattern of regulation regarding cell viability was observed in amelanotic Sk‐Mel‐28 cells. Subsequently, MNT‐1 cells were tested for the first time for evaluation of melanin/melatonin interaction. Thus primary, electron paramagnetic resonance (EPR) spectroscopy demonstrated that melatonin reduced melanin content. Artificially induced disturbances of melanogenesis by selected inhibitors (N‐phenylthiourea or kojic acid) were slightly antagonized by melatonin. Additionally, analysis using transmission electron microscopy has shown that melatonin, particularly at higher dose of 10−3 mol/L, triggered the appearance of premelanosomes (stage I‐II of melanosome) and MNT‐1 cells synthesize de novo endogenous melatonin shown by LC‐MS. In conclusion, these studies show a melanogenic‐like function of melatonin suggesting it as an advantageous agent for treatment of pigmentary disorders.
Bridging the Gap Between Theory and Practice in Neurofeedback Training for Attention
Authors: Krell Jason , Todd Anderson , Dolecki Patrick K.
Published: September 2019

Modernizing classroom pedagogical practice requires openness to revisiting previously held assumptions and theories about what constitutes authentic teaching/learning cycles. The ever‐growing gap between the number of stimuli that students are exposed to and their available attentional resources indicates that sustained attention may have increasing value transitioning into 21st‐century learning environments requiring self‐reflection, collaborative learning, and self‐directed decision‐making. Neurofeedback has shown promise in laboratory and clinical settings as a tool for building sustained attention, but little in situ research has been completed in bringing the technology into the school for empirical testing. Furthermore, attentional research lacks connections between neural network modeling and observable neuromarkers for attention. This article aims to bridge these distinct concepts to support an understanding of the potential impacts of neurofeedback training (NT) and to provide a framework for other Mind, Brain, and Education researchers planning in situ NT studies.
Coordinating septum formation and the actomyosin ring during cytokinesis in Schizosaccharomyces pombe
Authors: Hercyk Brian S. , Onwubiko Udo N. , Das Maitreyi E.
Published: September 2019

During cytokinesis, animal and fungal cells form a membrane furrow via actomyosin ring constriction. Our understanding of actomyosin ring‐driven cytokinesis stems extensively from the fission yeast model system. However, unlike animal cells, actomyosin ring constriction occurs simultaneously with septum formation in fungi. While the formation of an actomyosin ring is essential for cytokinesis in fission yeast, proper furrow formation also requires septum deposition. The molecular mechanisms of spatiotemporal coordination of septum deposition with actomyosin ring constriction are poorly understood. Although the role of the actomyosin ring as a mechanical structure driving furrow formation is better understood, its role as a spatiotemporal landmark for septum deposition is not widely discussed. Here we review and discuss the recent advances describing how the actomyosin ring spatiotemporally regulates membrane traffic to promote septum‐driven cytokinesis in fission yeast. Finally, we explore emerging questions in cytokinesis, and discuss the role of extracellular matrix during cytokinesis in other organisms.
Horizontal transfer of a pathway for coumarate catabolism unexpectedly inhibits purine nucleotide biosynthesis
Authors: Close Dan M. , Cooper Connor J. , Wang Xingyou , Chirania Payal , Gupta Madhulika , Ossyra John R. , Giannone Richard J. , Engle Nancy , Tschaplinski Timothy J. , Smith Jeremy C. , Hedstrom Lizbeth , Parks Jerry M. , Michener Joshua K.
Published: September 2019

A microbe’s ecological niche and biotechnological utility are determined by its specific set of co‐evolved metabolic pathways. The acquisition of new pathways, through horizontal gene transfer or genetic engineering, can have unpredictable consequences. Here we show that two different pathways for coumarate catabolism failed to function when initially transferred into Escherichia coli. Using laboratory evolution, we elucidated the factors limiting activity of the newly acquired pathways and the modifications required to overcome these limitations. Both pathways required host mutations to enable effective growth with coumarate, but the necessary mutations differed. In one case, a pathway intermediate inhibited purine nucleotide biosynthesis, and this inhibition was relieved by single amino acid replacements in IMP dehydrogenase. A strain that natively contains this coumarate catabolism pathway, Acinetobacter baumannii, is resistant to inhibition by the relevant intermediate, suggesting that natural pathway transfers have faced and overcome similar challenges. Molecular dynamics simulation of the wild type and a representative single‐residue mutant provide insight into the structural and dynamic changes that relieve inhibition. These results demonstrate how deleterious interactions can limit pathway transfer, that these interactions can be traced to specific molecular interactions between host and pathway, and how evolution or engineering can alleviate these limitations.
The effects of multimedia education on postoperative delirium in patients undergoing coronary artery bypass graft: A randomized clinical trial
Authors: Fahimi Kosar , Abbasi Ali , Zahedi Mahdi , Amanpour Farzaneh , Ebrahimi Hossein
Published: September 2019

Background

Patients undergoing cardiac surgeries are at high risk of developing delirium.

Aims and objectives

The present study aimed to determine the effects of multimedia education on postoperative delirium in patients undergoing a coronary artery bypass graft.

Design

This study was a randomized clinical trial.

Methods

In this study, 110 patients undergoing a coronary artery bypass graft were assigned to two groups, control and intervention. Patients in the intervention group received multimedia education, and those in the control group received routine training. The inclusion criteria were experiencing the coronary artery bypass graft for the first time and non‐development of post‐operative cardiogenic shock or myocardial rupture. After measuring the level of consciousness, patients were examined in terms of delirium using the confusion assessment method for the ICU scale twice a day from admission to discharge from the ICU. The data were statistically analysed using χ2 test and Fisher′s exact test.

Results

Patients of both groups were matched in terms of demographics. The highest incidence of delirium was observed on the first day after surgery in the intervention group (14.5%) and in the morning of the second day after surgery (29.1%) in the control group. Moreover, there was a significant difference between the two groups in the incidence of delirium in the morning of the second, third, and fourth days after surgery as it was higher in the control group over these days.

Conclusion

Considering the lower incidence of post‐operative delirium in patients who experienced multimedia education rather than control group, the use of this non‐pharmaceutical method is recommended to prevent delirium in such patients.

Relevance to clinical practice

Delirium is also an acute organic brain syndrome that often leads to complicated conditions after cardiac surgeries. Fortunately, delirium is a preventable issue. The implementation of multimedia education as a non‐pharmacological approach had positive effects on patients′ delirium.
Seasonality shapes the amplitude of vole population dynamics rather than generalist predators
Authors: Andreassen Harry P. , Johnsen Kaja , Joncour Barbara , Neby Magne , Odden Morten
Published: September 2019

Seasonality has been suggested as a necessary factor for the initiation of vole population cycles in Fennoscandia. This has been well described for a latitudinal gradient. Here, we used an elevational gradient as a proxy for winter length to study how the length of the winter season correlates with the amplitude of bank vole Myodes glareolus population cycles. In addition, we studied whether the small mammalian generalist predator community present locally could explain any elevational effects. We estimated the population size of 30 local bank vole populations. We found a strong effect of elevation on the amplitude of the population cycle with local populations at around 800 m elevation having 1.5 times greater densities than populations in the valley (ca 300 m elevation). A univariate model with elevation as predictor for amplitude was twice as likely to be the best model than models including generalist predators. Our results fit well with the theories of a positive effect of winter length on the amplitude of vole population cycles in Fennoscandia, irrespective of whether the seasonal effect corresponds to a latitudinal or elevational gradient. The mechanisms may be limited resources during winter rather than generalist predators.
Minimally Invasive Treatment of Mason Type II Radial Head Fracture by Intramedullary Pinning
Authors: Gao Xu , Yin Hai‐lei , Zhou Guang‐jie
Published: September 2019

Objective

To evaluate the outcome of Mason type II radial head fractures treated by intramedullary pinning.

Methods

From May 2013 to March 2017, we respectively reviewed 25 patients affected by Mason type II radial head fractures. A total of 12 patients who met criteria for inclusion and exclusion were collected and analyzed. They were all isolated displaced partial articular radial head fractures and treated with intramedullary pinning using titanium elastic nails (TEN). The patients comprised eight men and four women with the mean age of 40 years (range, 21–58 years). The clinical evaluation included the range of motion (ROM) in the elbow, the shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH), the visual analogue scale (VAS) for pain rating, and the Mayo Elbow Performance Score (MEPS). Follow‐up radiographs to monitor related complications were evaluated as well.

Results

All patients were followed‐up with a mean of 21.8 months (range, 12–28 months). The average range of elbow flexion‐extension was barely unaffected in the injured side when compared to the uninjured side (139.08° ± 3.14° vs 140.16° ± 3.01°, P = 0.398) as were pronation of the forearm (86.50° ± 2.75° vs 87.83° ± 2.12°, P = 0.197) and supination of the forearm (87.41° ± 2.53° vs 88.17° ± 1.95°, P = 0.425). The MEPS was 93.75 ± 5.28 points (range, 85–100), the QuickDASH revealed good to excellent results with 2.33 ± 4.56 points (range, 0–14), and the VAS for pain was 0.33 ± 0.78 (range, 0–2). Only two patients had a minor complication with constant affection of the superficial branch of radial nerve.

Conclusion

Intramedullary pinning technique in the treatment of Mason type II radial head fractures is minimally traumatic and effective and represents good to excellent results in adults.
Genomic regions associated with resistance to peanut bud necrosis disease (PBND) in a recombinant inbred line (RIL) population
Authors: Jadhav Yashoda , Manohar Surendra S. , Sunkad Gururaj , Kannalli Viswanatha P. , Pandey Manish K. , Variath Murali T. , Yaduru Shasidhar , Kona Praveen , Varshney Rajeev K. , Pasupuleti Janila
Published: September 2019

Parents and 318 F8 recombinant inbred lines (RILs) derived from the cross, TAG 24 × ICGV 86031 were evaluated for peanut bud necrosis disease (PBND) resistance and agronomic traits under natural infestation of thrips at a disease hotspot location for 2 years. Significant genotype, environment and genotype × environment interaction effects suggested role of environment in development and spread of the disease. Quantitative trait loci (QTL) analysis using QTL Cartographer identified a total of 14 QTL for six traits of which five QTL were for disease incidence. One quantitative trait locus q60DI located on LG_AhII was identified using both QTL Cartographer and QTL Network. Another QTL q90DI was detected with a high PVE of 12.57 using QTL Cartographer. A total of nine significant additive × additive (AA) interactions were detected for PBND disease incidence and yield traits with two and seven interactions displaying effects in favour of the parental and recombinant genotype combinations, respectively. This is the first attempt on QTL discovery associated with PBND resistance in peanut. Superior RILs identified in the study can be recycled or released as variety following further evaluations.
Prognostic factors for event‐free survival in liver transplantation for hepatoblastoma: A single‐center experience
Authors: Lauferman Leandro , Halac Esteban , Aredes Diego , Cañon Reyes Isabel , Cervio Guillermo , Dip Marcelo , Minetto Julia , Reijenstein Hayellen , Meza Veronica , Gole Maria , Jacobo Dillon Agustina , Rose Adriana , Imventarza Oscar
Published: September 2019

Hepatoblastoma (HB) is the most common malignant liver tumor in children. Twenty percent of the cases may remain unresectable after neoadjuvant chemotherapy and, for these patients, liver transplant (LT) is an accepted therapeutic option. To analyze the risk factors to event‐free survival (EFS) that influence the clinical outcome of patients with HB receiving LT, we retrospectively analyzed 21 patients with HB who underwent LT between January 1, 2005, and May 1, 2018. Overall survival (OS) was 90%. The univariate analysis shows that the AFP level at the time of LT was associated with a higher risk of EFS. With a ROC curve analysis, we established a cutoff point value of AFP levels at 16 000 ng/dL, with a sensitivity of 71.43% and a specificity of 85.71%. Multivariate analysis showed that patients with higher values of pretransplant AFP (>16 000 ng/dL) had a significantly higher risk of EFS than those transplanted with lower levels (HR: 10.180; 95% CI: 1.54‐66.97; P = .02). Efforts should be made to improve the selection of candidates for LT for unresectable HB, aiming at a better definition of chemoresistance as a risk factor of poor outcomes.
Expanding the scope of reflective knowledge: From MINE to OURS
Authors: Shieber Joseph
Published: September 2019

Ernest Sosa has suggested that we distinguish between animal knowledge, on the one hand, and reflective knowledge, on the other. Animal knowledge is direct, immediate, and foundationally structured, while reflective knowledge involves a knower's higher‐order awareness of her own mental states, and is structured by relations of coherence.

Although Sosa's distinction is extremely appealing, it also faces serious problems. In particular, the sorts of processes that would be required for reflective knowledge, as Sosa understands it, are not processes that are instantiated in human cognition.

I argue that the problems facing Sosa's notion of reflective knowledge stem from treating human cognitive processes individualistically. They stem from what I will term Sosa's perspective of methodologically individualistic noetic explanation—or MINE.

I suggest that these problems disappear if we expand the scope of what counts as cognitive processes to include socially distributed cognitive processes, if we adopt a framework of other‐derived united reflective self‐evaluation—or OURS.

In other words, I'll suggest that a solution to the problems facing the distinction between animal and reflective knowledge may be found in a shift of perspective from MINE to OURS.
Characterization of memory T cells in individuals resistant to Schistosoma mansoni infection
Authors: de Souza Robson da Paixão , Araújo Maria Ilma , Lopes Diego Mota , de Almeida Tarcísio Vila Verde Santana , Page Brady , Oliveira Ricardo Riccio , Carvalho Edgar M. , Cardoso Luciana Santos
Published: September 2019

Schistosomiasis affects about 240 million people worldwide and is estimated that about 700 million people live in areas at risk of infection. In the context of immune response associated with infection by Schistosoma mansoni, the role of memory T cells is not well understood.

Aim

To evaluate the frequency of memory CD4+ and CD8+ T cells from individuals resistant and susceptible to Schistosoma mansoni infection.

Methods and Results

We selected individuals with low (resistant) and high (susceptible) parasite burden using databases generated during previous studies carried out in the same endemic area. The cell surface markers were performed using flow cytometry. In this study, the resistant individuals showed an increase in the CD4+ memory T‐cell pool associated with an increase in the central memory cell (TCM) and a decrease in the effector memory cell (TEM). Individuals susceptible to infection had higher frequencies of effector memory cells compared to resistant individuals.

Conclusions

These data suggest that resistance to S mansoni infection may be associated with an increase in the number of CD4+ memory T cells and susceptibility to infection is associated with a decrease in the central memory cell as well as high proportions of effector memory cells.
Effect of heat wave on N2 fixation and N remobilisation of lentil (Lens culinaris MEDIK) grown under free air CO2 enrichment in a mediterranean‐type environment
Authors: Parvin S. , Uddin S. , Bourgault M. , Delahunty A. , Nuttall J. , Brand J. , O'Leary G. , Fitzgerald G. J. , Armstrong R. , Tausz M.
Published: September 2019

The stimulatory effect of elevated [CO2] (e[CO2]) on crop production in future climates is likely to be cancelled out by predicted increases in average temperatures. This effect may become stronger through more frequent and severe heat waves, which are predicted to increase in most climate change scenarios. Whilst the growth and yield response of some legumes grown under the interactive effect of e[CO2] and heat waves has been studied, little is known about how N2 fixation and overall N metabolism is affected by this combination.

To address these knowledge gaps, two lentil genotypes were grown under ambient [CO2] (a[CO2], ~400 µmol·mol−1) and e[CO2] (~550 µmol·mol−1) in the Australian Grains Free Air CO2 Enrichment facility and exposed to a simulated heat wave (3‐day periods of high temperatures ~40 °C) at flat pod stage. Nodulation and concentrations of water‐soluble carbohydrates (WSC), total free amino acids, N and N2 fixation were assessed following the imposition of the heat wave until crop maturity.

Elevated [CO2] stimulated N2 fixation so that total N2 fixation in e[CO2]‐grown plants was always higher than in a[CO2], non‐stressed control plants. Heat wave triggered a significant decrease in active nodules and WSC concentrations, but e[CO2] had the opposite effect. Leaf N remobilization and grain N improved under interaction of e[CO2] and heat wave.

These results suggested that larger WSC pools and nodulation under e[CO2] can support post‐heat wave recovery of N2 fixation. Elevated [CO2]‐induced accelerated leaf N remobilisation might contribute to restore grain N concentration following a heat wave.
Fused Density Estimation: Theory and Methods
Authors: Bassett Robert , Sharpnack James
Published: September 2019

We introduce a method for non-parametric density estimation on geometric networks. We define fused density estimators as solutions to a total variation regularized maximum likelihood density estimation problem. We provide theoretical support for fused density estimation by proving that the squared Hellinger rate of convergence for the estimator achieves the minimax bound over univariate densities of log-bounded variation. We reduce the original variational formulation to transform it into a tractable, finite dimensional quadratic program. Because random variables on geometric networks are simple generalizations of the univariate case, this method also provides a useful tool for univariate density estimation. Lastly, we apply this method and assess its performance on examples in the univariate and geometric network setting. We compare the performance of various optimization techniques to solve the problem and use these results to inform recommendations for the computation of fused density estimators.
Integration of Survival and Binary Data for Variable Selection and Prediction: A Bayesian Approach
Authors: Maity Arnab Kumar , Carroll Raymond J. , Mallick Bani K.
Published: September 2019

We consider the problem where the data consist of a survival time and a binary outcome measurement for each individual, as well as corresponding predictors. The goal is to select the common set of predictors which affect both the responses, and not just one of them. In addition, we develop a survival prediction model based on data integration. The paper is motivated by the Cancer Genomic Atlas databank, which is currently the largest genomics and transcriptomics database. The data contain cancer survival information along with cancer stages for each patient. Furthermore, it contains reverse phase protein array measurements for each individual, which are the predictors associated with these responses. The biological motivation is to identify the major actionable proteins associated with both survival outcomes and cancer stages. We develop a Bayesian hierarchical model to model jointly the survival time and the classification of the cancer stages. Moreover, to deal with the high dimensionality of the reverse phase protein array measurements, we use a shrinkage prior to identify significant proteins. Simulations and Cancer Genomic Atlas data analysis show that the joint integrated modelling approach improves survival prediction.
Validating the Suicide Status Form for the Collaborative Assessment and Management of Suicidality in a Psychiatric Adolescent Sample
Authors: Brausch Amy M. , O'Connor Stephen S. , Powers Jeffrey T. , McClay Michael M. , Gregory Jordan A. , Jobes David A.
Published: September 2019

Background

For adults, the Collaborative Assessment and Management of Suicidality (CAMS; Jobes, (2006, Managing suicidal risk: A collaborative approach, New York, Guilford) and Jobes, (2016, Managing suicidal risk: A collaborative approach, New York, Guilford)) is a treatment framework with replicated evidenced‐based support for effectiveness. The current study is a psychometric validation of the Suicide Status Form (SSF‐IV), the main assessment and treatment planning tool for CAMS, in an adolescent psychiatric sample.

Methods

Data were collected from 100 adolescents, aged 12–17, in inpatient settings (mean age = 14.6; 67.5% female, 80% white). Adolescents were administered Part A of the SSF‐IV, as well as measures of overall suicide risk (both explicit and implicit), mental pain, Stress, Agitation, reasons for living, and self‐esteem.

Results

Confirmatory factor analysis found a two‐factor model to fit the data best, with Psychological Pain, Stress, and Agitation loading on one factor, and Hopelessness and Self‐Hate on another. All of the core SSF constructs except Stress were significantly correlated with concurrent measures, and SSF overall suicide risk was significantly correlated with self‐reported and implicit suicidality. Adolescents with suicide attempt history reported significantly higher scores on most core SSF items compared to no attempt history.

Conclusions

These results provide initial psychometric validation of the SSF for use with adolescents and indicate that it does not need to be adapted or modified for this age group.
The Trouble with Community: How ‘Sense of Community’ Influences Participation in Formal, Community‐Led Organisations and Rural Governance
Authors: Dinnie Elizabeth , Fischer Anke
Published: September 2019

The term community has proved to be remarkably resilient in rural policy‐making, where it is used across a range of policy discourses. Policy narratives seldom acknowledge the multiple meanings associated with the term community; they therefore fail to make a distinction between community as it is experienced in everyday settings, and more formal community organising. However, policies and governance seeking to mobilise communities often rely on formal community organisations to represent the ‘community’ in multi‐level governance partnerships. Following research with two rural communities in Scotland this article explores different experiences of community, and sense of community in place. We then look at what these understandings and experiences of community mean for the creation and maintenance of formal, community‐led organisations, their inclusion in policies of community empowerment and resilience, and rural governance more widely.
Performance and reliability of a benchtop automated instrument for transfusion testing: a comparative multicenter clinical study in the US population
Authors: Roback John D. , Denomme Gregory A. , Billingsley Katrina , Bensing Kathleen , Parsons Jeremy C. , McDonough Wilda C.
Published: September 2019

BACKGROUND

Heavy workload in hospital transfusion services and blood centers necessitates the implementation of automated platforms. We evaluated the performance of Erytra Eflexis (Diagnostic Grifols), a recently developed midsize automated instrument for pretransfusion testing, in comparison with a US Food and Drug Administration (FDA)‐cleared device (Erytra). Reproducibility and repeatability of the results were also investigated.

STUDY DESIGN AND METHODS

Studies were conducted using the same card technology and reagents at three US sites. Tests were performed on 9174 specimens from hospital patients (55.61%) and blood donors (43.39%). Evaluations included 18,413 ABO/D/reverse typing; 9084 Rh phenotypes, 4640 K phenotypes, 2052 antibody screenings, 1232 antibody identifications, 469 direct antiglobulin tests, 612 IgG crossmatches, and 700 ABO‐compatibility crossmatches. A reference blood panel was also sent to each center, for a total of 3900 replicate tests. Concordance between results with the two instruments and performance among the different centers were statistically evaluated.

RESULTS

Agreement between instruments was 99.84% for 37,202 test results, with 61 discrepancies (0.16%). Percentages of positive and negative agreement were 99.82% and 99.85%, respectively. No discrepancies were observed in 12,276 tests for direct ABO/D grouping. Discrepancies were observed during antibody identification (n = 19), antibody screening (n = 15), and reverse grouping (n = 10). Investigations of the discrepancies were resolved in favor of the study instrument in 55.73% of the cases. Erytra Eflexis obtained the expected results in the reproducibility analysis.

CONCLUSION

This multicenter study demonstrates that Erytra Eflexis with its gel card technology and reagents is reliable and substantially equivalent to the FDA‐cleared instrument used as the reference.
Investigation of factors associated with allergic transfusion reaction due to platelet transfusion and the efficacy of platelets resuspended in BRS‐A in adult patients
Authors: Yamanaka Manjiro , Yanagisawa Ryu , Kojima Shunsuke , Nakazawa Hideyuki , Shimodaira Shigetaka
Published: September 2019

BACKGROUND

Although allergic transfusion reactions (ATRs) resulting from platelet concentrate (PC) are a common adverse reaction, the mechanism underlying ATRs has not been fully elucidated. Plasma‐replaced PC suspended in bicarbonate Ringer's solution and anticoagulant citrate dextrose solution A (RPC‐B) is effective for preventing ATRs in children in Japan; however, there is not enough evidence in adult populations.

STUDY DESIGN AND METHODS

We conducted a retrospective analysis focused on factors associated with ATRs developing from PC transfusions in adult patients in a single institution between 2015 and 2018. The clinical efficacy of RPC‐B for adult patients was also analyzed.

RESULTS

In total, 4,677 untreated regular PC products in plasma were transfused into 914 patients. ATRs developed in 65 patients (7.1%) treated with 92 PC products (2.0%). Multivariate analysis revealed that patients who were elderly, diagnosed with a non‐hematological disease, and who received a transfusion of fresh‐frozen plasma and red blood cell concentrate products together with PC products had lower frequencies of ATRs. Although 40 patients received 490 RPC‐B transfusions, six ATRs (1.2%) were confirmed in five patients (12.5%). The ATR frequency was not significantly lower in the analysis of all patients; however, ATRs in patients with hematological diseases were lower in terms of both the patient and product numbers. Corrected count increments (24 hr) were also within an acceptable range in patients with hematological diseases.

CONCLUSION

Several patient‐specific factors may be associated with the development of ATRs from PC transfusion. Because RPC‐B appears to efficiently prevent ATRs, even in adult patients, safe and efficient transfusions may be performed by using RPC‐B preferentially depending on the patient's risk factors.
CT identifies pulmonary cryptococcosis in a domestic feline
Authors: Schlacks Sallianne , Boozer Tara , Dial Sharon , Eichelberger Bunita
Published: September 2019

A domestic cat was presented for lethargy and coughing. Thoracic radiographs identified a mass within the right cranial lung lobe and a nodule in the left cranial lung lobe. Cryptococcus spp. was diagnosed via ultrasound‐guided fine needle aspirate cytology. Despite fluconazole and prednisolone treatment, clinical signs progressed and suggested airway obstruction. Computed tomography revealed mass invasion into the trachea and other areas of the lower airway resulting in obstruction. Bronchoscopy was performed to debulk the tracheal mass and obtain biopsies. Histopathology confirmed Cryptococcus spp. At the time of this report, the patient remained clinically stable with daily itraconazole (5 mg/kg) treatment.
Dynamic postnatal development of the cellular and circuit properties of striatal D1 and D2 spiny projection neurons
Authors: Krajeski Rohan N. , Macey‐Dare Anežka , van Heusden Fran , Ebrahimjee Farid , Ellender Tommas J.
Published: September 2019

Key points

Imbalances in the activity of the D1‐expressing direct pathway and D2‐expressing indirect pathway striatal projection neurons (SPNs) are thought to contribute to many basal ganglia disorders, including early‐onset neurodevelopmental disorders such as obsessive–compulsive disorder, attention deficit hyperactivity disorder and Tourette's syndrome.

This study provides the first detailed quantitative investigation of development of D1 and D2 SPNs, including their cellular properties and connectivity within neural circuits, during the first postnatal weeks.

This period is highly dynamic with many properties changing, but it is possible to make three main observations: many aspects of D1 and D2 SPNs progressively mature in parallel; there are notable exceptions when they diverge; and many of the defining properties of mature striatal SPNs and circuits are already established by the first and second postnatal weeks, suggesting guidance through intrinsic developmental programmes.

These findings provide an experimental framework for future studies of striatal development in both health and disease.

Many basal ganglia neurodevelopmental disorders are thought to result from imbalances in the activity of the D1‐expressing direct pathway and D2‐expressing indirect pathway striatal projection neurons (SPNs). Insight into these disorders is reliant on our understanding of normal D1 and D2 SPN development. Here we provide the first detailed study and quantification of the striatal cellular and circuit changes occurring for both D1 and D2 SPNs in the first postnatal weeks using in vitro whole‐cell patch‐clamp electrophysiology. Characterization of their intrinsic electrophysiological and morphological properties, the excitatory long‐range inputs coming from cortex and thalamus, as well their local gap junction and inhibitory synaptic connections reveals this period to be highly dynamic with numerous properties changing. However it is possible to make three main observations. Firstly, many aspects of SPNs mature in parallel, including intrinsic membrane properties, increases in dendritic arbours and spine densities, general synaptic inputs and expression of specific glutamate receptors. Secondly, there are notable exceptions, including a transient stronger thalamic innervation of D2 SPNs and stronger cortical NMDA receptor‐mediated inputs to D1 SPNs, both in the second postnatal week. Thirdly, many of the defining properties of mature D1 and D2 SPNs and striatal circuits are already established by the first and second postnatal weeks, including different electrophysiological properties as well as biased local inhibitory connections between SPNs, suggesting this is guided through intrinsic developmental programmes. Together these findings provide an experimental framework for future studies of D1 and D2 SPN development in health and disease.