bluuebunny/crossref_metadata_2025 huggingface dataset:
The development of the new assistant practitioner role in the English National Health Service: a critical realist perspective
Authors: Kessler Ian , Spilsbury Karen
Published: August 2019

Adopting a critical realist perspective, this article examines the emergence of a relatively new non‐professional healthcare role, the assistant practitioner (AP). The role is presented as a malleable construct cascading through and sensitive to structure–agency interaction at different levels of NHS England: the sector, organisation and department. At the core of the analysis is the permissiveness of structures established at the respective levels of the NHS, facilitating or restricting agency as the role progresses through the healthcare system. A permissive regulatory framework at the sector level is reflected in the different choices made by two case study NHS acute hospital trusts, in their engagement with the AP role. These different choices have consequences for how the AP impacts at the departmental level.
Pharmaceutical Drugs of Uncertain Value, Lifecycle Regulation at the US Food and Drug Administration, and Institutional Incumbency
Authors: HERDER MATTHEW
Published: August 2019

Policy Points

The US Food and Drug Administration (FDA) has in recent years allowed onto the market several drugs with limited evidence of safety and effectiveness, provided that manufacturers agree to carry out additional studies while the drugs are in clinical use.

Studies suggest that these postmarketing requirements (PMRs) frequently lack transparency, are subject to delays, and fail to answer the questions of greatest clinical importance. Yet, none of the literature speaks directly to the challenges that the FDA—as a regulatory institution—encounters in enforcing PMRs.

Through a series of interviews with FDA leadership, this article analyzes and situates those challenges in the midst of political threats to the FDA's public health mandate.

Context

Modern pharmaceutical regulation is premised on a rigorous examination of a drug's safety and effectiveness prior to its lawful sale. However, since the 1990s, the US Food and Drug Administration (FDA) has gradually shifted to a model of “lifecycle” regulation that increasingly relies on postmarketing requirements (PMRs) to encourage studies of drug safety and effectiveness following regulatory approval. This article examines the range of legal, institutional, and political challenges that FDA faces in the context of lifecycle regulation.

Methods

Document‐based legal and policy analysis was combined with a set of semistructured interviews of current and former FDA officials (n = 23) in order to explore the implications of the FDA's use of PMRs. The median interview time per official was 61 minutes, with a range of 24 to 227 minutes. All of the officials interviewed occupied positions of leadership and influence within the FDA, such as directors of an FDA center or office, key legal counsel on agency‐wide policy initiatives, and the commissioner of the FDA.

Findings

Insufficient resources and coordination within the FDA, inadequate legal authorities, and the political economy of withdrawing an approved indication in the face of opposition from companies and patients all contribute to the observed shortcomings in the FDA's use and enforcement of PMRs. Further, the FDA is fully aware of these challenges, yet is seemingly resigned to and resistant to criticism of its use of PMRs.

Conclusions

This study of the FDA's shift toward lifecycle regulation reveals not simply an agency in transition, but rather an agency on guard against a set of larger political threats to its mandate. This can be characterized as a state of institutional incumbency in which the agency is engaged in an effort to reproduce key features of the regulatory system—in concert with regulated industries and others—while simultaneously sanctioning significant changes to the regulatory standards the FDA has long applied, to the detriment of public health.
The business of anthropology and the European refugee regime
Authors: CABOT HEATH
Published: August 2019

Metaphors of flooding and “flows” are often applied in the public sphere to the phenomena of displacement and migration, but there are also “waves” and “tides” of humanitarian actors, “voluntourists,” and researchers now focused on refugees. Humanitarian, security, and anthropological interventions in the European “refugee crisis” of 2015–16 often operate according to a shared logic of urgency and crisis. Key problems and pitfalls in current anthropological trends in the study of displacement on Europe's doorstep are linked to the business dimensions of anthropological work. The business of anthropology reinforces the European refugee regime, which makes border crossers into targets of policing, intervention, and study. [crisis,refugees,displacement,anthropology,Greece,Europe]
Generation of microbubbles in extracorporeal life support and assessment of new elimination strategies
Authors: Born Frank , König Fabian , Chen Jinchi , Günther Sabina , Hagl Christian , Thierfelder Nikolaus
Published: August 2019

Occurrence of microbubbles (MB) is a major problem during venoarterial extracorporeal life support (ECLS) with partially severe clinical complications. The aim of this study was to establish an in vitro ECLS setup for the generation and detection of MB. Furthermore, we assessed different MB elimination strategies. Patient and ECLS circuit were simulated using reservoirs, a centrifugal pump, a membrane oxygenator, and an occluder (modified roller pump). The system was primed with a glycerin solution of 44%. Three different revolution speeds (2500, 3000, and 3400 rpm) were applied. For MB generation, the inflow line of the pump was either statically or dynamically (15 rpm) occluded. A bubble counter was used for MB detection. The effectiveness of the oxygenator and dynamic bubble traps (DBTs) was evaluated in regard to MB elimination capacities. MB generation was highly dependent on negative pressure at the inflow line. Increasing revolution speeds and restriction of the inflow led to increased MB activity. The significant difference between inflow and outflow MB volume identified the centrifugal pump as a main source. We could show that the oxygenator’s ability to withhold larger MB is limited. The application of one or multiple DBTs leads to a significant reduction in MB count and overall gas volume. The application of DBT can significantly reduce the overall gas volume, especially at high flow rates. Moreover, large MB can effectively be broken down for faster absorption. In general, the incidence of MBs is significantly dependent on pump speed and restriction of the inflow. The centrifugal pump was identified as a major source of MB generation.
Looking back on development and disaster‐related displacement and resettlement, anticipating climate‐related displacement in the Asia Pacific region
Authors: Price Susanna
Published: August 2019

The realisation that climate change might necessitate resettlement of people displaced initially raised interest in the experience of development‐forced displacement and resettlement (DFDR). Looking back, in 1980 the first international policy on involuntary resettlement was approved to address perceived weaknesses in state property and expropriation law to safeguard people in the way of development projects. Since then international policy and praxis have brought global attention to developmentally displaced people but have not guaranteed them an effective safeguard. Recently, renewed attention has focussed on state legal and governance frameworks substantively and procedurally. Identifying four key policy objectives that resonate with climate change displacement I analyse their treatment in a data base of DFDR laws and regulations from 40 Asia Pacific states. This analysis finds overall little legal congruence. Innovative new formulations in some Asian state laws address recent public criticisms and research findings, but mostly are yet to demonstrate positive outcomes for displaced people. Pacific states increasingly abandon expropriation law to negotiate lease terms for public infrastructure projects with customary landowners that do not extinguish customary title. Any laws governing climate change relocations must protect rights, livelihoods, well‐being, inclusive decision‐making and community initiatives with procedures whilst not relinquishing climate‐change‐reducing action.
Metagenomic profiles of the rumen microbiota during the transition period in low‐yield and high‐yield dairy cows
Authors: Sofyan Ahmad , Uyeno Yutaka , Shinkai Takumi , Hirako Makoto , Kushibiki Shiro , Kanamori Hiroyuki , Mori Satomi , Katayose Yuichi , Mitsumori Makoto
Published: August 2019

We investigated potential relationships between rumen microbiota and milk production in dairy cows during the transition period. Twelve dairy cows were divided into a low‐yield (LY) or high‐yield (HY) group based on their milk yield. Rumen samples were taken from dairy cows at 3 weeks before parturition, and at 4, 8, and 12 weeks after parturition. 16S rDNA‐based metagenomic analysis showed that diversities of rumen microbiota in both groups were similar and the number of operational taxonomic units (OTUs) was lower in the postpartum than prepartum period in both groups. The abundance of Bacteroidetes and ratio of Bacteroidetes:Firmicutes was higher in the HY than the LY group. OTUs assigned to Prevotella bryantii, Fibrobacter succinogenes, Ruminococcus albus, Butyrivibrio fibrisolvens, and Succinivibrio sp. were abundant in the HY group. These OTUs were significantly related to the propionate molar proportion of rumen fluids in the HY group. OTUs assigned to Lachnospiraceae, Bifidobacterium sp. and Saccharofermentans were dominant in the LY group. Predictive functional profiling revealed that abundance of gene families involved in amino acid and vitamin metabolism was higher in the HY than the LY group. These results suggest that the community structure and fermentation products of rumen microbiota could be associated with milk production of dairy cows.
Multinodular goitre is a gateway for molecular testing of DICER1 syndrome
Authors: Oliver‐Petit Isabelle , Bertozzi Anne‐Isabelle , Grunenwald Solange , Gambart Marion , Pigeon‐Kerchiche Patricia , Sadoul Jean‐Louis , Caron Philippe J. , Savagner Frédérique
Published: August 2019

Background

DICER1 syndrome is an autosomal dominant disorder that predisposes individuals to develop benign or malignant tumours from infancy to adulthood. There is low‐to‐moderate penetrance of tumour development, which is sex‐ and age‐dependent. Multinodular goitre (MNG) is among the most highly penetrant phenotype of the disorder, especially in females.

Patients and Methods

We report a series of eight families referred for childhood‐onset of MNG or DICER1‐related tumours with familial history of MNG in relatives. No additional families with these criteria stated were identified during the same date. We screened DNA samples from the probands and members of their family (40) for constitutional DICER1 variants using Next Generation Sequencing tools.

Results

Germline pathogenic DICER1 gene variants were identified in all probands and several of their relatives: 64% presented with MNG/thyroidectomy as the phenotypic expression of the syndrome. DICER1 gene variants were identified in the RNAseIII and the PAZ domains. All tumour tissues studied presented clonal pathogenic variants in hotspot regions. Early identification of DICER1 variant carriers has permitted diagnosis and therapeutic scheme correction for two patients and cascade testing in relatives.

Conclusions

Multinodular goitre is uncommon in children. Childhood‐onset MNG, multiple occurrences of the disease within the same family, or its association with rare benign or malignant tumours should raise suspicions of anomalies in the DICER1 gene, as proposed by recent international recommendations. Early detection of DICER1 pathogenic variants has important consequences in terms of therapeutic strategy, early tumour screening, and genetic counselling.
Effects of Bakuchiol on chondrocyte proliferation via the PI3K‐Akt and ERK1/2 pathways mediated by the estrogen receptor for promotion of the regeneration of knee articular cartilage defects
Authors: Xu Kang , Sha Yongqiang , Wang Sixiang , Chi Qingjia , Liu Yanju , Wang Chunli , Yang Li
Published: August 2019

Objectives

Cartilaginous tissue degradation occurs because of the lack of survival of chondrocytes. Here, we ascertained whether bakuchiol (BAK) has the capability of activating chondrocyte proliferation.

Materials and methods

The effect of BAK on the proliferation of rat chondrocytes at a concentration of 10 and 20 µmol/L was investigated. The molecular mechanisms involving target binding and signalling pathways were elucidated by RNA‐sequencing, qPCR, molecular docking and Western blotting. Matrigel mixed with bakuchiol was implanted locally into rat knee articular cartilage defects to verify the activation of chondrocytes due to bakuchiol in vivo.

Results

Bakuchiol implantation resulted in the activation of rat chondrocyte proliferation in a dose‐dependent manner. RNA‐sequencing revealed 107 differentially expressed genes (DEGs) with 75 that were up‐regulated and 32 that were down‐regulated, indicating increased activation of the PI3K‐Akt and cell cycle pathways. Activation of the phosphorylation of Akt, ERK1/2 and their inhibitors blocked the proliferative effect of bakuchiol treatment, confirming its direct involvement in these signal transduction pathways. Molecular docking and siRNA silencing revealed that estrogen receptor‐α (ERα) was the target of bakuchiol in terms of its cell proliferative effect via PI3K activation. Two weeks after implantation of bakuchiol, the appearance and physiological structure of the articular cartilage was more integrated with abundant chondrocytes and cartilage matrix compared to that of the control.

Conclusions

Bakuchiol demonstrated significant bioactivity towards chondrocyte proliferation via the PI3K‐Akt and ERK1/2 pathways mediated by estrogen receptor activation and exhibited enhanced promotion of the remodelling of injured cartilage.
Positive evidence for neonatal imitation: A general response, adaptive engagement
Authors: Nagy Emese , Pilling Karen , Blake Victoria , Orvos Hajnalka
Published: August 2019

The study employed four gestural models using frame‐by‐frame microanalytic methods, and followed how the behaviours unfolded over time. Forty‐two human newborns (0–3 days) were examined for their imitation of tongue protrusion, ‘head tilt with looking up’, three‐finger and two‐finger gestures. The results showed that all three gesture groups were imitated. Results of the temporal analyses revealed an early and a later, second stage of responses. Later responses were characterized by a suppression of similar, but non‐matching movements. Perinatal imitation is not a phenomenon served by a single underlying mechanism; it has at least two different stages. An early phase is followed by voluntary matching behaviour by the neonatal infant.
A sinister subject: Quantifying handedness‐based recruitment biases in current neuroimaging research
Authors: Bailey Lyam M. , McMillan Laura E. , Newman Aaron J.
Published: August 2019

Approximately ten per cent of humans are left‐handed or ambidextrous (adextral). It has been suggested that, despite their sizable representation at the whole‐population level, this demographic is largely avoided by researchers within the neuroimaging community. To date, however, no formal effort has been made to quantify the extent to which adextrals are excluded from neuroimaging‐based research. Here, we aimed to address this question in a review of over 1,000 recent articles published in high‐impact, peer‐reviewed, neuroimaging‐focused journals. Specifically, we sought to ascertain whether, and the extent to which adextrals are underrepresented in neuroimaging study samples, and to delineate potential trends in this bias. Handedness data were available for over 30,000 research subjects; only around 3%–4% of these individuals were adextral—considerably less than the 10% benchmark one would expect if neuroimaging samples were truly representative of the general population. This observation was generally consistent across different areas of research, but was modulated by the demographic characteristics of neuroimaging participants. The epistemological and ethical implications of these findings are discussed.
Shift in lateralization during illusory self‐motion: EEG responses to visual flicker at 10 Hz and frequency‐specific modulation by tACS
Authors: Dowsett James , Herrmann Christoph S. , Dieterich Marianne , Taylor Paul C.J.
Published: August 2019

Self‐motion perception is a key aspect of higher vestibular processing, suggested to rely upon hemispheric lateralization and alpha‐band oscillations. The first aim of this study was to test for any lateralization in the EEG alpha band during the illusory sense of self‐movement (vection) induced by large optic flow stimuli. Visual stimuli flickered at alpha frequency (approx. 10 Hz) in order to produce steady state visually evoked potentials (SSVEPs), a robust EEG measure which allows probing the frequency‐specific response of the cortex. The first main result was that differential lateralization of the alpha SSVEP response was found during vection compared with a matched random motion control condition, supporting the idea of lateralization of visual–vestibular function. Additionally, this effect was frequency‐specific, not evident with lower frequency SSVEPs. The second aim of this study was to test for a causal role of the right hemisphere in producing this lateralization effect and to explore the possibility of selectively modulating the SSVEP response. Transcranial alternating current stimulation (tACS) was applied over the right hemisphere simultaneously with SSVEP recording, using a novel artefact removal strategy for combined tACS‐EEG. The second main result was that tACS enhanced SSVEP amplitudes, and the effect of tACS was not confined to the right hemisphere. Subsequent control experiments showed the effect of tACS requires the flicker frequency and tACS frequency to be closely matched and tACS to be of sufficient intensity. Combined tACS‐SSVEPs are a promising method for future investigation into the role of neural oscillations and for optimizing tACS.
Plasma levels of protein C pathway proteins and brain magnetic resonance imaging volumes in multiple sclerosis
Authors: Ziliotto N. , Zivadinov R. , Baroni M. , Marchetti G. , Jakimovski D. , Bergsland N. , Ramasamy D. P. , Weinstock‐Guttman B. , Straudi S. , Manfredini F. , Ramanathan M. , Bernardi F.
Published: August 2019

Background and purpose

The involvement of protein C (PC) pathway components in multiple sclerosis (MS) has scarcely been explored. The aim was to investigate their levels in relation to clinical and neurodegenerative magnetic resonance imaging (MRI) outcomes in patients.

Methods

In all, 138 MS patients and 42 healthy individuals were studied. PC, protein S (PS) and soluble endothelial protein C receptor (sEPCR) were evaluated by multiplex assays and enzyme‐linked immunosorbent assay. Regression analyses between 3 T MRI outcomes and PC pathway components were performed. ancova was used to compare MRI volumes based on protein level quartiles. Partial correlation was assessed amongst levels of PC pathway components and hemostasis protein levels, including soluble thrombomodulin (sTM), heparin cofactor II (HCII), plasminogen activator inhibitor 1 (PAI‐1) and factor XII (FXII). The variation of PC concentration across four time points was evaluated in 32 additional MS patients.

Results

There was an association between PC concentration, mainly reflecting the zymogen PC, and MRI measures for volumes of total gray matter (GM) (P = 0.003), thalamus (P = 0.007), cortex (P = 0.008), deep GM (P = 0.009) and whole brain (P = 0.026). Patients in the highest PC level quartile were characterized by the lowest GM volumes. Correlations of PC–HCII, PC–FXII and sEPCR–sTM values were detectable in MS patients, whilst PC–PS and PS–PAI‐1 correlations were present in healthy individuals only.

Conclusions

Protein C plasma concentrations might be associated with neurodegenerative MRI outcomes in MS. Several differences in correlation amongst protein plasma levels suggest dysregulation of PC pathway components in MS patients. The stability of PC concentration over time supports a PC investigation in relation to GM atrophy in MS.
Worldwide distribution and theoretical spreading of Trichoferus campestris (Coleoptera: Cerambycidae) depending on the main climatic elements
Authors: Keszthelyi Sándor , Fehér Balázs , Somfalvi‐Tóth Katalin
Published: August 2019

The velvet longhorned beetle, Trichoferus campestris (Coleoptera: Cerambycidae) is a serious wood‐boring pest that is a major threat to the phytosanitary condition of forests and orchards. Its worldwide expansion is a major concern for plant health. We have collected all bibliographical references, phytosanitary reports and authentic photographic evidence from entomological websites to determine the worldwide distribution of T. campestris. The theoretical directions of the spreading and actually occupied area of this arthropod pest were determined over the whole Holarctic range. Furthermore, the potential distribution area was calculated using cumulated temperature in the growing season averaged over 15 years both in the Palearctic and Nearctic regions. Holarctic expansion of the species, including the main parts of North America and Eurasia, is clearly indicated. Its populations occur in 29 countries to date, supported by documentation from 64 publications and 30 online forums. Its spread is continuously westward in the Palearctic; in the Nearctic, the spread was first southward from the Great Lakes region then eastward from Utah. The species has excellently adapted to circumstances of freight by ship and plane, as wood is often used, ensuring optimal conditions for the pest. In addition, the active spreading achieved by flying is an important factor contributing to its expansion. The primary criterion for controlling the species would be the introduction of a monitoring system in affected and exposed areas.
Effects of habitat complexity, dominance and personality on habitat selection: Ideal despotic cichlids
Authors: Church Kathleen D. W. , Grant James W. A.
Published: August 2019

Habitat structure can impede visibility and movement, resulting in lower resource monopolization and aggression. Consequently, dominant individuals may prefer open habitats to maximize resource gain, or complex habitats to minimize predation risk. We explored the role of dominance on foraging, aggression and habitat choice using convict cichlids (Amatitlania nigrofasciata) in a two‐patch ideal free distribution experiment. Groups of six fish of four distinct sizes first competed for shrimp in one‐patch trials in both an open and complex habitat; half the groups experienced each habitat type first. Following these one‐patch trials, each group then chose between habitat types in a two‐patch trial while competing for food. Finally, each fish underwent an individual behavioural assessment using a battery of “personality” tests to determine if behaviour when alone accurately reflected behaviour within a social context. In the one‐patch trials, dominant fish showed similar food consumption between habitats, but chased more in the complex habitat. In the two‐patch choice trials, dominants preferred and defended the complex habitat, forming an ideal despotic distribution with more than half the fish and competitive weight in the open habitat. Within the groups, individual fish differed in foraging and chasing, with repeatabilities of 0.45 and 0.23 across all treatments. Although a higher foraging rate during the individual assessment predicted foraging rate and use of the complex habitat during the group trials, aggression and boldness tests were not reflective of group behaviour. Across groups, heavier dominants and those with higher foraging rate in the open habitat used the open habitat more, suggesting that both risk and energetic state affect habitat preference in dominant convict cichlids.
Individual and Dyadic Coping and Fear of Progression in Mothers and Fathers of Children with Hematologic Cancer
Authors: Clever Katharina , Schepper Florian , Maier Stephan , Christiansen Holger , Martini Julia
Published: August 2019

This study investigated the association of individual and dyadic coping strategies with fear of progression (FoP) in mothers and fathers of children with hematologic cancer. Parental couples (N = 44) whose children had been diagnosed with hematologic cancer were recruited at a university hospital and a rehabilitation clinic in Germany between 03/2017 and 08/2017. Data included parents' self‐report on FoP (Fear of Progression Questionnaire—parent version, FoP‐Q‐SF/PR), individual coping (Coping Health Inventory for Parents, CHIP‐D), and dyadic coping (Dyadic Coping Inventory, DCI). Statistical analyses were carried out for mothers and fathers individually as well as for parental couples using dyadic data analyses (e.g., actor‐partner interdependence model, APIM). Individual and dyadic coping strategies were significantly correlated with FoP in mothers, but not in fathers. Fathers' evaluation of the couple's dyadic coping significantly predicted mothers' FoP. The more frequent use of familial integration (CHIP‐D FAM) and maintaining social support (CHIP‐D SUP) as well as a better evaluation of their partners' dyadic coping was significantly associated with lower FoP in mothers. Differences in individual and dyadic coping in parental couples were not associated with FoP. Individual and dyadic coping strategies should be addressed in the psychosocial care of mothers and fathers of children with hematologic cancer. Study results support the benefits of involving fathers in psychosocial interventions, for example, in couple‐based interventions that acknowledge interpersonal effects of coping on FoP. Future research should further explore coping strategies applied by fathers of children with hematologic cancer for the regulation of FoP.
Effects of altered river network connectivity on the distribution of Salmo trutta: Insights from a metapopulation model
Authors: González‐Ferreras Alexia M. , Bertuzzo Enrico , Barquín José , Carraro Luca , Alonso Carlos , Rinaldo Andrea
Published: August 2019

Network connectivity is a key feature of rivers that affects patterns and processes in lotic ecosystems. Few studies have considered how changes in river reach connectivity might affect ecosystem attributes at a whole river network scale. The use of population dynamics models of keystone species at a river network scale allows exploration of how the effects of altered natural connectivity patterns might propagate through a river network.

In this study, we present a metapopulation model to estimate the spatial distribution of the population density of brown trout (Salmo trutta), an ecologically and socioeconomically important top predator, in a river network in northern Spain. The model accounts for the presence of barriers that limit longitudinal connectivity in upstream and downstream directions. The model estimates the spatial distribution of densities of three age‐classes (young‐of‐the‐year, juveniles, and adults) in all river reaches that make up the network based on topology, connectivity and population dynamics (e.g. age‐class specific mortality, spawning, age‐class dispersal, and spawning migration patterns).

Seventy‐five percent of the modelled population densities fell within the 95% confidence intervals of the empirical data (84.6% for young‐of‐the‐year, 69.2% for juveniles, and 69.2% for adults) collected in 13 reaches. The simulated removal of all longitudinal barriers to migration in the river network (re‐naturalisation of the whole catchment) produced a modelled increase in brown trout density in the most downstream reaches of the river network and lowered fish densities in the upstream portion of the network when bias in juvenile and adult movement direction was assumed. Furthermore, the simulated removal of a single obstacle affected fish density even in distant tributaries.

The proposed model is an appropriate tool for the evaluation of spatial patterns of brown trout density at a river network scale and for the assessment of the impact of altered connectivity. This might help simulate the results of management strategies regarding river connectivity and show where population decreases or increases could be expected, although empirical knowledge of overall trout movement in the studied river networks is required for drawing realistic scenarios.
CO2 fertilization does not affect biomass production and nutritive value of a C4 tropical grass in short timeframe
Authors: Abdalla Filho Adibe Luiz , Lima Paulo de Mello Tavares , Sakita Gabriel Zanuto , Silva Tairon Pannunzio Dias e , da Costa Wilian dos Santos , Ghini Raquel , Abdalla Adibe Luiz , Piccolo Marisa de Cássia
Published: August 2019

Increased atmospheric carbon dioxide (CO2) is a consequence of recent anthropogenic environmental changes, and few studies have evaluated its effects on tropical grasses used in Brazilian pastures, the main feed source for major part of ruminant livestock. This study evaluated forage production, chemical composition, in vitro total gas production and organic matter degradability of Brachiaria brizantha under contrasting CO2 atmospheric conditions in a free air carbon dioxide enrichment (FACE) facility. The forage plants were sown in each of the 12 octagonal rings of the FACE facility: six under ambient atmospheric CO2 concentration of approximately 390 μmol/mol, hereafter referred to as control (CON) plots, and other six rings enriched with pure CO2 flux to achieve a target CO2 concentration of 550 μmol/mol, hereafter called elevated CO2 (eCO2) plots. Soil samples were collected to determine carbon and nitrogen concentrations. After seventy days of sowing, a standardization cutting was performed and then at regular intervals of 21 days the forage was harvested (ten harvest dates) and forwarded to laboratorial analyses. Forage above‐ground biomass production (dry matter (DM): 6,143 vs. 6,554 kg/ha), as well as morphological characteristics (leaves: 71% vs. 68%; stem: 28% vs. 31%), chemical composition (crude protein: 162.9 vs. 161.8; neutral detergent fibre: 663.8 vs. 664.3; acid detergent fibre: 369.5 vs. 381; lignin: 60.1 vs. 64.1 g/kg DM; total C: 45.9 vs. 45.9; total N: 2.8 vs. 2.8; total S: 0.2% vs. 0.2%), organic matter in vitro degradability (573.5 vs. 585.3 g/kg), methane (5.7 vs. 4.3 ml/g DM) and total gas (128.3 vs. 94.5 ml/g DM) production did not differ significantly between CON and eCO2 treatments (p > .05). The results indicated that at least under short‐term enrichment, B. brizantha was not affected by eCO2.
Vertical Screening Distance Criteria to Evaluate Vapor Intrusion Risk from 1,2‐Dichloroethane (1,2‐DCA)
Authors: Kolhatkar Ravi V. , Lahvis Matthew A. , Hers Ian , Wilson John T. , Luo Emma (Hong) , Jourabchi Parisa
Published: August 2019

Vapor intrusion (VI) involves migration of volatile contaminants from subsurface through unsaturated soil into overlying buildings. In 2015, the US EPA recommended an approach for screening VI risks associated with gasoline releases from underground storage tank (UST) sites. Additional assessment of the VI risk from petroleum hydrocarbons was deemed unnecessary for buildings separated from vapor sources by more than recommended vertical screening distances. However, these vertical screening distances did not apply to potential VI risks associated with releases of former leaded gasoline containing 1,2‐dichloroethane (1,2‐DCA), because of a lack of empirical data on the attenuation of 1,2‐DCA in soil gas. This study empirically evaluated 144 paired measurements of 1,2‐DCA concentrations in soil gas and groundwater collected at 47 petroleum UST sites combined with BioVapor modeling. This included (1) assessing the frequency of 1,2‐DCA detections in soil gas below 10−6 risk‐based screening levels at different vertical separation distances and (2) comparing the US EPA recommended vertical screening distances with those predicted by BioVapor modeling. Vertical screening distances were predicted for different soil types using aerobic biodegradation rate constants estimated from the measured soil‐gas data combined with conservative estimates of source concentrations. The modeling indicates that the vertical screening distance of 6 feet (1.8 m) recommended for dissolved‐phase sources is applicable for 1,2‐DCA below certain threshold concentrations in groundwater, while 15 feet (4.6 m) recommended for light nonaqueous phase liquid (LNAPL) sources is applicable for sites with clay and loam soils in the vadose zone, but not sand, if 1,2‐DCA concentrations in groundwater exceed 150 μg/L. This dependence of the predicted vertical screening distances on soil type places added emphasis on proper soil characterization for VI screening at sites with 1,2‐DCA sources. The soil‐gas data suggests that a vertical screening distance of 15 feet (4.6 m) is necessary for both dissolved‐phase and LNAPL sources.
Sodium pyruvate pre‐treatment prevents cell death due to localised, damaging mechanical strains in the context of pressure ulcers
Authors: Alvarez‐Elizondo Martha B. , Barenholz‐Cohen Tamar , Weihs Daphne
Published: August 2019

We demonstrate sodium pyruvate (NaPy) pre‐treatment as a successful approach for pressure ulcer (PU) prevention by averting their aetiological origin—cell‐level damage and death by large, sustained mechanical loads. We evaluated the NaPy pre‐treatment effect on permeability changes in the cell's plasma membrane (PM) following application of in vitro damaging‐level strains. Fibroblasts or myoblasts, respectively, models for superficial or deep‐tissue damage were grown in 0 or 1 mM NaPy, emulating typical physiological or cell culture conditions. Cells were pre‐treated for 4 hours with 0 to 5 mM NaPy prior to 3‐hour sustained, damaging‐level loads (12% strain). PM permeability was quantified by the cell uptake of small (4 kDa), fluorescent dextran compared with unstrained control using fluorescence‐activated cell sorting (FACS). Pre‐treatment with 1 mM, and especially 5 mM, NaPy significantly reduces damage to PM integrity. Long‐term NaPy pre‐exposure can improve protective treatment, affecting fibroblasts and myoblasts differently. Pre‐treating with NaPy, a natural cell metabolite, allows cells under damaging‐level mechanical loads to maintain their PM integrity, that is, to avoid loss of homeostasis and inevitable, eventual cell death, by preventing initial, microscale stages of PU formation. This pre‐treatment may be applied prior to planned periods of immobility, for example, planned surgery or transport, to prolong safe time in a position by preventing initial cell damage that can cascade and lead to PU formation.
Warm white light emitting from single composition SrGa12O19:Dy3+ phosphors for AC‐LED
Authors: Lai Junan , Long Zhangwen , Qiu Jianbei , Zhou Dacheng , Zhou Junhe , Zhu Congcong , Hu Songhan , Zhang Ke , Wang Qi
Published: August 2019

Making illumination light sources become comfortable to the human eye is a long‐term effort, which justifies the current research on warm white‐light‐emitting diodes (w‐LEDs). In this work, a novel phosphor for w‐LEDs, namely SrGa12O19: Dy3+(SGO: Dy3+), with a low‐color temperature (CT) was designed and synthesized. The crystal structure, the luminescence properties, the thermoluminescence properties and the stability of SGO: Dy3+ were investigated. We demonstrate outstanding luminescent characteristics and excellent stabilities. The intensity of emission light keep remained when excited by a flickering light source with a chopping speed or off‐time of a few seconds, which indicates that the SGO: Dy3+ phosphor has anti‐flicker properties that will be useful for potential applications, as LEDs driven by alternating current (AC‐LED). The chromaticity coordinates and the correlated color temperature (CCT) of SGO: Dy3+ phosphors with different Dy3+ concentrations are close with an optimal doping at 4.00 mol% Dy3+ for chromaticity coordinate (0.4269, 0.4348) and a lowest CCT of 3361 K. The perfect weatherability of this phosphor was also confirmed since the phosphorescence intensity and the color were stable at high temperature and in a high humidity environment. The performance obtained shows that SGO: Dy3+ is a suitable candidate for illumination sources that are beneficial to human health.
Editorial: Common factors in the art of healing
Authors: Peterson Bradley S.
Published: August 2019

Meta‐analyses have consistently shown a wide variety of psychotherapeutic and pharmacological interventions to yield similar effect sizes, suggesting the possibility that those interventions share common factors that account for the vast majority of variance in clinical outcomes. Although mediation analyses are needed to know definitively whether factors common or specific to the interventions are responsible for clinical improvement, a large number of association studies suggest that a common set of characteristics representing the ways in which clinicians relate to their patients, and not the technical expertise of clinicians or the therapeutic modality in which they work, account for the majority of therapeutic change across all medical disciplines and cultures. These characteristics include clinician empathy, warmth, and genuineness, a capacity to maintain a positive regard for the patient in moments of vulnerability, and an ability to establish a strong therapeutic alliance and clinical narrative through which the patient understands their suffering and is challenged to change through health‐promoting activities. These common factors are amenable to study to improve our knowledge of precisely how they produce clinical change. They can be taught across all medical disciplines, in order to deepen the shared understanding, interpersonal attunement, and alliance between clinicians and their patients, which together constitute the true science and art of healing.
Optimization of osmosonication pretreatment of ginger (Zingiber officinaleRoscoe) using response surface methodology: Effect on antioxidant activity, enzyme inactivation, phenolic compounds, and physical properties
Authors: Osae Richard , Zhou Cunshan , Tchabo William , Xu Baoguo , Bonah Ernest , Alenyorege Evans A. , Ma Haile
Published: August 2019

The study assessed the effect of sonication frequency (UF) 33–68 kHz, sucrose concentration (SC) 20–60% wt/vol, and pretreatment time (PT) 10–30 min for maximizing 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH), cupric ion reducing capacity (CUPRAC), ferric reducing antioxidant power capacity (FRAP), total phenolic content (TPC), weight reduction (WR), water loss (WL), rehydration ratio (RR) and minimizing polyphenol oxidase (PPO), and solid gain (SG) of ginger by using response surface methodology (RSM). The results revealed that osmosonication pretreatment had a significant impact on DPPH, FRAP, CUPRAC, TPC, WL, WR, RR, SG, and PPO. The optimal operating conditions to attain the best DPPH, CUPRAC, FRAP, TPC, WL, WR, RR, PPO, and SG were UF (50 kHz), SC (35% wt/vol), and PT (30 min). Based on the aforementioned conditions, the experimental outcome obtained including WL (62.97 ± 0.85%), SG (9.06 ± 0.04%), WR (53.98 ± 0.18%), RR (3.09 ± 0.02), DPPH (65.69 ± 0.23 mgTE/g dw), FRAP (50.93 ± 0.15 mgTE/g dw), CUPRAC (55.32 ± 0.11 mgTE/g dw), TPC (23.96 ± 0.35 mgGAE/g dw), and PPO (13.21 ± 0.05%) were consisted with the predicted values and the overall desirability was 0.758. The RSM plots also revealed that the independent variables significantly enhanced the physiochemical properties of osmosonicated pretreated ginger samples.

Practical applications

Concerning the increasing demand for new pretreatment techniques for dehydration of ginger, osmosonication could be presented as a unique, efficient, and innovative predehydration method for the pharmaceutical, beverage, and the food industries. It application preceding to drying of agricultural crops could reduce moisture content, increase drying rate, lessen the processing time and cost, and retain the physiochemical properties of the dried product.
Patients' experiences of coping with multiple chronic conditions: A qualitative descriptive study
Authors: Cheng Cheng , Bai Jie , Yang Cong‐Yan , Li Ming , Inder Kerry , Chan Sally Wai‐Chi
Published: August 2019

Objective

To explore the experiences of how Chinese adults cope with multiple chronic conditions in everyday life.

Background

Having multiple chronic conditions is stressful, requiring people to make physical and mental adaptations. There is little evidence exploring how people cope with multiple chronic conditions, especially in an Asian context.

Design

A qualitative descriptive design was employed. The Consolidated criteria for reporting qualitative research (COREQ) was used to report this study.

Methods

This study was conducted in a tertiary referral and teaching hospital in Bengbu, Anhui, China, between August and October 2018. A purposive sample of 14 people with multiple chronic conditions, aged between 32 and 75 years, completed a demographic questionnaire and semi‐structured face‐to‐face interviews. The interviews were digitally recorded and transcribed verbatim. Qualitative content analysis guided data analysis.

Results

Four distinctive themes comprising subthemes were developed from participants' narratives pertaining to coping with multiple chronic conditions: (a) appraising multiple chronic conditions, (b) addressing multiple chronic conditions management, (c) maintaining psychological well‐being and (d) fulfilling a social role. Illustrative quotations were cited to support each theme.

Conclusions

This study underscores that people cope with multiple chronic conditions in everyday life by using a compendium of coping strategies. As one of the influencing factors, culture dominates the ways of coping at different levels among people with multiple chronic conditions. These findings expand the current literature on coping based on an Asian perspective and inform further cross‐culture research on this topic.

Relevance to clinical practice

Healthcare professionals should understand peoples' experiences of coping with multiple chronic conditions to provide more holistic and dynamic health care to address their actual needs. Healthcare professionals should be acquainted with how culture impacts individuals' coping and develops culture‐tailored supportive programmes such as family‐based interventions, to promote the health of people with multiple chronic conditions.
OLIGOPOLY GAMES AND THE COURNOT–BERTRAND MODEL: A SURVEY
Authors: Tremblay Carol Horton , Tremblay Victor J.
Published: August 2019

Traditional oligopoly models hold that firms compete in the same strategic variable, output (Cournot) or price (Bertrand). Alternatively, a hybrid model allows some firms to compete in output and other firms to compete in price, also known as the Cournot–Bertrand model. When the choice of strategic variable is endogenous, the established dominant strategy is output competition. A growing body of work demonstrates, however, that the Cournot–Bertrand outcome can be a subgame‐perfect Nash equilibrium in the presence of market asymmetries. Observations of real‐world markets consistent with Cournot–Bertrand behavior bolster justification for the model and have stimulated an impressive and evolving literature on advances and applications. We lay out the roots of the Cournot–Bertrand model and explore a number of model developments. We categorize 12 primary models in the literature based on alternative assumptions. In particular, some authors consider when the timing of play as well as the choice of strategic variable are endogenous. Altogether, this research identifies when Cournot–Bertrand behavior can emerge in a dynamic setting and under alternative market conditions. We also review the Cournot–Bertrand model applications in the fields of international economics, industrial organization, labor, and public economics. We expect the literature to continue to expand in the future.
Predictors of dental care use, unmet dental care need, and barriers to unmet need among women: results from NHANES, 2011 to 2016
Authors: Gupta Avni , Feldman Sarah , Perkins Rebecca B. , Stokes Andrew , Sankar Vidya , Villa Alessandro
Published: August 2019

Objectives

To examine socio‐demographic and economic predictors of dental care access among women in the United States.

Methods

A total of 52,493,940 women at the US national level aged 20‐44 years were identified from the National Health and Nutrition Examination Survey, 2011 to 2016. Weighted multivariate logistic regression models were computed to identify predictors of dental care use, unmet dental‐care need, and reported reasons for unmet need.

Results

Young, Mexican‐American, other minority race‐ethnicities, less educated, and uninsured women were independently more likely to have never visited a dental clinic (P < 0.025). Mexican‐Americanwomen with a poverty income ratio (PIR) <2.00 and less than excellent health status and those uninsured were independently more likely to have unmet dental need (P < 0.025). Women with PIR <1.00 and those uninsured were independently more likely to have an unmet need because of unaffordable cost (P < 0.0008) or lack of procedure coverage by insurance (P < 0.0008). Younger women were more likely to think that the dental problem would go away (P < 0.0001).

Conclusions

While young, less educated, and women from minority race‐ethnicities were less likely to report ever use of dental care, only low income, poor health, and uninsured women were more likely to report unmet dental care need. Racial‐ethnic minority, less educated, and young women may benefit from improved education about the value of dental care. Expanding insurance coverage for dental care and improving access for women with poor health may address racial‐ethnic and education‐level disparities in unmet dental care need.
Melatonin as host modulating agent supporting nonsurgical periodontal therapy in patients affected by untreated severe periodontitis: A preliminary randomized, triple‐blind, placebo‐controlled study
Authors: Tinto Manuel , Sartori Matteo , Pizzi Ileana , Verga Alessandra , Longoni Salvatore
Published: August 2019

Objectives

The aim of the current clinical trial was to evaluate if the oral supplementation of melatonin after nonsurgical periodontal therapy (NSPT) determined a better periodontal healing than NSPT alone, in patients affected by untreated severe periodontitis.

Background

Melatonin's anti‐inflammatory, antioxidant and immunomodulatory capacities, together with its pharmacokinetic and pharmacodynamic profiles are key characteristics that justify the therapeutic use for the treatment of periodontitis.

Methods

This is a randomized, triple‐blind, placebo‐controlled study. Twenty patients were blindly randomized either to melatonin or placebo group. The melatonin group received NSPT and melatonin capsules 1 mg per day for 1 month, while the placebo, NSPT, and placebo capsules for 1 month. The patients were evaluated at baseline and 6 months after. Mean change from baseline probing depth (PD) was the primary outcome; site of probing was used as unit of analysis; FMBS (%) and FMPS (%) were also calculated. Mann‐Whitney test was used to evaluate statistical significance (α = 0.05).

Results

Melatonin was well tolerated by all patients. Both treatments were effective in reducing PD, but no statistical difference was found when comparing posttreatment PD (probing all sites), P = .62. When considering the primary outcome, melatonin administration resulted in greater mean PD change at 6 months if compared to control group: for 4‐5 mm sites 1.86 (0.81) vs 1.04 (0.69), P = .00001 and for sites >5 mm 3.33 (1.43) vs 2.11 (0.96), P = .00012. No difference was found for FMBS and FMPS.

Conclusion

Current study, within its limitations, concluded that oral administration of melatonin (1 mg per day for 30 days) after one‐stage full mouth NSPT determined a greater change from baseline PD if compared to NSPT alone, in untreated stage III periodontitis. This could provide a non‐pharmacological support to improve periodontal healing of periodontal sites after NSPT.