bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive habitat suitability models for nesting woodpeckers following wildfire in the Sierra Nevada and Southern Cascades of California
Authors: Campos Brent R , Latif Quresh S , Burnett Ryan D , Saab Victoria A
Published: November 2019

Woodpeckers are often focal species for informing management of recently burned forests. Snags generated by wildfire provide key nesting and foraging resources for woodpeckers, and nest cavities excavated by woodpeckers are subsequently used by many other species. Habitat suitability models applicable in newly burned forest are important management tools for identifying areas likely to be used by nesting woodpeckers. Here we present and test predictive models for mapping woodpecker nest-site habitat across wildfire locations that can be used to inform post-fire planning and salvage logging decisions. From 2009 to 2016, we monitored 313 nest sites of 4 species—Black-backed Woodpecker (Picoides arcticus), Hairy Woodpecker (Dryobates villosus), White-headed Woodpecker (D. albolarvatus), and Northern Flicker (Colaptes auratus)—from 3 wildfires in the Northern Sierra Nevada and Southern Cascades 1–5 yr after fire. Using these data, we developed habitat suitability index models that compared nest vs. non-nest sites for each species using (1) exclusively remotely sensed covariates, and (2) combinations of remotely sensed and field-collected covariates. We emphasized predictive performance across wildfire locations when selecting models to retain generalizable habitat relationships useful for informing management in newly burned locations. We identified models for all 4 species with strong predictive performance across wildfire locations despite notable variation in conditions among locations, suggesting broad applicability to guide post-fire management in the Sierra Nevada region. Top models for nest-site selection underscored the importance of high burn severity at the local scale, lower burn severity at the 1-km scale, mid-sized nest-tree diameters, and nest trees with broken tops. Models restricted to remotely sensed covariates exhibited similar predictive performance as combination models and are valuable for mapping habitat across entire wildfire locations to help delineate project areas or habitat reserves. Combination models are especially relevant for design of silvicultural prescriptions.
Peer Relationship Experiences Of Deaf And Hard-Of-Hearing Adolescents
Authors: Terlektsi E , Kreppner J , Mahon M , Worsfold S , Kennedy Colin R
Published: November 2019

Deaf and hard-of-hearing adolescents (DHH) experience more peer problems and lower levels of friendships than their hearing peers. This study used a qualitative approach to identify their experiences of peer problems and factors influencing them. A sample of 30, 13–19 year-old DHH adolescents with a moderate to profound hearing loss, drawn from a population-based cohort study in which their receptive language and social–emotional skills had been assessed, underwent semi-structured interviews. Interviews were analyzed using thematic analysis. Participants reported that, overall, they had developed positive and rewarding relationships with their peers, notwithstanding their earlier experience of being bullied. Conflicts and infrequency of interaction in their friendships were mainly reported by girls. Adolescents with moderate hearing loss were identified as facing the same or even more barriers than adolescents with severe to profound hearing loss in making new friends. Implications for educational practice are discussed.
Non-vitamin K antagonist oral anticoagulants and warfarin in atrial fibrillation patients with concomitant peripheral artery disease
Authors: Lee Hsin-Fu , See Lai-Chu , Li Pei-Ru , Liu Jia-Rou , Chao Tze-Fan , Chang Shang-Hung , Wu Lung-Sheng , Yeh Yung-Hsin , Kuo Chi-Tai , Chan Yi-Hsin , Lip Gregory Y H
Published: November 2019

Aims 

To investigate the effectiveness, safety, and outcomes of lower limb events for non-vitamin K antagonist oral anticoagulants (NOACs) vs. warfarin among atrial fibrillation (AF) patients with concomitant peripheral artery disease (PAD).

Methods and results

In this nationwide retrospective cohort study collected from Taiwan National Health Insurance Research Database, a total of 5768 and 2034 consecutive AF patients with PAD patients taking NOACs or warfarin were identified from 1 June 2012 to 31 December 2017, respectively. We used propensity score stabilized weighting to balance covariates across study groups. In the cohort, there were 89% patients were taking low-dose NOAC (dabigatran 110 mg twice daily, rivaroxaban 10–15 mg daily, apixaban 2.5 mg twice daily, or edoxaban 30 mg daily). Non-vitamin K antagonist oral anticoagulant was associated with a comparable risk of ischaemic stroke, and a lower risk of acute myocardial infarction [hazard ratio (HR): 0.61, 95% confidence interval (CI): 0.42–0.87; P = 0.007], lower extremity thromboembolism (HR: 0.56, 95% CI: 0.44–0.72; P < 0.0001), revascularization procedure (HR: 0.58, 95% CI: 0.47–0.72; P < 0.0001), lower limb amputation (HR: 0.32, 95% CI: 0.23–0.46; P < 0.0001), and all major bleeding (HR: 0.64, 95% CI: 0.50–0.80; P = 0.0001) than warfarin after weighting. The advantage of NOACs over warfarin persisted in high-risk subgroups including patients of ≥75 years of age, diabetes, renal impairment, or use of concomitant antiplatelet agent.

Conclusion 

This population-based study indicated that NOACs were associated with a comparable risk of ischaemic stroke, and a significantly lower risk of major adverse limb events and major bleeding than warfarin among AF patients with concomitant PAD. Therefore, thromboprophylaxis with NOACs may be considered for such patients.
Surgical versus percutaneous multivessel coronary revascularization in patients with chronic kidney disease
Authors: Kilic Arman , Sultan Ibrahim , Gleason Thomas G , Wang Yisi , Smith Conrad , Marroquin Oscar C , Thoma Floyd , Toma Catalin , Lee Joon S , Mulukutla Suresh R
Published: November 2019

OBJECTIVES

This study compared contemporary outcomes following surgical versus percutaneous coronary revascularization for multivessel coronary artery disease (MVCAD) in patients with chronic kidney disease.

METHODS

Patients with MVCAD and a reduced glomerular filtration rate (<60 ml/min) undergoing coronary bypass surgery (CABG) or percutaneous coronary intervention (PCI) at a single institution between 2010 and 2017 were included. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite outcome of death, stroke, myocardial infarction or repeat revascularization. Multivariable Cox regression models were used for risk-adjustment and propensity matching was also performed.

RESULTS

A total of 1853 patients were included in the study (1269 CABG, 584 PCI). CABG was associated with greater 5-year freedom from MACCE (70.1% vs 47.3%, P < 0.0001), a finding that persisted after risk-adjustment. The rates of early and late mortality and readmission were also lower with CABG as were individual rates of myocardial infarction and repeat revascularization. A propensity-matched analysis generated 704 well-matched patients (352 in each arm) with similar results, including greater 5-year freedom from MACCE (72.8% vs 45.8%, P < 0.0001), improved 5-year survival (73.9% vs 52.3%, P < 0.0001), lower readmission (cause-specific hazard ratio 0.68, 95% confidence interval 0.58–0.80; P < 0.0001), lower individual rates of myocardial infarction (2.6% vs 9.7%, P < 0.0001) and repeat revascularization (1.1% vs 7.4%, P < 0.0001).

CONCLUSIONS

CABG is associated with a lower MACCE rate than that of PCI in patients with MVCAD and chronic kidney disease. Multidisciplinary discussions regarding the optimal revascularization strategy are important in MVCAD, particularly in more complex scenarios such as chronic kidney disease.
Electromagnetic navigation-guided versus computed tomography-guided percutaneous localization of small lung nodules before uniportal video-assisted thoracoscopic surgery: a propensity score-matched analysis
Authors: Hung Chia-Tsung , Chen Chun-Ku , Chang Ying-Yueh , Hsu Po-Kuei , Hung Jung-Jyh , Huang Chien-Sheng , Wu Yu-Chung , Hsu Han-Shui
Published: November 2019

OBJECTIVES

An optimal method for preoperative localization of small lung nodules is yet to be established, and there are few comparative studies in the literature. In the present study, we aimed to compare electromagnetic navigation-guided and computed tomography (CT)-guided methods of percutaneous transthoracic localization.

METHODS

The clinical, radiographic, surgical and pathological data of patients who underwent electromagnetic navigation-guided localization (EMNGL) and CT-guided localization (CTGL) before uniportal video-assisted thoracic surgery (VATS) were reviewed. Propensity score matching analysis was performed to compare the localization and surgical results.

RESULTS

After matching, 25 EMNGL and 50 CTGL patients were included in the analysis. In the CTGL group, pulmonary haemorrhage and pneumothorax were noted in 56% and 34% of patients, respectively, on postprocedural CT scans. Successful localization was achieved in 96% and 100% of patients in the EMNGL and CTGL groups, respectively (P = 0.333). The median time in the operation room was significantly shorter in the CTGL group {142.5 [interquartile range (IQR) 123.8–175.0] vs 205.0 [IQR 177.5–290.0] min, P < 0.001}. In contrast, EMNGL significantly decreased the total time [205.0 (IQR 177.5–290.0) vs 324.0 (IQR 228.3–374.0) min, P = 0.002]. The median duration of chest drainage was 1 day shorter in the EMNGL group [2.0 (IQR 1.5–2.5) vs 3.0 (IQR 2.0–3.0), P = 0.002]; the surgical complication rates were comparable between the 2 groups.

CONCLUSIONS

The localization and surgical results were similar between the EMNGL and CTGL groups. EMNGL is comparable to conventional CTGL with respect to preoperative localization of small lung nodules before uniportal VATS.
False lumen ejection fraction predicts growth in type B aortic dissection: preliminary results
Authors: Burris Nicholas S , Nordsletten David A , Sotelo Julio A , Grogan-Kaylor Ross , Houben Ignas B , Figueroa C Alberto , Uribe Sergio , Patel Himanshu J
Published: November 2019

OBJECTIVES

Current risk assessment strategies in type B aortic dissection are focused on anatomic parameters, although haemodynamic abnormalities that result in false lumen (FL) pressurization are thought to play a significant role in aortic growth. The objective of this study was to evaluate blood flow of the FL using 4D flow magnetic resonance imaging (MRI) and identify haemodynamic and anatomic factors that independently predict the rate of aortic growth.

METHODS

Patients with dissection of the descending thoraco-abdominal aorta (n = 18) were enrolled in a prospective observational study and underwent 4D flow MRI for haemodynamic assessment of the entry tear and FL. Anatomic parameters were obtained by magnetic resonance angiography and baseline computed tomography. False lumen ejection fraction (FL EF) was defined the ratio of retrograde flow rate at the dominant entry tear during diastole over the antegrade systolic flow rate.

RESULTS

The median aortic growth rate was 3.5 mm/year (interquartile range 0.5–8.1 mm/year). Entry tear peak velocity was lower in patients with enlarging aortic dimensions (95.5 ± 24.1 vs 128.1 ± 37.4 cm/s, P = 0.039). After adjusting for co-variates FL EF (β = 0.15, P = 0.004), baseline maximal aortic diameter (β = 0.37, P = 0.001) and the entry tear distance from the left subclavian artery (β = 0.07, P = 0.016) were significant predictors of aortic growth rate.

CONCLUSIONS

Beyond standard anatomic risk factors, FL EF is an independent predictor of aortic growth rate and may represent an intuitive, non-invasive method to estimate FL pressurization and improve patient-specific risk assessment in patients with type B aortic dissection.
Transapical mitral valve-in-ring procedure with a novel self-expandable transcatheter heart valve: first- and last-in-man report
Authors: Schaefer Andreas , Seiffert Moritz , Blankenberg Stefan , Conradi Lenard
Published: November 2019

Interventional therapy of failing surgical mitral valve replacement and repair is an appealing option in patients who are not eligible for redo surgery. We herein report on the first-in-human use of a repositionable, self-expandable transcatheter heart valve with motorized delivery for a transapical mitral valve-in-ring procedure. After implantation, fluoroscopy showed no residual regurgitation and pressure measurements did not reveal any signs of left ventricular outflow tract obstruction.
Sleep patterns, genetic susceptibility, and incident cardiovascular disease: a prospective study of 385 292 UK biobank participants
Authors: Fan Mengyu , Sun Dianjianyi , Zhou Tao , Heianza Yoriko , Lv Jun , Li Liming , Qi Lu
Published: November 2019

Aims

To quantify the association of combined sleep behaviours and genetic susceptibility with the incidence of cardiovascular disease (CVD).

Methods and results

This study included 385 292 participants initially free of CVD from UK Biobank. We newly created a healthy sleep score according to five sleep factors and defined the low-risk groups as follows: early chronotype, sleep 7–8 h per day, never/rarely insomnia, no snoring, and no frequent excessive daytime sleepiness. Weighted genetic risk scores of coronary heart disease (CHD) or stroke were calculated. During a median of 8.5 years of follow-up, we documented 7280 incident CVD cases including 4667 CHD and 2650 stroke cases. Compared to those with a sleep score of 0–1, participants with a score of 5 had a 35% (19–48%), 34% (22–44%), and 34% (25–42%) reduced risk of CVD, CHD, and stroke, respectively. Nearly 10% of cardiovascular events in this cohort could be attributed to poor sleep pattern. Participants with poor sleep pattern and high genetic risk showed the highest risk of CHD and stroke.

Conclusion

In this large prospective study, a healthy sleep pattern was associated with reduced risks of CVD, CHD, and stroke among participants with low, intermediate, or high genetic risk.
Vascular responses to coronary calcification following implantation of newer-generation drug-eluting stents in humans: impact on healing
Authors: Torii Sho , Jinnouchi Hiroyuki , Sakamoto Atsushi , Mori Hiroyoshi , Park Joohyung , Amoa Falone C , Sawan Mariem , Sato Yu , Cornelissen Anne , Kuntz Salome H , Kutyna Matthew , Paek Ka Hyun , Fernandez Raquel , Braumann Ryan , Mont Eric K , Surve Dipti , Romero Maria E , Kolodgie Frank D , Virmani Renu , Finn Aloke V
Published: November 2019

Aims

Vascular calcification is routinely encountered in percutaneous coronary intervention (PCI) and severe coronary calcification is a known predictor of in-stent restenosis and stent thrombosis. However, the histopathologic mechanisms behind such events have not been systematically described.

Methods and results

From our registry of 1211 stents, a total of 134 newer-generation drug-eluting stents (DES) (Xience, Resolute-Integrity, PROMUS-Element, and Synergy) with duration of implant ≥30 days were histologically analysed. The extent of calcification of the stented lesions was evaluated radiographically and divided into severe (SC, n = 46) and non-severely calcified lesions (NC, n = 88). The percent-uncovered struts per section {SC vs. NC; median 2.4 [interquartile range (IQR) 0.0–19.0] % vs. 0.0 (IQR 0.0–4.6) %, P = 0.02} and the presence of severe medial tears (MTs) (59% vs. 44%, respectively, P = 0.03) were greater in SC than NC. In addition, SC had a higher prevalence of ≥3 consecutive struts lying directly in contact with surface calcified area (3SC) (52% vs. 8%, respectively, P < 0.0001). Multivariate analysis demonstrated that sections with duration of implantation ≤6 months [odds ratio (OR): 7.7, P < 0.0001], 3SC (OR: 6.5, P < 0.0001), strut malapposition (OR: 5.0, P < 0.0001), and lack of MTs (OR: 2.5, P = 0.0005) were independent predictors of uncovered struts. Prevalence of neoatherosclerosis was significantly lower in SC than that of NC (24% vs. 44%, P = 0.02).

Conclusion

Severe calcification, especially surface calcified area is an independent predictor of uncovered struts and delayed healing after newer-generation DES implantation. These data expand of knowledge of the vascular responses of stenting of calcified arteries and suggests further understand of how best to deal with calcification in patients undergoing PCI.
Pilot of a screening, brief intervention and referral to treatment process for symptoms of trauma among primary care patients
Authors: Avey Jaedon P , Moore Laurie , Beach Barbara , Hiratsuka Vanessa Y , Dirks Lisa G , Dillard Denise A , Novins Douglas
Published: November 2019

Background

For populations with high rates of trauma exposure yet low behavioural health service use, identifying and addressing trauma in the primary care setting could improve health outcomes, reduce disability and increase the efficiency of health system resources.

Objective

To assess the acceptability and feasibility of a screening, brief intervention and referral to treatment (SBIRT) process for trauma and symptoms of posttraumatic stress disorder (PTSD) among American Indian and Alaska Native people. We also examine the short-term effects on service utilization and the screening accuracy of the Primary Care Posttraumatic Stress Disorder Screen.

Methods

Cross-sectional pilot in two tribal primary care settings. Surveys and interviews measured acceptability among patients and providers. Health service utilization was used to examine impact. Structured clinical interview and a functional disability measure were used to assess screening accuracy.

Results

Over 90% of patient participants (N = 99) reported the screening time was acceptable, the questions were easily understood, the right staff were involved and the process satisfactory. Ninety-nine percent would recommend the process. Participants screening positive had higher behavioural health utilization in the 3 months after the process than those screening negative. The Primary Care Posttraumatic Stress Disorder Screen was 100% sensitive to detect current PTSD with 51% specificity. Providers and administrators reported satisfaction with the process.

Conclusions

The SBIRT process shows promise for identifying and addressing trauma in primary care settings. Future research should explore site specific factors, cost analyses and utility compared to other behavioural health screenings.
Salinity reduces bacterial diversity, but increases network complexity in Tibetan Plateau lakes
Authors: Ji Mukan , Kong Weidong , Yue Linyan , Wang Junbo , Deng Ye , Zhu Liping
Published: November 2019

Salinity is one of the most important environmental factors influencing bacterial plankton communities in lake waters, while its influence on bacterial interactions has been less explored. Here, we investigated the influence of salinity on the bacterial diversity, interactions and community structure in Tibetan Plateau lakes. Our results revealed that saline lakes (salinity between 0.5 and 50 g/L) harboured similar or even higher bacterial diversity compared with freshwater lakes (< 0.5 g/L), while hyper-saline lakes (> 50 g/L) exhibited the lowest diversity. Network analysis demonstrated that hyper-saline lakes exhibited the highest network complexity, with higher total correlation numbers (particularly the negative correlations), but lower network module numbers than freshwater and saline lakes. Furthermore, salinity dominantly explained the bacterial community structure variations in saline lakes, while those in freshwater and hyper-saline lakes were predominately explained by water temperature and geospatial distance, respectively. The core operational taxonomic units (OTUs), which were ubiquitously present in all lakes, were less sensitive to enhancing salinity than the indicative OTUs whose presence was dependent on lake type. Our findings offer a new understanding of how salinity influences bacterial community in plateau lakes.
Environmental factors determining distribution and activity of anammox bacteria in minerotrophic fen soils
Authors: Bagnoud Alexandre , Guye-Humbert Sylvia , Schloter-Hai Brigitte , Schloter Michael , Zopfi Jakob
Published: November 2019

In contrast to the pervasive occurrence of denitrification in soils, anammox (anaerobic ammonium oxidation) is a spatially restricted process that depends on specific ecological conditions. To identify the factors that constrain the distribution and activity of anammox bacteria in terrestrial environments, we investigated four different soil types along a catena with opposing ecological gradients of nitrogen and water content, from an amended pasture to an ombrotrophic bog. Anammox was detected by polymerase chain reaction (PCR) and quantitative PCR (qPCR) only in the nitrophilic wet meadow and the minerotrophic fen, in soil sections remaining water-saturated for most of the year and whose interstitial water contained inorganic nitrogen. Contrastingly, aerobic ammonia oxidizing microorganisms were present in all examined samples and outnumbered anammox bacteria usually by at least one order of magnitude. 16S rRNA gene sequencing revealed a relatively high diversity of anammox bacteria with one Ca. Brocadia cluster. Three additional clusters could not be affiliated to known anammox genera, but have been previously detected in other soil systems. Soil incubations using 15N-labeled substrates revealed that anammox processes contributed about <2% to total N2 formation, leaving nitrification and denitrification as the dominant N-removal mechanism in these soils that represent important buffer zones between agricultural land and ombrotrophic peat bogs.
Assessment of human diploid genome assembly with 10x Linked-Reads data
Authors: Zhang Lu , Zhou Xin , Weng Ziming , Sidow Arend
Published: November 2019

Background

Producing cost-effective haplotype-resolved personal genomes remains challenging. 10x Linked-Read sequencing, with its high base quality and long-range information, has been demonstrated to facilitate de novo assembly of human genomes and variant detection. In this study, we investigate in depth how the parameter space of 10x library preparation and sequencing affects assembly quality, on the basis of both simulated and real libraries.

Results

We prepared and sequenced eight 10x libraries with a diverse set of parameters from standard cell lines NA12878 and NA24385 and performed whole-genome assembly on the data. We also developed the simulator LRTK-SIM to follow the workflow of 10x data generation and produce realistic simulated Linked-Read data sets. We found that assembly quality could be improved by increasing the total sequencing coverage (C) and keeping physical coverage of DNA fragments (CF) or read coverage per fragment (CR) within broad ranges. The optimal physical coverage was between 332× and 823× and assembly quality worsened if it increased to >1,000× for a given C. Long DNA fragments could significantly extend phase blocks but decreased contig contiguity. The optimal length-weighted fragment length (W${\mu _{FL}}$) was ~50–150 kb. When broadly optimal parameters were used for library preparation and sequencing, ~80% of the genome was assembled in a diploid state.

Conclusions

The Linked-Read libraries we generated and the parameter space we identified provide theoretical considerations and practical guidelines for personal genome assemblies based on 10x Linked-Read sequencing.
Using Bayesian model averaging to improve ground motion predictions
Authors: Bertin M , Marin S , Millet C , Berge-Thierry C
Published: November 2019

In low-seismicity areas such as Europe, seismic records do not cover the whole range of variable configurations required for seismic hazard analysis. Usually, a set of empirical models established in such context (the Mediterranean Basin, northeast U.S.A., Japan, etc.) is considered through a logic-tree-based selection process. This approach is mainly based on the scientist’s expertise and ignores the uncertainty in model selection. One important and potential consequence of neglecting model uncertainty is that we assign more precision to our inference than what is warranted by the data, and this leads to overly confident decisions and precision. In this paper, we investigate the Bayesian model averaging (BMA) approach, using nine ground-motion prediction equations (GMPEs) issued from several databases. The BMA method has become an important tool to deal with model uncertainty, especially in empirical settings with large number of potential models and relatively limited number of observations. Two numerical techniques, based on the Markov chain Monte Carlo method and the maximum likelihood estimation approach, for implementing BMA are presented and applied together with around 1000 records issued from the RESORCE-2013 database. In the example considered, it is shown that BMA provides both a hierarchy of GMPEs and an improved out-of-sample predictive performance.
Temporal changes of seismic velocities in the San Jacinto Fault zone associated with the 2016Mw 5.2 Borrego Springs earthquake
Authors: Qiu Hongrui , Hillers Gregor , Ben-Zion Yehuda
Published: November 2019

We study temporal changes of seismic velocities associated with the 10 June 2016 Mw 5.2 Borrego Springs earthquake in the San Jacinto fault zone, using nine component Green's function estimates reconstructed from daily cross correlations of ambient noise. The analysed data are recorded by stations in two dense linear arrays, at Dry Wash (DW) and Jackass Flat (JF), crossing the fault surface trace ∼3 km northwest and southeast of the event epicentre. The two arrays have 9 and 12 stations each with instrument spacing of 25–100 m. Relative velocity changes (δv/v) are estimated from arrival time changes in the daily correlation coda waveforms compared to a reference stack. The obtained array-average δv/v time-series exhibit changes associated with the Borrego Springs event, superposed with seasonal variations. The earthquake-related changes are characterized by a rapid coseismic velocity drop followed by a gradual recovery. This is consistently observed at both arrays using time- and frequency-domain δv/v analyses with data from different components in various frequency bands. Larger changes at lower frequencies imply that the variations are not limited to the near surface material. A decreasing coseismic velocity reduction with coda wave lapse time indicates larger coseismic structural perturbations in the fault zone and near-fault environment compared to the surrounding rock. Observed larger changes at the DW array compared to the JF array possibly reflect the northwestward rupture directivity of the Borrego Springs earthquake.
Understanding the impacts of NPM and proposed solutions to the healthcare system reforms in Indonesia: the case of BPJS
Authors: Erniaty Erniaty , Harun Harun
Published: November 2019

This study critically evaluates the adoption of a universal healthcare system recently introduced by the Indonesian government in 2014. Our study is driven by the lack of critical analysis of social and political factors and unintended consequences of New Public Management, which is evident in the healthcare sector reforms in emerging economies. This study not only examines the impact of economic and political forces surrounding the introduction of a universal health insurance programme in the country but also offers insights into the critical challenges and undesirable outcomes of a fundamental reform of the healthcare sector in Indonesia. Through a systematic and detailed review of prior studies, legal sources and reports from government and media organizations about the implementation and progress of an UHC health insurance programme in Indonesia, the authors find that a more democratic political system that emerged in 1998 created the opportunity for politicians and international financial aid agencies to introduce a universal social security administration agency called Badan Penyelenggara Jaminan Sosial (BPJS). Despite the introduction of BPJS to expand the health services’ coverage, this effort faces critical challenges and unintended outcomes including: (1) increased financial deficits, (2) resistance from medical professionals and (3) politicians’ tendency to blame BPJS’s management for failing to pay healthcare services costs. We argue that the adoption of the insurance system was primarily motivated by politicians’ own interests and those of international agencies at the expense of a sustainable national healthcare system. This study contributes to the healthcare industry policy literature by showing that a poorly designed UHC system could and will undermine the core values of healthcare services. It will also threaten the sustainability of the medical profession in Indonesia. The authors offer several suggestions for devising better policies in this sector in the developing nations.
Glycogen storage disease type 1a is associated with disturbed vitamin A metabolism and elevated serum retinol levels
Authors: Saeed Ali , Hoogerland Joanne A , Wessel Hanna , Heegsma Janette , Derks Terry G J , van der Veer Eveline , Mithieux Gilles , Rajas Fabienne , Oosterveer Maaike H , Faber Klaas Nico
Published: November 2019

Glycogen storage disease type 1a (GSD Ia) is an inborn error of metabolism caused by mutations in the G6PC gene, encoding the catalytic subunit of glucose-6-phosphatase. Early symptoms include severe fasting intolerance, failure to thrive and hepatomegaly, biochemically associated with nonketotic hypoglycemia, fasting hyperlactidemia, hyperuricemia and hyperlipidemia. Dietary management is the cornerstone of treatment aiming at maintaining euglycemia, prevention of secondary metabolic perturbations and long-term complications, including liver (hepatocellular adenomas and carcinomas), kidney and bone disease (hypovitaminosis D and osteoporosis). As impaired vitamin A homeostasis also associates with similar symptoms and is coordinated by the liver, we here analysed whether vitamin A metabolism is affected in GSD Ia patients and liver-specific G6pc−/− knock-out mice. Serum levels of retinol and retinol binding protein 4 (RBP4) were significantly increased in both GSD Ia patients and L-G6pc−/− mice. In contrast, hepatic retinol levels were significantly reduced in L-G6pc−/− mice, while hepatic retinyl palmitate (vitamin A storage form) and RBP4 levels were not altered. Transcript and protein analyses indicate an enhanced production of retinol and reduced conversion the retinoic acids (unchanged LRAT, Pnpla2/ATGL and Pnpla3 up, Cyp26a1 down) in L-G6pc−/− mice. Aberrant expression of genes involved in vitamin A metabolism was associated with reduced basal messenger RNA levels of markers of inflammation (Cd68, Tnfα, Nos2, Il-6) and fibrosis (Col1a1, Acta2, Tgfβ, Timp1) in livers of L-G6pc−/− mice. In conclusion, GSD Ia is associated with elevated serum retinol and RBP4 levels, which may contribute to disease symptoms, including osteoporosis and hepatic steatosis.
Revisiting the competency trap
Authors: Denrell Jerker , Le Mens Gaël
Published: November 2019

We revisit the competency trap and reexamine when it occurs. We show that a bias against alternatives that improve with practice does not require that learning is myopic in the sense of lacking foresight or failing to explore. The same bias occurs even if learners engage in substantial exploration and have foresight. In fact, we demonstrate that even a rational and foresighted learner, who follow an optimal strategy for balancing exploration and exploitation, will learn to prefer alternatives with initially high payoffs that decrease with practice over alternatives, with identical expected values, that have initially low payoffs that increase with practice. Our results show that a bias against alternatives that improve with practice is due to an asymmetry in error correction rather than to myopic learning. The implication is that a wide range of selection systems, even optimally designed ones, will be biased against late-bloomers.
Otolith increment width-based chronologies disclose temperature and density-dependent effects on demersal fish growth
Authors: Vieira Ana Rita , Dores Sandra , Azevedo Manuela , Tanner Susanne E
Published: November 2019

Climate change and fishing are drastically impacting marine ecosystems. Comprehending the biological consequences of these effects on commercially exploited fish is especially challenging. Here, we developed a 43-year otolith increment width-based growth chronology for one of the most important commercially exploited fish species in the Northeast Atlantic (European hake, Merluccius merluccius). Increasingly complex linear mixed-effects models were used to partition growth variation into intrinsic (age, sex, and age-at-capture) and extrinsic (environmental and biotic variables) factors, allowing age interaction with extrinsic variables to assess age-dependent responses in growth. Our results provided strong evidence that European hake growth is impacted by ocean temperature, namely sea surface temperature and temperature at depth, and species abundance (recruitment), with different responses depending on fish age. We found evidence that increasing ocean temperature could be highly detrimental for species growth especially during the first years of life. We provided insights into the effects of environmental and biotic factors on species growth variation. Such information is key to recognize the sensitivity of European hake growth to climate change, which may contribute to sustainable management policies for this valuable resource.
Analysis of Time-Course, Dose-Effect, and Influencing Factors of Antidepressants in the Treatment of Acute Adult Patients With Major Depression
Authors: Cheng Qingqing , Huang Jihan , Xu Ling , Li Yunfei , Li Huafang , Shen Yifeng , Zheng Qingshan , Li Lujin
Published: November 2019

Objective

Model-based meta-analysis was used to describe the time-course and dose-effect relationships of antidepressants and also simultaneously investigate the impact of various factors on drug efficacy.

Methods

This study is a reanalysis of a published network meta-analysis. Only placebo-controlled trials were included in this study. The change rate in depression rating scale scores from baseline was used as an efficacy indicator because a continuous variable is more likely to reflect subtle differences in efficacy between drugs.

Results

A total 230 studies containing 64 346 patients were included in the analysis. The results showed that the number of study sites (single or multi-center) and the type of setting (inpatient or noninpatient) are important factors affecting the efficacy of antidepressants. After deducting the placebo effect, the maximum pure drug efficacy value of inpatients was 18.4% higher than that of noninpatients, and maximum pure drug efficacy value of single-center trials was 10.2% higher than that of multi-central trials. Amitriptyline showed the highest drug efficacy. The remaining 18 antidepressants were comparable or had little difference. Within the approved dose range, no significant dose-response relationship was observed. However, the time-course relationship is obvious for all antidepressants. In terms of safety, with the exception of amitriptyline, the dropout rate due to adverse events of other drugs was not more than 10% higher than that of the placebo group.

Conclusion

The number of study sites and the type of setting are significant impact factors for the efficacy of antidepressants. Except for amitriptyline, the other 18 antidepressants have little difference in efficacy and safety.
Dispersal From Overwintering Sites, Action Thresholds for Blueberry Maggot Fly (Diptera: Tephritidae), and Factors That Can Influence Variation in Predicted Fruit Infestation Levels in Maine Wild Blueberry: Part I
Authors: Drummond Francis A , Collins Judith A
Published: November 2019

Between 1996 and 2003 field studies were conducted in wild blueberry, Vaccinium angustifolium Aiton (Ericales: Ericaceae) to determine action thresholds for the blueberry maggot fly, Rhagoletis mendax Curran (Diptera: Tephritidae). Thresholds were based upon cumulative fly trap captures on baited Pherocon AM traps. The cumulative numbers of R. mendax flies captured over time was a significant predictor of infested fruit levels (maggots/liter blueberries). Fifty percent of the variance in fruit infestation is explained by fly captures. Based upon this relationship, the University of Maine Cooperative Extension has recommended action threshold of 10 cumulative fly captures/trap. However, this threshold is liberal in terms of risk as only 50% of the variance in fruit infestation is explained by fly captures. The dynamics of colonization rate and fly physiological status entering fruit-bearing fields might partially explain the variance in the action threshold. The majority of flies emerge from pruned fields or along forest scrub/shrub field edges, and it takes between 1 and 10 d (mean = 4.1 ± 0.9 d) for the populations to enter adjacent fruit-bearing fields. Flies dispersed from pruned fields at a decreasing rate the farther they dispersed. The rate of dispersal into fruit-bearing wild blueberry fields also depends upon the overwintering site quality. Sites with fruit exhibited both delayed colonization and lower colonization rates into fruit-bearing fields than adjacent pruned fields with no fruit. We also found that as the season progressed the proportion of flies capable of laying eggs varied greatly by location and year.
Pushing for Political and Legal Change: Protecting the Cultural Identity of Travellers in the Netherlands
Authors: Huijbers Leonie M , Loven Claire M S
Published: November 2019

On 12 July 2018, the central government of the Netherlands changed its approach relating to traveller camps in the Netherlands. This change constitutes a huge political shift, as the government had previously adopted a ‘hands-off’ and ‘repressive-inclusion’ strategy, which was especially known for its infamous ‘phase-out policy’ or ‘extinction policy’ of traveller camps. This has now been replaced by a fundamental rights-proof approach that facilitates the travellers’ way of life. This article aims to uncover the various actions undertaken by international and national actors that seem to have contributed to the Dutch government’s changed stance. It looks particularly at the role played by four national actors: the Netherlands Institute for Human Rights, the National Ombudsman, the Public Interest Litigation Project, and activist Roma, Sinti and travellers and their various interest groups. The article concludes that these actors’ efforts to establish political and legal change were successful as they addressed the same issue from different vantage points and through different means. That is, they all focused on the issue of the incompatibility of the phase-out policy with fundamental rights standards and relied on a variety of means available to them (such as litigation, lobbying, reporting, raising international awareness, and ensuring media coverage). By drawing some general lessons from this case study, this article aims to contribute to the existing literature on mobilizing human rights. In particular, it focuses on the (legal) activities national actors can undertake to bring about political and legal change in order to enforce the compliance of national authorities with fundamental rights standards in both law and policy.
Robo-Advising: Learning Investors’ Risk Preferences via Portfolio Choices*
Authors: Alsabah Humoud , Capponi Agostino , Ruiz Lacedelli Octavio , Stern Matt
Published: November 2019

We introduce a reinforcement learning framework for retail robo-advising. The robo-advisor does not know the investor’s risk preference but learns it over time by observing her portfolio choices in different market environments. We develop an exploration–exploitation algorithm that trades off costly solicitations of portfolio choices by the investor with autonomous trading decisions based on stale estimates of investor’s risk aversion. We show that the approximate value function constructed by the algorithm converges to the value function of an omniscient robo-advisor over a number of periods that is polynomial in the state and action space. By correcting for the investor’s mistakes, the robo-advisor may outperform a stand-alone investor, regardless of the investor’s opportunity cost for making portfolio decisions.
Recursive enumerability and elementary frame definability in predicate modal logic
Authors: Rybakov Mikhail , Shkatov Dmitry
Published: November 2019

We investigate the relationship between recursive enumerability and elementary frame definability in first-order predicate modal logic. On one hand, it is well known that every first-order predicate modal logic complete with respect to an elementary class of Kripke frames, i.e. a class of frames definable by a classical first-order formula, is recursively enumerable. On the other, numerous examples are known of predicate modal logics, based on ‘natural’ propositional modal logics with essentially second-order Kripke semantics, that are either not recursively enumerable or Kripke incomplete. This raises the question of whether every Kripke complete, recursively enumerable predicate modal logic can be characterized by an elementary class of Kripke frames. We answer this question in the negative, by constructing a normal predicate modal logic which is Kripke complete, recursively enumerable, but not complete with respect to an elementary class of frames. We also present an example of a normal predicate modal logic that is recursively enumerable, Kripke complete, and not complete with respect to an elementary class of rooted frames, but is complete with respect to an elementary class of frames that are not rooted.
Standpoint semantics for polysemy in spatial prepositions
Authors: Rodrigues Edilson J , Santos Paulo E , Lopes Marcos , Bennett Brandon , Oppenheimer Paul E
Published: November 2019

In this paper, we present a formalism for handling polysemy in spatial expressions based on supervaluation semantics called standpoint semantics for polysemy (SSP). The goal of this formalism is, given a prepositional phrase, to define its possible spatial interpretations. For this, we propose to characterize spatial prepositions by means of a triplet $\langle $image schema, semantic feature, spatial axis$\rangle $. The core of SSP is predicate grounding theories, which are formulas of a first-order language that define a spatial preposition through the semantic features of its trajector and landmark. Precisifications are also established, which are a set of formulae of a qualitative spatial reasoning formalism that aims to provide the spatial characterization of the trajector with respect to the landmark. In addition to the theoretical model, we also present results of a computational implementation of SSP for the preposition ‘in’.
Identical or fraternal twins? The chemical homogeneity of wide binaries from Gaia DR2
Authors: Hawkins Keith , Lucey Madeline , Ting Yuan-Sen , Ji Alexander , Katzberg Dustin , Thompson Megan , El-Badry Kareem , Teske Johanna , Nelson Tyler , Carrillo Andreia
Published: November 2019

One of the high-level goals of Galactic archaeology is chemical tagging of stars across the Milky Way to piece together its assembly history. For this to work, stars born together must be uniquely chemically homogeneous. Wide binary systems are an important laboratory to test this underlying assumption. Here, we present the detailed chemical abundance patterns of 50 stars across 25 wide binary systems comprised of main-sequence stars of similar spectral type identified in Gaia DR2 with the aim of quantifying their level of chemical homogeneity. Using high-resolution spectra obtained with McDonald Observatory, we derive stellar atmospheric parameters and precise detailed chemical abundances for light/odd-Z (Li, C, Na, Al, Sc, V, Cu), α (Mg, Si, Ca), Fe-peak (Ti, Cr, Mn, Fe, Co, Ni, Zn), and neutron capture (Sr, Y, Zr, Ba, La, Nd, Eu) elements. Results indicate that 80 per cent (20 pairs) of the systems are homogeneous in [Fe/H] at levels below 0.02 dex. These systems are also chemically homogeneous in all elemental abundances studied, with offsets and dispersions consistent with measurement uncertainties. We also find that wide binary systems are far more chemically homogeneous than random pairings of field stars of similar spectral type. These results indicate that wide binary systems tend to be chemically homogeneous but in some cases they can differ in their detailed elemental abundances at a level of [X/H] ∼ 0.10 dex, overall implying chemical tagging in broad strokes can work.
Enstatite (MgSiO3) and forsterite (Mg2SiO4) monomers and dimers: highly detectable infrared and radioastronomical molecular building blocks
Authors: Valencia E Michael , Worth Charlie J , Fortenberry Ryan C
Published: November 2019

Isolated MgSiO3 and Mg2SiO4 molecules are shown here to exhibit bright infrared (IR) features that fall close to unattributed astronomical lines observed toward objects known to possess crystalline enstatite and forsterite, minerals of the same respective empirical formulae. These molecules are therefore tantalizing candidates for explaining the origin of such features. Furthermore, the C2v monomer minima of each formula set have dipole moments on the order of 10.0 D or larger making them desirable candidates for radioastronomical observation as enabled through rotational spectroscopic data further provided in this high-level CCSD(T)-F12/cc-pVTZ-F12 quantum chemical study. Astrophysical detection of these molecules could inform the build-up pathways for creating nanocrystals from small molecules in protoplanetary discs or could show the opposite in explaining the destruction of enstatite and forsterite minerals in supernovae events or other high-energy stellar processes. This work also shows that the lowest energy isomers for molecules containing the geologically necessary elements Mg and Si have oxygen bonded between any of the other heavier elements making oxygen the glue for pre-mineralogic chemistry.
Know thy star, know thy planet: chemo-kinematically characterizing TESS targets
Authors: Carrillo Andreia , Hawkins Keith , Bowler Brendan P , Cochran William , Vanderburg Andrew
Published: November 2019

The Transiting Exoplanet Survey Satellite (TESS) has already begun to discover what will ultimately be thousands of exoplanets around nearby cool bright stars. These potential host stars must be well understood to accurately characterize exoplanets at the individual and population levels. We present a catalogue of the chemo-kinematic properties of 2218 434 stars in the TESS Candidate Target List using survey data from Gaia DR2, APOGEE, GALAH, RAVE, LAMOST, and photometrically derived stellar properties from SkyMapper. We compute kinematic thin disc, thick disc, and halo membership probabilities for these stars and find that though the majority of TESS targets are in the thin disc, 4 per cent of them reside in the thick disc and <1 per cent of them are in the halo. The TESS Objects of Interest in our sample also display similar contributions from the thin disc, thick disc, and halo with a majority of them being in the thin disc. We also explore metallicity and [α/Fe] distributions for each Galactic component and show that each cross-matched survey exhibits metallicity and [α/Fe] distribution functions that peak from higher to lower metallicity and lower to higher [α/Fe] from the thin disc to the halo. This catalogue will be useful to explore planet occurrence rates, among other things, with respect to kinematics, component membership, metallicity, or [α/Fe].