bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole‐exome sequencing and RNA sequencing analyses of acinic cell carcinomas of the breast
Authors: Beca Francisco , Lee Simon S K , Pareja Fresia , Da Cruz Paula Arnaud , Selenica Pier , Ferrando Lorenzo , Gularte‐Mérida Rodrigo , Wen Hannah Y , Zhang Hong , Guerini‐Rocco Elena , Rakha Emad A , Weigelt Britta , Reis‐Filho Jorge S
Published: July 2019

Aims

Acinic cell carcinoma (ACC) of the breast is a rare histological form of triple‐negative breast cancer (TNBC). Despite its unique histology, targeted sequencing analysis has failed to identify recurrent genetic alterations other than those found in common forms of TNBC. Here we subjected three breast ACCs to whole‐exome and RNA sequencing to determine whether they would harbour a pathognomonic genetic alteration.

Methods and results

DNA and RNA samples from three breast ACCs were subjected to whole‐exome sequencing and RNA‐sequencing, respectively. Somatic mutations, copy number alterations, mutational signatures and fusion genes were determined with state‐of‐the‐art bioinformatics methods. Our analyses revealed TP53 hotspot mutations associated with loss of heterozygosity of the wild‐type allele in two cases. Mutations affecting homologous recombination DNA repair‐related genes were found in two cases, and an MLH1 pathogenic germline variant was found in one case. In addition, copy number analysis revealed the presence of a somatic BRCA1 homozygous deletion and focal amplification of 12q14.3–12q21.1, encompassing MDM2, HMGA2, FRS2, and PTPRB. No oncogenic in‐frame fusion transcript was identified in the three breast ACCs analysed.

Conclusions

No pathognomonic genetic alterations were detected in the breast ACCs analysed. These tumours have somatic genetic alterations similar to those of common forms of TNBC, and may show homologous recombination deficiency or microsatellite instability. These findings provide further insights into why breast ACCs, which are usually clinically indolent, may evolve into or in parallel with high‐grade TNBC.
Immune‐related adverse events in the gastrointestinal tract: diagnostic utility of upper gastrointestinal biopsies
Authors: Zhang M. Lisa , Neyaz Azfar , Patil Deepa , Chen Jonathan , Dougan Michael , Deshpande Vikram
Published: July 2019

Aims

Immune checkpoint inhibitors (ICIs) improve survival across a range of malignancies but are also associated with a spectrum of gastrointestinal (GI) immune‐related adverse events (GI‐irAEs). The aims of this study were to explore the diagnostic value of gastric and duodenal biopsies and to address considerations in the differential diagnosis.

Methods and results

We identified 39 patients who were treated with ICIs and had a subsequent upper GI biopsy. We recorded clinical data and endoscopic findings, and reviewed their gastric, duodenal and colonic biopsies. Twenty‐one (54%) patients were treated with an anti‐programmed cell death protein 1 (PD‐1)/anti‐programmed cell death ligand 1 antibody alone, and 17 (44%) patients were treated with a combination of anti‐cytotoxic T‐lymphocyte‐associated protein‐4 and anti‐PD‐1 antibodies. Thirty‐two (82%) patients presented with diarrhoea. Gastric alterations included periglandular inflammation and granulomas, and duodenal changes included villous blunting, intraepithelial lymphocytosis, granulomas, and neutrophilic activity. We recognised four patterns of colonic injury: (i) acute self‐limiting colitis; (ii) lymphocytic colitis; (iii) collagenous colitis; and (iv) apoptosis‐only. Twenty‐nine (74%) and 10 (26%) patients were diagnosed clinically as positive and negative for GI‐irAEs, respectively. Gastric periglandular inflammation (P = 0.004) and an increased number of colonic lamina propria mononuclear cells (P = 0.04) correlated with the clinical diagnosis of a GI‐irAE. Histological alterations associated with ICI injury were more often identified in upper GI biopsies (71%) than in colonic biopsies (65%).

Conclusions

The morphological spectrum of ICI‐related GI disease is broad, and mimics a range of infectious and inflammatory diseases. Gastric periglandular inflammation represents one of the more characteristic histological features of GI‐irAEs. The study underscores the importance of a comprehensive review of upper and lower GI biopsies for the diagnosis of GI‐irAEs.
Exploring the fluid boundary between ‘legitimate performance management’ and ‘downward bullying’: an experimental approach
Authors: Timming Andrew R. , French Michael T. , Fan Di
Published: July 2019

Using an experimental design, this research examines the extent to which managers and employees perceive management behaviours differently. Eight simulated employment scenarios were presented to an aggregated sample of managers and non‐managerial employees (n = 435), and the respondents were asked to evaluate the extent to which the behaviours depicted are seen as bullying. It was found that employees are more likely than managers to perceive ‘legitimate performance management’ as bullying but also that managers are more likely than employees to perceive more overt bullying as bullying per se. This divergence in perceptions suggests that what constitutes bullying, ontologically speaking, depends on one's point of view and implies that reality is socially constructed. The research has important implications for organisations and trade unions in the development of bullying policies and procedures.
Role of light‐intensity‐dependent changes in thiol and amino acid metabolism in the adaptation of wheat to drought
Authors: Gyugos Mónika , Ahres Mohamed , Gulyás Zsolt , Szalai Gabriella , Darkó Éva , Végh Balázs , Boldizsár Ákos , Mednyánszky Zsuzsa , Kar Rup Kumar , Dey Narottam , Simon‐Sarkadi Livia , Galiba Gábor , Kocsy Gábor
Published: July 2019

Light‐intensity‐dependent (low, normal and high) differences in thiol and amino acid metabolism during drought were compared in wheat seedlings. The drought‐tolerant genotype (Plainsman) recovered better than the sensitive one (Cappelle Desprez) after the stress as shown by growth and photosynthetic parameters, the levels of which were greater in low and high light, respectively. Glutathione as an antioxidant contributed to this difference, since its level was twofold greater in Plainsman throughout the experiment. In addition, the accumulation of most amino acids even increased in normal light during drought in Plainsman, while such change occurred in Cappelle Desprez only in high light. The higher contents of proline, glutamate and γ‐aminobutyrate are especially important because of their involvement in the protection against drought. The transcription of certain genes related to amino acid and glutathione metabolism and various antioxidants was even induced by higher light intensities before drought, which can contribute to the subsequent increase in the amount of the corresponding metabolites during stress. Increase in light intensity activated various protective mechanisms including greater accumulation of glutathione, proline and other amino acids during drought, which contributed to the efficient recovery of wheat after stress.
Forest community assembly is driven by different strata‐dependent mechanisms along an elevational gradient
Authors: Luo Ya‐Huang , Cadotte Marc W. , Burgess Kevin S. , Liu Jie , Tan Shao‐Lin , Xu Kun , Li De‐Zhu , Gao Lian‐Ming
Published: July 2019

Aim

The mechanisms driving forest community assembly along elevational gradients remain elusive. The distinct strata in heterogeneous forest are subject to differing assembly mechanisms. This study aims to evaluate how different ecological mechanisms driving forest community assembly across strata and spatial scales, and to identify how these assemblages respond to different abiotic or biotic variables along an elevational gradient.

Location

Yulong Mountain within Hengduan Mountains, Southwest China.

Taxon

Seed plants.

Methods

We sampled plant species along a 1,200 m elevational gradient across forest strata (trees, shrubs and herbs) at different spatial scales (neighbourhood and community). We integrated phylogenetic and functional diversity to disentangle the roles of ecological mechanisms in structuring community assembly. We also determined the relative effects of climatic, soil and biotic variables and their interactions on these community assemblages.

Results

The phylogenetic and functional diversity of trees were lower at the extremes of the elevational gradient, where they were constrained by water availability or temperature. While communities with higher species diversity exhibited an overdispersed structure at mid‐elevations. For shrubs, overdispersion was exhibited at high elevations despite low species richness, which could be consistent with facilitative interactions or competition exclusion. However, most communities of herbs appear to have a markedly random structure, despite some incongruence between phylogenetic divergence and functional convergence, as well as influences from overstorey trees and local light conditions. The relative effects of abiotic variables on community structure were larger at the community scale than at the neighbourhood scale.

Main conclusions

Our study emphasises the importance of considering phylogenies and traits in understanding the strata‐ and scale‐dependent mechanisms of forest community assembly. Collectively, results indicate that contrasting assembly mechanisms interact across different strata along elevational gradients to shape diverse forest communities.
Functional study of a KCNH2 mutant: Novel insights on the pathogenesis of the LQT2 syndrome
Authors: De Zio Roberta , Gerbino Andrea , Forleo Cinzia , Pepe Martino , Milano Serena , Favale Stefano , Procino Giuseppe , Svelto Maria , Carmosino Monica
Published: July 2019

The K+ voltage‐gated channel subfamily H member 2 (KCNH2) transports the rapid component of the cardiac delayed rectifying K+ current. The aim of this study was to characterize the biophysical properties of a C‐terminus‐truncated KCNH2 channel, G1006fs/49 causing long QT syndrome type II in heterozygous members of an Italian family. Mutant carriers underwent clinical workup, including 12‐lead electrocardiogram, transthoracic echocardiography and 24‐hour ECG recording. Electrophysiological experiments compared the biophysical properties of G1006fs/49 with those of KCNH2 both expressed either as homotetramers or as heterotetramers in HEK293 cells. Major findings of this work are as follows: (a) G1006fs/49 is functional at the plasma membrane even when co‐expressed with KCNH2, (b) G1006fs/49 exerts a dominant‐negative effect on KCNH2 conferring specific biophysical properties to the heterotetrameric channel such as a significant delay in the voltage‐sensitive transition to the open state, faster kinetics of both inactivation and recovery from the inactivation and (c) the activation kinetics of the G1006fs/49 heterotetrameric channels is partially restored by a specific KCNH2 activator. The functional characterization of G1006fs/49 homo/heterotetramers provided crucial findings about the pathogenesis of LQTS type II in the mutant carriers, thus providing a new and potential pharmacological strategy.
Effect of tofogliflozin on cardiac and vascular endothelial function in patients with type 2 diabetes and heart diseases: A pilot study
Authors: Tochiya Mayu , Makino Hisashi , Tamanaha Tamiko , Matsuo Miki , Hishida Ai , Koezuka Ryo , Ohata Yoko , Tomita Tsutomu , Son Choel , Miyamoto Yoshihiro , Yasuda Satoshi , Hosoda Kiminori
Published: July 2019

Recent studies have shown that sodium–glucose cotransporter 2 inhibitors decrease the risk of heart failure in patients with type 2 diabetes. However, the precise mechanisms of action of these drugs are not well understood. In the present study, we evaluated the effect of treatment with tofogliflozin for 6 months on cardiac and vascular endothelial function in 26 patients with type 2 diabetes and heart diseases. Tofogliflozin treatment significantly decreased left ventricular end‐diastolic dimensions and significantly increased flow‐mediated vasodilation. Although E/e′ did not significantly change after treatment, the decrease observed in the E/e′ ratio was significantly correlated with the increase in acetoacetic acid and 3‐hydroxybutyrate levels. These results suggest that sodium–glucose cotransporter 2 inhibitor might improve left ventricular dilatation and vascular endothelial function in patients with type 2 diabetes. Furthermore, it is suggested that the elevation of ketone bodies induced by sodium–glucose cotransporter 2 inhibitors might contribute to a protective effect in left ventricular diastolic dysfunction.
Dietary emulsifier polysorbate‐80‐induced small‐intestinal vulnerability to indomethacin‐induced lesions via dysbiosis
Authors: Furuhashi Hirotaka , Higashiyama Masaaki , Okada Yoshikiyo , Kurihara Chie , Wada Akinori , Horiuchi Kazuki , Hanawa Yoshinori , Mizoguchi Akinori , Nishii Shin , Inaba Kenichi , Sugihara Nao , Watanabe Chikako , Komoto Shunsuke , Tomita Kengo , Miura Soichiro , Hokari Ryota
Published: July 2019

Background and Aim

Dietary emulsifiers are widely used in processed foods and officially approved as safe for intake. However, recent studies have demonstrated that some emulsifiers alter the colonic microbiota, leading to colonic low‐grade inflammation, in mice. The effect of dietary emulsifiers on small‐intestinal microbiota, which is important for gut immunity, has not been studied. We aimed to investigate the effect of a representative dietary emulsifier, polysorbate‐80 (P80), on the small‐intestinal microbiota in normal mice.

Methods

Some mice were pretreated with P80 for 8 weeks with or without indomethacin administration on the last 2 days, and intestinal damage was evaluated histologically. The ileal and colonic microbiota composition was assessed using 16S rRNA polymerase chain reaction.

Results

Polysorbate‐80 increased the Gammaproteobacteria abundance and decreased the α‐diversity in the small intestine. No decrease in α‐diversity was observed in the colon. P80 pretreatment exacerbated the indomethacin‐induced small‐intestinal lesions and significantly increased the interleukin‐1β expression. Culture of ileal content on deoxycholate hydrogen sulfide lactose agar showed that P80 significantly increased the colonies of the sulfide‐producing bacteria Proteus spp. (genetically identified as Proteus mirabilis). Antibiotic pretreatment abolished the P80‐induced aggravation of indomethacin‐induced ileitis. Motility assay in semisolid agar showed that adding 0.02% P80 to the agar significantly increased the diameter of P. mirabilis colonies but not that of Escherichia coli colonies.

Conclusions

Polysorbate‐80 enhances the vulnerability of the small intestine to indomethacin‐induced injury by inducing ileal dysbiosis. Direct enhancement of the motility of specific flagellated microbiota by P80 might be related to dysbiosis and intestinal injury.
Increasing burden of biliary tract infection caused by extended‐spectrum beta‐lactamase‐producing organisms in Korea: A nationwide population‐based study
Authors: Jang Dong Kee , Kim Jungmee , Park Wan Beom , Yi Sun Young , Lee Jun Kyu , Yoon Won Jae
Published: July 2019

Background and Aim

Biliary tract infections (BTIs) are a major cause of bacteremia. The prevalence of antibiotic‐resistant pathogens in BTI patients is reported to be increasing. We used a nationwide database to evaluate the prevalence of, and risk factors for, BTIs caused by extended‐spectrum beta‐lactamase‐producing organisms (ESBL‐PO) in Korea.

Methods

Patients with a BTI diagnosis, an admission history, a history of a BTI‐related procedure, and antibiotic use for ≥ 4 days between 2007 and 2016 were identified from the Health Insurance Review and Assessment Service database. A BTI treated with carbapenems (BTI‐TC) was used as the surrogate for a BTI caused by ESBL‐PO. We conducted a multivariate logistic regression analysis to determine the risk factors for BTI‐TC.

Results

In total, 341 002 patients were enrolled. The overall percentage of BTI‐TC among BTIs was 2.4%, with an increasing annual trend (P < 0.0001). The risk of acute cholangitis caused by ESBL‐PO increased significantly in men, older patients, patients with comorbidities, patients with a history of a biliary procedure within the previous year, and patients with a history of antibiotic use within the previous 90 days. Regarding antibiotic use, the patients at highest risk were those previously prescribed carbapenems (adjusted odds ratio, 4.77; P < 0.0001).

Conclusions

The prevalence of BTIs caused by ESBL‐PO has increased during the last 10 years. Initial carbapenem therapy should be considered for elderly patients with acute cholangitis if they have had a previous biliary procedure and/or a history of carbapenem administration within the previous 90 days.
The role of adenosine receptors in mood and anxiety disorders
Authors: van Calker Dietrich , Biber Knut , Domschke Katharina , Serchov Tsvetan
Published: July 2019

Adenosine receptor subtypes, first described 40 years ago, are known to regulate diverse biological functions and have a role in various conditions, such as cerebral and cardiac ischemia, immune and inflammatory disorders and cancer. In the brain, they limit potentially dangerous over excitation, but also regulate mechanisms essential in sleep and psychiatric disorders. In this review, we discuss the role of adenosine receptors in mood and anxiety disorders. Activation of A2A receptors is associated with increased depression‐like symptoms, while increased A1 receptors signaling elicits rapid antidepressant effects. Indeed, several lines of evidence demonstrate that the therapeutic effects of different non‐pharmacological treatments of depression, like sleep deprivation and electroconvulsive therapy are mediated by A1 receptor up‐regulation or activation. In addition, A1 receptors may also play a role in the antidepressant effects of transcranial direct current stimulation and deep brain stimulation. As a potential downstream mechanism, which facilitates the antidepressant effects of A1 receptors, we propose a crosstalk between adenosinergic and glutamatergic systems mediated via synaptic plasticity protein Homer1a and α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid receptors. Moreover, adenosine receptors are also involved in the control of circadian rhythms, sleep homeostasis and some neuro‐immunological mechanisms, all of them implicated in mood regulation. Antagonists of adenosine receptors such as caffeine have general anxiogenic effects. In particular, A2A receptors appear to have an important role in the pathophysiology of anxiety disorders. Taken together, the results discussed here indicate that the adenosinergic system is involved in both the etiology and the treatment of mood and anxiety disorders.

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Financial Knowledge and “Don't Know” Response
Authors: Kim Namhoon , Mountain Travis P.
Published: July 2019

We investigate the effect of group characteristics and educational interventions on young respondents' objective financial knowledge level. We examine six questions about personal finance and covariates selected from the 2015 National Financial Capability Study. Because these questions include “Don't Know” or “Refuse” (DK/RF) responses, a simple regression model could cause researchers to reach misleading conclusions if DK/RF responses are not random. Thus, we suggest a binomial‐latent regression model to evaluate the effect of educational interventions and group differences that are hidden in DK/RF responses. The estimation result shows that rejecting financial education opportunities is disadvantageous to obtaining proper financial knowledge. In addition, both formal and informal financial education are less effective in improving objective financial knowledge in our preferred model. We also find few or no gender, income, and age differences in young adults' objective financial knowledge level after controlling for financial education interventions.
Women's experience of shiftwork in nursing whilst caring for children: A juggling act
Authors: Matheson Annabel , O’Brien Louise , Reid Jo‐Anne
Published: July 2019

Aims and Objectives

To explore women's experiences of working shiftwork in nursing whilst caring for children.

Background

In nursing, almost 90% of Australia's practising nurses and midwives are women. Much of the research undertaken in the shiftwork area uses men as their sample and uses a quantitative methodology to achieve results. Little work has been undertaken that explores the experience of women working shiftwork whilst raising children.

Design

Heideggerian Hermeneutic Phenomenological Design.

Methods

Semistructured interviews were conducted with ten women who cared for children about their experience of shiftwork. Each interview was digitally audio‐recorded. The interviews were transcribed verbatim and thematically analysed. The interpretation used first Heideggerian phenomenology as a lens and then second research on women's work and gender roles to resituate the experience in context. Reporting rigour has been demonstrated using the COREQ checklist.

Results

Two major themes were derived from the data, Being Guilty and Being Juggler. Each is discussed in this paper.

Conclusions

This study adds a qualitative voice to the substantial quantitative shiftwork body of literature. The themes uncovered in this study have thrown light on the nature of work done by women who are nurses, particularly the work related to their home and children.

Relevance to Clinical Practice

There are opportunities to increase education around the importance of sleep and shiftwork self‐care in both preservice and new graduate education to assist nurses to ensure that sleep is a priority whilst working shiftwork.
Nonalcoholic fatty liver disease increases risk of incident advanced chronic kidney disease: a propensity‐matched cohort study
Authors: Park Haesuk , Dawwas Ghadeer K. , Liu Xinyue , Nguyen Mindie H.
Published: July 2019

Background

As the prevalence of nonalcoholic fatty liver disease (NAFLD) escalates, understanding its potential impact on the development of chronic kidney disease (CKD) is needed.

Objective

To determine the longitudinal association of NAFLD with the development of advanced CKD in the United States.

Methods

A retrospective cohort analysis of the Truven Health MarketScan Database (2006–2015) was conducted. We used Cox proportional hazards models to compare the risk of developing CKD stages 3–5 in patients with NAFLD versus non‐NAFLD, identified by ICD‐9 codes, after 1:3 propensity score (PS) matching.

Results

In a cohort of 262 619 newly diagnosed patients with NAFLD and 769 878 PS (1:3)‐matched non‐NAFLD patients, we identified 5766 and 8655 new advanced (stage 3–5) CKD cases, respectively. The crude CKD incidence rate was 8.2 and 5.5 per 1000 person‐years in NAFLD and non‐NAFLD groups, respectively. In multivariable Cox model, patients with NAFLD had a 41% increased risk of developing advanced CKD compared with non‐NAFLD patients [adjusted hazard ratio (aHR), 1.41; 95% confidence interval (CI), 1.36–1.46]. In the sensitivity analysis adjusting for time‐varying covariates after NAFLD diagnosis, NAFLD persisted as a significant CKD risk factor (aHR, 1.58; 95% CI, 1.52–1.66) and the association remained significant when stratified by age, gender and pre‐existing comorbidities. The risk of CKD increased in NAFLD with compensated cirrhosis (aHR, 1.47; 95% CI, 1.36–1.59) and decompensated cirrhosis (aHR, 2.28; 95% CI, 2.12–2.46).

Conclusion

Nonalcoholic fatty liver disease was independently associated with an increased risk of advanced CKD development suggesting renal function screening and regular monitoring are needed in this population.
Survival and complications: A 9‐ to 15‐year retrospective follow‐up of dental implant therapy
Authors: Adler Lottie , Buhlin Kåre , Jansson Leif
Published: July 2019

Long‐term follow‐up of oral implant therapy seldom report all biological and technical complications. The objective of this study was to evaluate the long‐term (9‐15 years) outcome after dental implant therapy, assess survival and complication rates. In addition, to identify the risk indicators of these complications at patient and implant levels. Patients (n = 376) treated with dental implants (n = 1095) between 1999 and 2005 at a specialist clinic in Stockholm, Sweden, were included. Longitudinal data were collected retrospectively from digital dental records. A subset of the included patient underwent a clinical examination at the 9‐15 years follow‐up (n = 163). Chi‐square tests, Kaplan‐Meier analyses and the general estimating equations (GEE) procedure were adopted for multilevel analyses. The cumulative implant survival rate up to 15 years was 82.6% (SE 4.1%). The prevalences of biological and technical complications at patient level were 52% and 32%, respectively. In total, 763 complications occurred, 65% of patients experienced at least one complications. Implant loss occurred significantly more frequently in subjects with a history of treated severe periodontitis Stage III‐IV (P = .008) and in cases when complications were registered during implant surgery (P = .010). Smoking was a significant risk indicator for peri‐implantitis (P = .006). The long‐term implant survival and complication rates at patient level were 83% and 79%, respectively. Implant loss was significantly more frequent for subjects with a history of treated severe periodontitis and if complication was registered during implant surgery. Smoking was a significant risk indicator for peri‐implantitis.
An alternative early childhood caries risk surveillance methodology for public policy and practice advancements
Authors: Kelly Abigail L. , Horsman Emily , Ziegler Lauren , Hipp Cynthia , Martin Amy B.
Published: July 2019

Objectives

Early childhood caries (ECC) negatively impacts many child health outcomes and can lead to greater costs for medical and dental care as well as negatively impact future oral health wellness. ECC risk factors are rooted in many social determinants of health. Addressing ECC at the population‐level is a national public health priority. The purpose of this study was to identify the South Carolina counties with the greatest risk for ECC. As policy‐makers seek to address inequities stemming from early childhood caries, documenting its prevalence is essential.

Methods

Since no county level ECC rates were published for South Carolina, we identified an opportunity to strengthen ECC surveillance through public use data, so as to properly equip policy‐makers and pediatric providers with an evidence based understanding of the scope of the problem. As a result we sought to develop an overall county level prevalence measure for ECC risk through an ecological analysis of public use data.

Results

Ten counties with the greatest overall risk for ECC were all rural as hypothesized. Additionally, seven of the 10 highest risk counties fell into what is often referred to as the “Corridor of Shame.”

Conclusions

We have found an affordable way of measuring county level risk for ECC that allows pediatric advocates and policy‐makers to develop population level interventions to reduce and measure risk with public‐use data.
Seeking freedom: A systematic review and thematic synthesis of the literature on patients' experience of absconding from hospital
Authors: Voss Isobel , Bartlett Ruth
Published: July 2019

Accessible summary

What is known on the subject?

Absconding refers to patients leaving psychiatric hospitals in an unexpected and/or unauthorized way and is often recognized as a form of challenging behaviour.

There is some research about the rates of absconding, risks associated with it and interventions to try and reduce it; however, relatively little is known about the experience from the perspective of patients and this evidence has not previously been systematically reviewed.

What this paper adds to existing knowledge?

Patients abscond to find relief, to regain power and control over their lives and/or to address unmet needs.

Absconding can therefore be viewed as a means of seeking freedom.

What are the implications for practice?

Nurses need to be aware that absconding is a positive act from the patient perspective and work collaboratively with them to reduce factors which motivate this behaviour.

From the point of admission, nurses have an important role to play in reducing the sense of fear, isolation and powerlessness which motivates patients to abscond.

Practical interventions such as giving patients the time and information necessary to be involved in decision‐making, or asking about their responsibilities and commitments outside of hospital, may have a significant impact on the experience of admission and reduce the risk of absconding.

Introduction

Absconding from psychiatric hospitals is associated with significant risks, but is difficult to assess. It is often considered a form of challenging behaviour for mental health nurses, yet there is little evidence considering the behaviour from the patient perspective.

Aim

To identify and review evidence pertaining to the experience of patients who abscond from hospital, paying particular attention to their reasons for doing so.

Method

A systematic review and thematic synthesis of eight peer‐reviewed studies.

Results

The meaning patients associated with absconding is best characterized as an act of seeking freedom. Within this, four sub‐themes were identified: 1) seeking freedom to find relief, 2) to regain power and control over their lives, 3) to address unmet needs and 4) opportunistically.

Discussion

Perspectives on absconding are markedly different between nurses and patients. Nurses may view absconding as challenging or deviant behaviour, whilst patients understand it as a positive experience. This is because the hospital environment is not meeting their needs.

Implications for practice

Patients decide to abscond from hospital for valid and rational reasons. Mental health nurses are in a position to understand and address the issues underpinning them with a view to reducing absconding. Further research on absconding from hospital, taking the patient's perspective, is needed.
Alloimmunization of a dog erythrocyte antigen 1− dog transfused with weakly dog erythrocyte antigen 1+ blood
Authors: Guidetti Maryline , Goy‐Thollot Isabelle , Boisvineau Catherine , Giger Urs
Published: July 2019

Background

Acute hemolytic transfusion reactions because of dog erythrocyte antigen (DEA) 1 sensitization after mismatched transfusions are serious complications. Dog erythrocyte antigen 1 expression varies from negative to weakly to strongly positive.

Objectives

To assess alloimmunization after transfusion of weakly DEA 1+ blood to a DEA 1− dog.

Animals

One DEA 1− recipient and 1 weakly DEA 1+ donor, and 106 control dogs.

Methods

Long‐term follow‐up study. Matched for DEA 3, 4, 5, and 7, Dal, and Kai 1 and 2, weakly DEA 1+ donor packed red blood cells (RBCs) were transfused 3 times (0.45 mL/kg at Day 0, 16, and 37) to a DEA 1− recipient. Alloantibodies against RBCs from donor and 106 controls were determined in recipient's plasma samples using a commercial antiglobulin‐enhanced immunochromatographic strip and gel tube crossmatches. Alloantibody titers were determined.

Results

The DEA 1− recipient was sensitized after 16 days to ≥1657 days after transfusion to weakly DEA 1+ and otherwise matched RBCs. Strong to moderate crossmatch incompatibilities were observed between recipient's plasma and all 61 DEA 1+ crossmatched controls. Moderate to weak incompatibilities were also observed to DEA 1− controls. Anti‐DEA 1 and other alloantibodies were detected over the 4.5 year observation period.

Conclusions and Clinical Importance

Blood from a weakly DEA 1+ donor induces a strong and durable alloimmunization in a DEA 1− recipient dog. Additional alloantibodies developed against yet to be defined RBC antigens. Those results support the recommendation of typing dogs against DEA 1, considering weakly DEA 1+ as immunogenic, and crossmatching all previously transfused dogs.
Structural heterogeneity of trees influences epiphyte distributions in a northern temperate rainforest
Authors: Woods Carrie L. , Nevins Laura M. , Didier Emma J.
Published: July 2019

Questions

Large trees provide structural heterogeneity that may influence the distribution and diversity of epiphytes, yet this has not been fully examined in northern temperate rainforest trees. How does epiphyte diversity, percent cover and composition vary among trunk and branch zones within northern temperate rainforest trees? Are there steep gradients in environmental conditions or resources within northern temperate rainforest trees? To what degree do species show specialization to particular zones within northern temperate rainforest trees?

Location

Temperate rainforest on the Olympic Peninsula in Washington State, USA.

Methods

We recorded epiphyte richness, percent cover, and composition in 78 plots from six tree zones (three trunk zones and three branch zones) in six large bigleaf maple (Acer macrophyllum) trees. At each survey point, we measured temperature, relative humidity, canopy cover, moss depth, height in tree, and branch diameter to examine the degree of habitat specialization along measured environmental and resource gradients and the importance of structural heterogeneity for epiphyte species diversity in entire trees.

Results

Rarefied epiphyte richness was 25% higher on the trunk than in the branches, and there was little overlap in species composition between trunk and branch zones. Species composition changed with height as well as decreasing canopy cover along the trunk. Within the branches, epiphyte composition was related to branch diameter and moss depth; while the inner and mid‐branch zone communities were similar, the outer branch community differed. Microclimate variables did not vary significantly among tree zones and were not related to epiphyte distributions.

Conclusions

The structural heterogeneity of large A. macrophyllum trees created gradients in canopy cover and substrate characteristics that enabled up to 13 different epiphyte species to coexist. Thus, these trees are critical structures for the maintenance of forest diversity.
Thomas Percy's racialization of the European Middle Ages
Authors: Young Helen
Published: July 2019

Thomas Percy (1729–1811) was influential in popularising medieval vernacular English literature, especially ballads and Old Norse poetry, in the mid‐to‐late 18th century. Scholarship has explored nationalist political leanings in Percy's three major medievalist anthologies, first published in 1763–1770, but to date, there has been no in‐depth exploration of the significance of race in his thought and writing. This article argues that Percy's medievalist works were shaped profoundly by his conception of race as an immutable and inherited category of identity encompassing physiology, society, and culture. It draws on critical race theory to argue that Percy racialized the European Middle Ages in ways that continue to shape contemporary medievalism.
A data‐driven approach to determining freeway incident impact areas with fuzzy and graph theory‐based clustering
Authors: Ou Jishun , Xia Jingxin , Wang Yuqing , Wang Chen , Lu Zhenbo
Published: July 2019

Determining spatiotemporal impact areas of incidents plays a significant role in incident impact analysis. Although existing empirical methods have proven to be promising, they suffer from the drawbacks that limit their wide applications in automated freeway safety management. This study presents a data‐driven approach to automatically determining the spatiotemporal impact areas of freeway incidents. The spatiotemporal contour plots were first constructed using three representative traffic measures. Next, a nonrecurrent congestion area identification method based on fuzzy clustering was developed. To distinguish possible multiple independent blocks in the nonrecurrent congestion area, a clustering algorithm based on graph theory was adopted. The incident impact areas were then determined by conducting a postprocessing strategy. The incident records and the associated traffic flow data, collected on I‐5 freeway segments in San Diego Region, CA, were used to evaluate the proposed approach. Experimental results show the proposed approach can automatically and properly determine incident impact areas while accounting for the uncertainty resulting from traffic variations.
Identification, characterization and benefits of an exclusion system in an integrative and conjugative element of Bacillus subtilis
Authors: Avello Monika , Davis Kathleen P. , Grossman Alan D.
Published: July 2019

Integrative and conjugative elements (ICEs) are mobile genetic elements that transfer from cell to cell by conjugation (like plasmids) and integrate into the chromosomes of bacterial hosts (like lysogenic phages or transposons). ICEs are prevalent in bacterial chromosomes and play a major role in bacterial evolution by promoting horizontal gene transfer. Exclusion prevents the redundant transfer of conjugative elements into host cells that already contain a copy of the element. Exclusion has been characterized mostly for conjugative elements of Gram‐negative bacteria. Here, we report the identification and characterization of an exclusion mechanism in ICEBs1 from the Gram‐positive bacterium Bacillus subtilis. We found that cells containing ICEBs1 inhibit the activity of the ICEBs1‐encoded conjugation machinery in other cells. This inhibition (exclusion) was specific to the cognate conjugation machinery and the ICEBs1 gene yddJ was both necessary and sufficient to mediate exclusion by recipient cells. Through a mutagenesis and enrichment screen, we identified exclusion‐resistant mutations in the ICEBs1 gene conG. Using genes from a heterologous but related ICE, we found that the exclusion specificity was determined by ConG and YddJ. Finally, we found that under conditions that support conjugation, exclusion provides a selective advantage to the element and its host cells.
Small RNAs from the plant pathogenic fungus Sclerotinia sclerotiorum highlight host candidate genes associated with quantitative disease resistance
Authors: Derbyshire Mark , Mbengue Malick , Barascud Marielle , Navaud Olivier , Raffaele Sylvain
Published: July 2019

Fungal plant pathogens secrete effector proteins and metabolites to cause disease. Additionally, some species transfer small RNAs (sRNAs) into plant cells to silence host mRNAs through complementary base pairing and suppress plant immunity. The fungus Sclerotinia sclerotiorum infects over 600 plant species, but little is known about the molecular processes that govern interactions with its many hosts. In particular, evidence for the production of sRNAs by S. sclerotiorum during infection is lacking. We sequenced sRNAs produced by S. sclerotiorum in vitro and during infection of two host species, Arabidopsis thaliana and Phaseolus vulgaris. We found that S. sclerotiorum produces at least 374 distinct highly abundant sRNAs during infection, mostly originating from repeat‐rich plastic genomic regions. We predicted the targets of these sRNAs in A. thaliana and found that these genes were significantly more down‐regulated during infection than the rest of the genome. Predicted targets of S. sclerotiorum sRNAs in A. thaliana were enriched for functional domains associated with plant immunity and were more strongly associated with quantitative disease resistance in a genome‐wide association study (GWAS) than the rest of the genome. Mutants in A. thaliana predicted sRNA target genes SERK2 and SNAK2 were more susceptible to S. sclerotiorum than wild‐type, suggesting that S. sclerotiorum sRNAs may contribute to the silencing of immune components in plants. The prediction of fungal sRNA targets in plant genomes can be combined with other global approaches, such as GWAS, to assist in the identification of plant genes involved in quantitative disease resistance.
Impact of school and work status on diet and physical activity in rural Guatemalan adolescent girls: a qualitative study
Authors: Kurschner Sophie , Madrigal Luisa , Chacon Violeta , Barnoya Joaquin , Rohloff Peter
Published: July 2019

In low‐ and middle‐income countries, gender norms and access to energy‐dense, nutrient‐poor foods are well‐studied determinants of food and physical activity choices for adolescent girls. However, most work has been done in urban and school settings. In many settings, a large proportion of the adolescent population is rural or not enrolled in school. We conducted in‐depth interviews with 20 adolescent girls (ages 15–19) in Tecpán, Guatemala, a rural, largely indigenous Maya community. Interviews were coded and themes analyzed for insights into eating habits, food choices, and physical activity. Twelve participants were enrolled in school and eight were employed and not in school. Girls enrolled in school had more disrupted eating schedules and consumed more energy‐dense, nutrient‐poor foods. Girls not enrolled in school had fewer opportunities for physical activity and were more sedentary. To our knowledge, this study is the first in a low‐ and middle‐income country to consider diet and physical activity of adolescent girls enrolled and not enrolled in school. Key implications include (1) the need to reduce exposure to nutrient‐poor foods and promote healthy eating schedules in schools, and (2) the need to create community‐based opportunities for the activity for girls no longer enrolled in school.
Review of available evidence supporting different transfusion thresholds in different patient groups with anemia
Authors: Chai Khai Li , Cole‐Sinclair Merrole
Published: July 2019

In patients with anemia, transfusion of red blood cells (RBCs) can save lives and improve quality of life. The choice to transfuse should be cautiously made owing to risks of transfusion, economic costs, and limitations on the blood supply. Until the 1980s, the decision for RBC transfusion was guided by Hb threshold, with the aim of maintaining the patient's blood Hb level over 100 grams per liter. Since then, multiple randomized controlled trials and key systematic reviews have provided evidence‐based guidelines as to appropriate transfusion thresholds in a number of clinical settings. Here, we aimed to address the outcome of defining different anemia criteria in specific clinical populations exclusively on the basis of the need for RBC transfusion based on Hb concentration. We focused on the patient populations, where there were the most available data on differing transfusion thresholds, which looked at transfusing to a higher or liberal transfusion threshold in comparison with a lower or restrictive transfusion threshold. These included patients in intensive care with or without septic shock, hip fracture surgery, cardiovascular surgery, and upper gastrointestinal bleeding, the pediatric population, and also those with malaria, by reviewing key randomized controlled trials and systematic reviews. Twenty‐four randomized controlled studies and 12 systematic reviews have been included, and these are discussed below.
Comparative transcriptomics enables the identification of functional orthologous genes involved in early leaf growth
Authors: Vercruysse Jasmien , Van Bel Michiel , Osuna‐Cruz Cristina M. , Kulkarni Shubhada R. , Storme Véronique , Nelissen Hilde , Gonzalez Nathalie , Inzé Dirk , Vandepoele Klaas
Published: July 2019

Leaf growth is a complex trait for which many similarities exist in different plant species, suggesting functional conservation of the underlying pathways. However, a global view of orthologous genes involved in leaf growth showing conserved expression in dicots and monocots is currently missing. Here, we present a genome‐wide comparative transcriptome analysis between Arabidopsis and maize, identifying conserved biological processes and gene functions active during leaf growth. Despite the orthology complexity between these distantly related plants, 926 orthologous gene groups including 2829 Arabidopsis and 2974 maize genes with similar expression during leaf growth were found, indicating conservation of the underlying molecular networks. We found 65% of these genes to be involved in one‐to‐one orthology, whereas only 28.7% of the groups with divergent expression had one‐to‐one orthology. Within the pool of genes with conserved expression, 19 transcription factor families were identified, demonstrating expression conservation of regulators active during leaf growth. Additionally, 25 Arabidopsis and 25 maize putative targets of the TCP transcription factors with conserved expression were determined based on the presence of enriched transcription factor binding sites. Based on large‐scale phenotypic data, we observed that genes with conserved expression have a higher probability to be involved in leaf growth and that leaf‐related phenotypes are more frequently present for genes having orthologues between dicots and monocots than clade‐specific genes. This study shows the power of integrating transcriptomic with orthology data to identify or select candidates for functional studies during leaf development in flowering plants.
Nail lichen striatus: Is dermoscopy useful for the diagnosis?
Authors: Iorizzo Matilde , Rubin Adam I. , Starace Michela
Published: July 2019

Background/Objectives

Lichen striatus is a unilateral inflammatory dermatosis that rarely affects the nail unit. When the inflammation involves the nail unit, classic lichenoid nail changes are easily detectable, more often limited to only one portion of the nail. Usually the nail dystrophy coexists with periungual skin papules following Blaschko's lines, but it could also be an isolated feature. Because a nail unit biopsy presents difficulties in execution, especially in a child, the aim of our study has been to describe the nail unit dermoscopy features of lichen striatus hoping to provide a valid aid to clinicians in the diagnosing this rare disorder.

Methods

We reviewed the images of five pediatric patients with a clinical diagnosis of lichen striatus. Data about sex, age, localization, predisposing/triggering factors, and associated disorders are reported.

Results

The diagnosis of lichen striatus can be challenging as there are clinically overlapping features with related dermatoses. A common diagnostic pitfall occurs with inflammatory linear verrucous epidermal nevus and lichen planus. Involvement of only one part of the nail plate with linear longitudinal fissuring, ridging, and distal splitting, especially if seen with perionychial skin lesions, is characteristic of lichen striatus.

Conclusions

Nail lichen striatus is rare, and there is sparse published literature on it. When the changes in lichen striatus are limited to the nail, the diagnosis may easily be missed. We therefore believe that dermoscopy is an important diagnostic maneuver, which should be integrated into the evaluation of patients with potential lichen striatus, and in particular is helpful for clinicians unwilling or unable to perform a nail unit biopsy.
Quantitative methods in philosophy of language
Authors: Ventura Rafael
Published: July 2019

In this paper, I survey and defend the use of quantitative methods in philosophy of language. Quantitative methods in philosophy of language include a wide variety of methods, ranging from model‐based techniques (computer simulations and mathematical models) to data‐driven approaches (experimental philosophy and corpus‐based studies). After offering a few case studies of these methodologies in action, I single out some debates in philosophy of language that are especially well served by their use. These are cases in which quantitative methods increase precision, improve the accuracy and reliability of results, and allow philosophers of language to borrow from other fields the best epistemic practices available. I conclude with some far‐reaching considerations about the role of qualitative and quantitative methods in debates about philosophical methodology.