bluuebunny/crossref_metadata_2025 huggingface dataset:
The identification and deletion of the polyketide synthase‐nonribosomal peptide synthase gene responsible for the production of the phytotoxic triticone A/B in the wheat fungal pathogen Pyrenophora tritici‐repentis
Authors: Rawlinson Catherine , See Pao Theen , Moolhuijzen Paula , Li Hang , Moffat Caroline S. , Chooi Yit‐Heng , Oliver Richard P.
Published: November 2019

The economically important necrotrophic fungal pathogen, Pyrenophora tritici‐repentis (Ptr), causes tan spot of wheat, a disease typified by foliar necrosis and chlorosis. The culture filtrate of an Australian Ptr isolate, M4, possesses phytotoxic activity and plant bioassay guided discovery led to the purification of necrosis inducing toxins called triticone A and B. High‐resolution LC–MS/MS analysis of the culture filtrate identified an additional 37 triticone‐like compounds. The biosynthetic gene cluster responsible for triticone production (the Ttc cluster) was identified and deletion of TtcA, a hybrid polyketide synthase (PKS)‐nonribosomal peptide synthase (NRPS), abolished production of all triticones. The pathogenicity of mutant (ttcA) strains was not visibly affected in our assays. We hypothesize that triticones possess general antimicrobial activity important for competition in multi‐microbial environments.
Complete natal cleft removal with kite incision in the treatment of extensive sacrococcygeal pilonidal sinus
Authors: Ozdemir Hakan , Unal Ozdemir Zehra , Sunamak Oguzhan
Published: November 2019

Background

Pilonidal sinus (PS) is a benign disease for which different treatment modalities are used, varying from non‐surgical treatments to surgical treatments with flap use for big defects. High recurrence is the main problem in complicated cases. We presented complete natal cleft excision with kite incision and fasciocutaneous flap (CNCEF with kite incision) in extensive sacrococcygeal PS.

Methods

Seventy‐six patients who underwent CNCEF with kite incision because of extensive PS extending through intergluteal sulcus to the anus, with multiple sinus tracts and recurrent PS were retrospectively analysed. A special incision involving natal cleft and all sinus tracts completely and fasciocutaneous flap, lateralizing median line, was used in all cases. Post‐operative complications and recurrence was recorded.

Results

Sixteen (21.1%) patients were operated because of recurrence. The mean age and body mass index were 33.04 ± 6.78 and 29.86 ± 5.46, respectively. The mean hospital stay period and mean operation time was 2.95 ± 0.76 days and 64.33 ± 8.64 min, respectively. The mean drain removal time was 2.78 ± 0.7 days and mean follow‐up was 13.46 ± 4.31 months. There were flap oedema and seroma in one (1.3%) and four (5.3%) of the patients, respectively. Surgical site infection necessitating antibiotic treatment developed in three (3.9%) patients. The overall post‐operative complication rate was 10.5% and there was recurrence in one patient on follow‐up period (1.3%).

Conclusion

CNCEF with kite incision method, which shifts midline, is a safe and reliable method with acceptable post‐operative complication and recurrence rates in extensive sacrococcygeal PS patients.
Working on Water: Introduction
Authors: Roseman Sharon R.
Published: November 2019

This special issue focuses on the work lives of individuals with jobs that take place on and around boats. This introduction to the special issue “Working on Water” provides an overview of the long history of anthropological research on forms of human work that take place in and around salt and fresh bodies of water, such as food harvesting, watercraft construction, and transportation. It also discusses links between the multidisciplinary “mobilities turn” and research on aquamobilities. The last section introduces the ethnographic papers included in this issue of the journal, which focus on various sectors, including seafood harvesting, coastal tourism, passenger and vehicle ferries, and cargo transportation.
Efficiency analysis for stochastic dynamic facility layout problem using meta‐heuristic, data envelopment analysis and machine learning
Authors: Tayal Akash , Kose Utku , Solanki Arun , Nayyar Anand , Saucedo José Antonio Marmolejo
Published: November 2019

The facility layout problem (FLP) is a combinatorial optimization problem. The performance of the layout design is significantly impacted by diverse, multiple factors. The use of algorithmic or procedural design methodology in ranking and identification of efficient layout is ineffective. In this context, this study proposes a three‐stage methodology where data envelopment analysis (DEA) is augmented with unsupervised and supervised machine learning (ML). In stage 1, unsupervised ML is used for the clustering of the criteria in which the layouts need to be evaluated using homogeneity. Layouts are generated using simulated annealing, chaotic simulated annealing, and hybrid firefly algorithm/chaotic simulated annealing meta‐heuristics. In stage 2, the nonparametric DEA approach is used to identify efficient and inefficient layouts. Finally, supervised ML utilizes the performance frontiers from DEA (efficiency scores) to generate a trained model for getting the unique rankings and predicted efficiency scores of layouts. The proposed methodology overcomes the limitations associated with large datasets that contain many inputs / outputs from the conventional DEA and improves the prediction accuracy of layouts. A Gaussian distribution product demand dataset for time period T = 5 and facility size N = 12 is used to prove the effectiveness of the methodology.
Organic carbon decomposition rates with depth and contribution of inorganic carbon to CO2emissions under a Mediterranean agroforestry system
Authors: Cardinael Rémi , Chevallier Tiphaine , Guenet Bertrand , Girardin Cyril , Cozzi Thomas , Pouteau Valérie , Chenu Claire
Published: November 2019

Agroforestry systems have been much studied for their potential to store soil organic carbon (SOC). However, few data are available on their specific impact on potential SOC mineralization, especially at depth in subsoils. Moreover, many soils of the world, especially in arid and semiarid environments, also contain large stocks of soil inorganic carbon (SIC) as carbonates. Consequently, the organic carbon dynamics have been poorly investigated in these soils due to the complexity of measurements and of the processes involved. To assess mineralization rates of SOC with depth, we incubated soil samples from an 18‐year‐old agroforestry system (both tree row and alley) and an adjacent agricultural plot established on a calcareous soil in France. Soil samples were taken at four different depths: 0–10, 10–30, 70–100 and 160–180 cm. Total CO2emissions, the isotopic composition (δ13C, ‰) of the CO2and microbial biomass were measured. The SIC concentrations ranged from 48 to 63 g C kg−1soil and the SOC concentrations ranged from 4 to 17 g C kg−1soil. The contribution of SIC‐derived CO2represented about 20% in the topsoil and 60% in the subsoil of the total soil CO2emissions. The microbial biomass and the SOC‐derived CO2emissions were larger in the topsoil, but the decomposition rates (day−1) remained stable with depth, suggesting that only the size of the labile carbon pool was modified with depth. Subsoil organic carbon seems to be as prone to decomposition as surface organic carbon. No difference in CO2emissions was found between the agroforestry and the control plot, except in the tree row at 0–10 cm. Our results suggest that the measurement of soil respiration in calcareous soils could be overestimated if the isotopic signature of the CO2is not taken into account. It also advocates more in‐depth studies on carbonate dissolution–precipitation processes and their impact on CO2emissions.

Highlights

We measured SOC mineralization and inorganic carbon contribution to CO2emissions in agroforestry

Subsoil organic carbon was as prone to decomposition as surface organic carbon

Inorganic carbon contribution to CO2emissions ranged from 20 to 60% depending on soil depth

Measurement of soil respiration in calcareous soils could be overestimated
Short‐term growth response of jack pine and spruce spp. to wood ash amendment across Canada
Authors: Emilson Caroline E. , Bélanger Nicolas , Brais Suzanne , Chisholm Colin E. , Diochon Amanda , Joseph Ruth , Markham John , Morris Dave , Van Rees Ken , Rutherford Michael , Venier Lisa A. , Hazlett Paul W.
Published: November 2019

Wood ash amendment to forest soils contributes to the sustainability of the growing bioenergy industry, not only through decreased wood ash waste disposal in landfills but also by increasing soil/site productivity and tree growth. However, tree growth studies to date have reported variable responses to wood ash, highlighting the need to identify proper application rates under various soil/site conditions to maximize their benefits. We explored the influence of tree species, wood ash nutrient application rates, time since application, stand development stage, and initial (i.e., before wood ash application) soil pH and N on short‐term tree growth response to wood ash amendment across eight unique study sites spanning five Canadian Provinces. Jack pine (Pinus banksianaLamb) had the most positive response to wood ash amendment compared to white (Picea glaucaMoench), hybrid (Picea engelmanniixglaucaParry), and black spruce (Picea marianaMiller), where increasing nutrient application rates increased height growth response. In comparison, black spruce had the most negative response to wood ash amendment, where increasing nutrient application rates slightly decreased height growth response. Site as a random effect explained additional variation, highlighting the importance of other unidentified site characteristics. By examining trends in short‐term growth response across multiple studies with variable site characteristics, we found growth response differed by tree species and nutrient application rates, and that jack pine is a promising candidate for wood ash amendment. These results contribute to our knowledge of optimal wood ash amendment practices and environmentally sustainable bioenergy production.
Activation of extracellular signal‐regulated kinase is associated with hepatocellular carcinoma with aggressive phenotypes
Authors: Minagawa Takuya , Yamazaki Ken , Masugi Yohei , Tsujikawa Hanako , Ojima Hidenori , Hibi Taizo , Abe Yuta , Yagi Hiroshi , Kitago Minoru , Shinoda Masahiro , Itano Osamu , Kitagawa Yuko , Sakamoto Michiie
Published: November 2019

Aim

Sorafenib inhibits multiple kinase signaling pathways, including the rat sarcoma virus (Ras)/rapidly accelerated fibrosarcoma (Raf)/mitogen‐activated protein kinase kinase (MEK)/extracellular signal‐regulated kinase (ERK) pathway, and is a promising therapy for hepatocellular carcinoma (HCC). However, the role of ERK activation in HCC remains unclear. This study was designed to investigate the potential link between ERK activation and aggressive HCC phenotypes.

Methods

We evaluated nuclear ERK expression by immunohistochemistry in 154 resected HCC nodules from 136 patients. We then investigated the associations of ERK expression with the clinicopathological characteristics of HCC, c‐MET expression, and the molecular subclass biomarkers Ki‐67, keratin 19 (KRT19, CK19, or K19), and sal‐like protein 4. Multivariate Cox regression analysis was carried out to determine independent prognostic factors for overall survival and recurrence‐free survival. The effects of ERK activation by hepatocyte growth factor (HGF) on eight HCC cell lines were further examined.

Results

High‐level nuclear expression of ERK was observed in 20 (13%) of 154 nodules and was significantly associated with higher serum alpha‐fetoprotein levels (P = 0.034), poorer differentiation (P = 0.003), a higher Ki‐67 index (P < 0.001), high‐level expression of c‐MET (P = 0.008), KRT19 (P = 0.002), or sal‐like protein 4 (P < 0.001), and shorter overall survival (multivariate hazard ratio 3.448; P = 0.028) and recurrence‐free survival (multivariate hazard ratio 2.755; P = 0.004). HCC cells treated with hepatocyte growth factor showed enhanced cell proliferation together with ERK activation and upregulated KRT19 expression, both of which were inhibited by sorafenib.

Conclusions

High‐level ERK activation is associated with a KRT19‐positive highly proliferative subtype of HCC with a dismal prognosis. These findings support the key role of the hepatocyte growth factor/c‐MET/ERK axis in HCC progression.
Fresh Expressions of Church and the Mixed Economy
Authors: Müller Sabrina
Published: November 2019

The term “fresh expressions of church” has been used since 2004 in the Church of England to refer to small contextual churches that start alongside but aim to be different to parish churches. What is characteristic of a fresh expression of church is not its newness, but its ability to pass on and contextualize inherited theology, ecclesiology, tradition, and spiritual experience. The ecclesiology of fresh expressions of church can be summarized as a dialogical‐relational ecclesiology that is focused on a theological centre.

There may be around 2,100 of them in the Church of England, both urban and rural. During the past 15 years, the self‐understanding of the Church of England, a traditional state church with its parish structure, has changed. The mother church of the Anglican World Communion claims since 2008 to be a mixed‐economy church: one that supports and recognizes innovative ecclesial spaces (fresh expressions of church) as church, as well as parish churches. It is the goal to have an innovative diversity of churches in a pluralistic society. At the same time, these churches should be recognizable and contextual. It is the concept of the mixed economy that manages a fair cooperation between parochial and fresh expressions of church. In the meantime, the concept of mixed economy is received not only in the UK, but in different national and free churches in continental Europe, the US, South Africa, Canada, and Australia. Lately, the concept has been taken up by the Community of Protestant Churches in Europe (CPCE).
Irisin reverses intestinal epithelial barrier dysfunction during intestinal injury via binding to the integrin αVβ5 receptor
Authors: Bi Jianbin , Zhang Jia , Ren Yifan , Du Zhaoqing , Li Teng , Wang Tao , Zhang Lin , Wang Mengzhou , Wu Zheng , Lv Yi , Wu Rongqian
Published: November 2019

Disruption of the gut barrier results in severe clinical outcomes with no specific treatment. Metabolic disorders and destruction of enterocytes play key roles in gut barrier dysfunction. Irisin is a newly identified exercise hormone that regulates energy metabolism. However, the effect of irisin on gut barrier function remains unknown. The therapeutic effect of irisin on gut barrier dysfunction was evaluated in gut ischemia reperfusion (IR). The direct effect of irisin on gut barrier function was studied in Caco‐2 cells. Here, we discovered that serum and gut irisin levels were decreased during gut IR and that treatment with exogenous irisin restored gut barrier function after gut IR in mice. Meanwhile, irisin decreased oxidative stress, calcium influx and endoplasmic reticulum (ER) stress after gut IR. Moreover, irisin protected mitochondrial function and reduced enterocyte apoptosis. The neutralizing antibody against irisin significantly aggravated gut injury, oxidative stress and enterocyte apoptosis after gut IR. Further studies revealed that irisin activated the AMPK‐UCP 2 pathway via binding to the integrin αVβ5 receptor. Inhibition of integrin αVβ5, AMPK or UCP 2 abolished the protective role of irisin in gut barrier function. In conclusion, exogenous irisin restores gut barrier function after gut IR via the integrin αVβ5‐AMPK‐UCP 2 pathway.
Fracture Toughness, Flexural Strength, and Flexural Modulus of New CAD/CAM Resin Composite Blocks
Authors: Lucsanszky Iben J.R. , Ruse N. Dorin
Published: November 2019

Purpose

To determine and compare the fracture toughness, flexural strength and flexural modulus of four new, commercially available CAD/CAM resin composite blocks and one new CAD/CAM lithium disilicate glass‐ceramic block, tested under dry and aged conditions.

Materials and Methods

Three dispersed‐fillers resin composite blocks, CERASMART, KZR‐CAD‐HR2, and CAMouflage NOW, one polymer‐infiltrated ceramic network resin composite block, Enamic, along with Obsidian, a lithium disilicate glass‐ceramic block, were characterized. Fracture toughness was determined through the notchless triangular prism specimen test, while flexural strength and flexural modulus were determined by three‐point bend testing. Blocks were cut and ground to obtain (6 × 6 × 6 × 12) mm prisms and 10:1 span‐to‐thickness ratio bars (n = 25/group); half of the resin composite specimens were aged in 37°C distilled water for 30 days before testing. Fractured surfaces were characterized using a scanning electron microscope. Results were analyzed using Weibull statistics and two‐way ANOVA, followed by Scheffé multiple means comparisons (α = 0.05).

Results

With regards to fracture toughness, KZR stood out among resin composites with a dry value of 1.37 MPa·m1/2; this was significantly affected by ageing, while the fracture toughness of the other dispersed‐fillers resin composite blocks was not. Obsidian had the highest fracture toughness at 1.47 MPa·m1/2. With regards to flexural strength, Obsidian > CERASMART = KZR > CAMouflage > Enamic. The flexural strength of the resin composites was lowered by ageing. Enamic was found to have the highest flexural modulus among the resin composites (33.02 GPa), but its value was significantly lower than that of Obsidian (76.46 GPa); flexural modulus was not affected by ageing.

Conclusion

There was a significant difference in flexural strength between the materials, but not unanimously in flexural modulus and fracture toughness. The tested resin composite block materials had inferior flexural strength, flexural modulus and fracture toughness compared with the tested lithium disilicate glass‐ceramic block (Obsidian). Enamic, the polymer infiltrated ceramic network material, had a significantly higher flexural modulus than the dispersed‐fillers materials. Ageing had a deleterious impact on the flexural strength of all RCB, while its effect on the flexural modulus was insignificant. The selection of any restorative material requires a thorough analysis of its advantages and limitations to inform the clinical decision in a case‐by‐case approach.
Evaluation of posaconazole plasma concentrations achieved with the delayed‐release tablets in Korean high‐risk patients with haematologic malignancy
Authors: Chae Hyojin , Cho Sung‐Yeon , Yi Yunmi , Lee Jeong Joong , Cha Kyoungho , Kim Myungshin , Kim Yonggoo , Kim Yoo‐Jin , Kim Hee‐Je , Lee Dong‐Gun
Published: November 2019

Background

Posaconazole (PCZ) is a triazole approved for prophylaxis of invasive fungal infections.

Objectives

Herein, the impact of clinical variables on PCZ plasma concentrations (PPCs) attained with PCZ delayed‐release tablet (DRT) was investigated and compared with a historical cohort treated with PCZ oral suspension (OS).

Patients/Methods

Steady‐state PCZ PPCs in 513 patients with haematologic malignancy treated with PCZ‐DRT were assessed and impact of variables were analysed. Also, a comparison with matched historical cohort treated with PCZ‐OS was made.

Results

The median PPC in the PCZ‐DRT group was 1,308.9 ng/mL (range: 29.8‐10 455.9). Use of proton pump inhibitor (1181 vs 1344 ng/mL, P = .0337) in the AML/myelodysplastic syndrome remission induction group, diarrhoea (867 vs 1543 ng/mL, P = .0325) and gastrointestinal graft‐versus‐host disease (870 vs 1713 ng/mL, P = .0178) in the HSCT group were associated with lower PPCs. There was lack of evidence that hepatotoxicity was related with PCZ‐DRT. Higher prevalence of UGT1A4*3 allele (33.0%) was noted compared to allele frequency in Koreans in those with PPCs < 500 mg/mL. The median PPC in the PCZ‐DRT group was significantly higher than that in the PCZ‐OS group (1308.9 vs 713.0 ng/mL, P < .0001). Significantly less patients had PPCs < 700 ng/mL in the PCZ‐DRT group compared to the PCZ‐OS group (18.7% vs 48.0%, P < .0001).

Conclusions

Our study demonstrates that PCZ‐DRT has enhanced absorption and bioavailability than PCZ‐OS in real‐world clinical settings. In addition, specific factors associated with lower PPCs should prompt consideration of therapeutic drug monitoring in patients treated with PCZ‐DRT.
Catheter ablation of ventricular tachycardia in the pediatric patients: A single‐center experience
Authors: Wu Jinjin , Chen Yiwei , Ji Wei , Gu Beiyin , Shen Jie , Fu Lijun , Li Fen
Published: November 2019

Background

Ventricular tachycardia (VT) with or without structural heart disease is uncommon but well‐recognized clinically in children. With this retrospective study, we collected the data from the in‐hospital pediatric patients of VT with catheter ablation therapy. The purpose of this study is to assess the acute results and the long‐term outcome of catheter ablation in pediatric patients of VT in our single pediatric center.

Methods

This study included 53 consecutive children (male/female = 33/20, mean age = 8.2 ± 3.4 years, mean bodyweight = 32.6 ± 13.7 kg). All patients underwent electrophysiological study with an attempt of catheter ablation for clinical monomorphic VT. Acute and long‐term success rate of catheter ablation for the treatment of VT were compared between right and left VT as well as fascicular VT (FVT) and nonfascicular VT.

Results

There were 53 idiopathic VT forms found in the children, including FVT (n = 32), outflow tract VT (n = 15), papillary muscle VT (n = 5), and bundle branch reentry VT (n = 1). Acute success of catheter ablations for VT was achieved in 57 of all the 59 ablation procedures (97%) with VT recurrence occurred in six of 53 patients (11%). During a mean follow‐up period of 29.2 ± 21.7 months (range 1‐76 months) after hospital discharge, ablations in nonfascicular VT were as successful as FVT. There was no significant difference in the success rate between the right and left VT.

Conclusion

Catheter ablation is an effective treatment for idiopathic VT in children. The acute and long‐term success rates of catheter ablation for idiopathic VT in pediatric patients with normal heart structure are satisfying.
High night temperature induced changes in grain starch metabolism alters starch, protein, and lipid accumulation in winter wheat
Authors: Impa Somayanda M. , Vennapusa Amaranatha R. , Bheemanahalli Raju , Sabela David , Boyle Dan , Walia Harkamal , Jagadish S.V. Krishna
Published: November 2019

Unlike sporadic daytime heat spikes, a consistent increase in night‐time temperatures can potentially derail the genetic gains being achieved. Ten winter wheat genotypes were exposed to six different night‐time temperatures (15–27°C) during flowering and grain‐filling stages in controlled environment chambers. We identified the night‐time temperature of 23oC as the critical threshold beyond which a consistent decline in yields and quality was observed. Confocal laser scanning micrographs of central endosperm, bran, and germ tissue displayed differential accumulation of protein, lipid, and starch with increasing night‐time temperatures. KS07077M‐1 recorded a decrease in starch and an increase in protein and lipid in central endosperm with increasing night‐time temperatures, whereas the same was significantly lower in the tolerant SY Monument. Expression analysis of genes encoding 21 enzymes (including isoforms) involved in grain–starch metabolism in developing grains revealed a high night‐time temperature (HNT)‐induced reduction in transcript levels of adenosine diphosphate glucose pyrophosphorylase small subunit involved in starch synthesis and a ≥2‐fold increase in starch degrading enzymes isoamylase III, alpha‐, and beta‐amylase. The identified critical threshold, grain compositional changes, and the key enzymes in grain starch metabolism that lead to poor starch accumulation in grains establish the foundational knowledge for enhancing HNT tolerance in wheat.
DCF Valuation of Nonprofit Universities
Authors: He Yan , Long Frank
Published: November 2019

We conduct the Discounted Cash Flow (DCF) valuation of two nonprofit organizations: Syracuse University and Indiana University. We transform nonprofits to for-profits by converting nonprofit social benefit to net earnings and by adopting for-profit cost of equity and tax rate. These adjustments attempt to capture considerable hidden value to equityholders. We find that in the best scenario, the net worth (market value of equity) could be about 2 times the book equity for both universities in June 2017.
Simulation of IAEA Reactivity Initiated Transient Benchmarks Using Reactor Dynamics Code “REDAC”
Authors: Kale Vivek A. , K. Obaidurrahman
Published: November 2019

This paper presents the analysis of reactivity initiated transients in an idealized, light water research reactor as a part of International Atomic Energy Agency (IAEA) safety related benchmark. The simulation model is based on point reactor kinetics coupled with one-dimensional (1D), two-channel model for thermal hydraulics. The point kinetics equations (PKEs) have been solved using an implicit Runge–Kutta (RK) method and the coolant transport equations have been solved using implicit finite difference formulation. Accuracy of the implemented models and methods has been demonstrated. Important safety parameters like peak power, peak fuel, and coolant temperatures have been predicted for a series of transients. Intercode comparison shows that the predictions of the present simulations are in good agreement with other codes. This approach provides a time efficient solution for safety analysis of reactors with tightly coupled core where point kinetics can be applied. To address the sensitivity of predictions with respect to important input parameters, simulations have been carried out with different sets of inputs reported in the literature. They indicate that predictions for fast transients are spread over a wider range compared to slow transients. For a given transient, predictions of peak power have a wider spread, while peak temperatures are relatively less sensitive to neutronic inputs. Also, for fast transients, prompt neutron generation time and delayed neutron fraction have dominant influence on the evolution of power. For slow transients, the reactivity feedback effects are equally important.
Nonlinear Dynamics of Cattaneo–Christov Heat Flux Model for Third-Grade Power-Law Fluid
Authors: Sharma Bhuvnesh , Kumar Sunil , Cattani Carlo , Baleanu Dumitru
Published: November 2019

A rigorous analysis of coupled nonlinear equations for third-grade viscoelastic power-law non-Newtonian fluid is presented. Initially, the governing partial differential equations for conservation of energy and momentum are transformed to nonlinear coupled ordinary differential equations using exact similarity transformations which are known as Cattaneo–Christov heat flux model for third-grade power-law fluid. The homotopy analysis method (HAM) is utilized to approximate the systematic solutions more precisely with shear-thickening, moderately shear-thinning, and most shear-thinning fluids. The solution depends on various parameters including Prandtl number, power index, and temperature variation coefficient. A systematic analysis of boundary-layer flow demonstrates the impact of these parameters on the velocity and temperature profiles.
Printed and unprinted office paper, by near-ambient pressure XPS
Authors: Shah Dhruv , Bahr Stephan , Dietrich Paul , Meyer Michael , Thißen Andreas , Linford Matthew R.
Published: November 2019

Near-ambient pressure x-ray photoelectron spectroscopy (NAP-XPS) is a less-traditional form of XPS that allows samples to be analyzed at relatively high pressures, i.e., at ca. 2500 Pa, or even higher in some cases. With NAP-XPS, XPS can probe moderately volatile liquids, biological samples, porous materials, and/or polymeric materials that outgas significantly. In this submission, the authors show NAP-XPS survey spectra, and C 1s and O 1s narrow scans of two samples of paper (a white office paper and the nonsticky side of a yellow post-it note). The white office paper was analyzed at three specific positions: an unprinted portion, a light blue letter, and a dark blue letter in the “SPECS” logo. Survey spectra show the presence of carbon, oxygen, nitrogen, and calcium in all the samples. The yellow paper shows a small amount of silicon. Fits to the C 1s and O 1s regions are shown. The O 1s narrow scans are fit with four peaks using a literature approach previously employed for paper and with three peaks in a more ad hoc fashion. The latter approach yields better fits.
Late Activation of the Vastus Medialis in Determining the Risk of Anterior Cruciate Ligament Injury in Soccer Players
Authors: Marotta Nicola , Demeco Andrea , de Scorpio Gerardo , Indino Angelo , Iona Teresa , Ammendolia Antonio
Published: November 2019

Context: Activation time of the quadriceps is important in determining injury risk in professional soccer players. Objective: To compare the activation time of the quadriceps and hamstrings muscles during a movement that puts stress on anterior cruciate ligament (ACL) to assess the risk of ACL injury. Design: Case series. Setting: University laboratory for movement analysis. Patients or Other Participants: Twenty (10 males and 10 females) professional soccer players. Intervention(s): An inertial sensor and 4 electrodes positioned on the quadriceps and hamstrings muscles were used for the surface electromyography. The athlete resting on 1 leg dropped, from a 32-cm-high platform, on the suspended foot (testing leg), without jumping or lowering his center of gravity and maintaining single-leg landing for 5 seconds. Using a software, it is possible to calculate the activation time of the rectus femoris, vastus medialis (VM), biceps femoris, and semimembranosus muscles before ground contact. Main Outcome Measures: To evaluate the activation times of the rectus femoris, VM, biceps femoris, and semitendinosus muscles before ground contact in comparison with the range of normality calculated by the manufacturer. Results: All male soccer players demonstrated a low risk related to the correct activation of all the examined muscles, while female soccer players demonstrated delayed activation of the VM. Conclusions: Delayed activation of the VM registered in females determines an increase in anterior shear force, which is an important risk factor for incurring an ACL injury. This testing protocol becomes adequate for the screening of high-risk athletes and for targeting interventions to specific imbalances that may increase injury risk.
Adaptive mutability of colorectal cancers in response to targeted therapies
Authors: Russo Mariangela , Crisafulli Giovanni , Sogari Alberto , Reilly Nicole M. , Arena Sabrina , Lamba Simona , Bartolini Alice , Amodio Vito , Magrì Alessandro , Novara Luca , Sarotto Ivana , Nagel Zachary D. , Piett Cortt G. , Amatu Alessio , Sartore-Bianchi Andrea , Siena Salvatore , Bertotti Andrea , Trusolino Livio , Corigliano Mattia , Gherardi Marco , Lagomarsino Marco Cosentino , Di Nicolantonio Federica , Bardelli Alberto
Published: November 2019

A cross-kingdom tale of drug resistance

Physicians who treat bacterial infections and those who treat cancer often face a common challenge: the development of drug resistance. It is well known that when bacteria are exposed to antibiotics, they temporarily increase their mutation rate, thus increasing the chance that a descendant antibiotic-resistant cell will arise. Russo
et al.
now provide evidence that cancer cells exploit a similar mechanism to ensure their survival after drug exposure (see the Perspective by Gerlinger). They found that human colorectal cancer cells treated with certain targeted therapies display a transient up-regulation of errorprone DNA polymerases and a reduction in their ability to repair DNA damage. Thus, like bacteria, cancer cells can adapt to therapeutic pressure by enhancing their mutability.

Science
, this issue p.
1473
; see also p.
1458
Efficient, stable solar cells by using inherent bandgap of α-phase formamidinium lead iodide
Authors: Min Hanul , Kim Maengsuk , Lee Seung-Un , Kim Hyeonwoo , Kim Gwisu , Choi Keunsu , Lee Jun Hee , Seok Sang Il
Published: November 2019

Maintaining the bandgap

The bandgap of the black α-phase of formamidinium-based lead triiodide (FAPbI
3
) is near optimal for creating high-efficiency perovskite solar cells. However, this phase is unstable, and the additives normally used to stabilize this phase at ambient temperature—such as methylammonium, caesium, and bromine—widen its bandgap. Min
et al.
show that doping of the α-FAPbI
3
phase with methylenediammonium dichloride enabled power conversion efficiencies of 23.7%, which were maintained after 600 hours of operation. Unencapsulated devices had high thermal stability and retained >90% efficiency even after annealing for 20 hours at 150°C in air.

Science
, this issue p.
749
Environmental Presence and Genetic Characteristics of Carbapenemase-Producing
Enterobacteriaceae
from Hospital Sewage and River Water in the Philippines
Authors: Suzuki Yuki , Nazareno Pearl Joy , Nakano Ryuichi , Mondoy Melisa , Nakano Akiyo , Bugayong Mark Philip , Bilar Josie , Perez Mauricio , Medina Emarld Julian , Saito-Obata Mariko , Saito Mayuko , Nakashima Kazutoshi , Oshitani Hitoshi , Yano Hisakazu
Published: November 2019

Carbapenemase-producing
Enterobacteriaceae
(CPE) cause severe health care-associated infections, and their increasing prevalence is a serious concern. Recently, natural ecosystems have been recognized as important reservoirs of antibiotic resistance genes. We investigated the prevalence and genetic characteristics of CPE isolated from the environment (hospital sewage and river water) in the Philippines and found several CPE, including
Escherichia coli
and other species, with different carbapenemases. The most prevalent carbapenemase gene type was NDM, which is endemic in clinical settings. This study revealed that isolates belonging to carbapenemase-producing
E. coli
CC10 and
K. pneumoniae
sequence type 147 (ST147), which are often detected in clinical settings, were dominant in the natural environment. Our work here provides a report on the presence and characteristics of CPE in the environment in the Philippines and demonstrates that both hospital sewage and river water are contaminated by CPE strains belonging to clinically important clonal groups.
Relationship between general practice capitation funding and the quality of primary care in England: a cross-sectional, 3-year study
Authors: L’Esperance Veline , Gravelle Hugh , Schofield Peter , Santos Rita , Ashworth Mark
Published: November 2019

Objective

To explore the relationship between general practice capitation funding and quality ratings based on general practice inspections.

Design

Cross-sectional study pooling 3 years of primary care administrative data.

Setting

UK primary care.

Participants

7310 practices (95% of all practices) in England which underwent Care Quality Commission (CQC) inspections between November 2014 and December 2017.

Main outcome measures

CQC ratings. Ordered logistic regression methods were used to predict the relationship between practice capitation funding and CQC ratings in each of five domains of quality: caring, effective, responsive, safe and well led, together with an overall practice rating.

Results

Higher capitation funding per patient was significantly associated with higher CQC ratings across all five quality domains: caring (OR 1.14, 95% CI 1.04 to 1.23), effective (OR 1.08, 95% CI 1.00 to 1.16), responsive (OR 1.09, 95% CI 1.02 to 1.17), safe (OR 1.11, 95% CI 1.05 to 1.18), well led (OR 1.13, 95% CI 1.06 to 1.20) and overall rating (OR 1.13, 95% CI 1.06 to 1.19).

Conclusion

Higher capitation funding was consistently associated with higher ratings across all CQC domains and in the overall practice rating. This study suggests that measured dimensions of the quality of care are related to the underlying capitation funding allocated to each general practice, implying that additional capitation funding may be associated with higher levels of primary care quality.
Developing process measures in value-based healthcare: the case of aortic valve disease
Authors: Akmaz Berdel , Zipfel Nina , Bal Roland A , Rensing Benno J W M , Daeter Edgar J , van der Nat Paul B
Published: November 2019

Background

As process measures can be means to change practices, this article presents process measures that impact on outcome measures for surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) within value-based healthcare.

Methods

Desk research and observations of patient trajectories were performed to map the processes involved in TAVR and SAVR. Semistructured interviews were conducted with healthcare professionals (n=8) and patients (n=2) to explore which processes were most important in relation to a standard set of outcome measures that was already monitored. Additionally, open interviews (n=2) were held to prioritise results. A focus group was performed for validation of the formulated process measures. Numerical data for these measures was not collected.

Results

Process maps of the full cycle of care of TAVR and SAVR treatments in theory and in practice were developed. 28 processes were found important by interview participants due to their expected impact on patient-relevant outcomes. Seven processes were prioritised to be most important and were formulated into 12 process measures for both TAVR and SAVR: ‘Number of times that deficient information provision to SAVR patients causes negative outcomes’, ‘Type of TAVR/SAVR prosthesis’, ‘Brand of TAVR prosthesis’, ‘Number of times the frailty score of a TAVR/SAVR patient >75 years is measured’, ‘Time between TAVR/SAVR surgery indication and surgery’, ‘Number of times that anticoagulants are stopped within 3 days before surgery’, ‘Time in hours between TAVR/SAVR surgery and permanent pacemaker implantation’ and ‘Percentage of standardised pain measurements’.

Conclusion

This study proposes an addition of select process measures to standard sets of outcome measures to improve healthcare quality. It illustrates a clear method for identifying process measures with impact on health outcomes in the future.
Large-scale empirical optimisation of statistical control charts to detect clinically relevant increases in surgical site infection rates
Authors: Ilieş Iulian , Anderson Deverick J , Salem Joseph , Baker Arthur W , Jacobsen Margo , Benneyan James C
Published: November 2019

Objective

Surgical site infections (SSIs) are common costly hospital-acquired conditions. While statistical process control (SPC) use in healthcare has increased, limited rigorous empirical research compares and optimises these methods for SSI surveillance. We sought to determine which SPC chart types and design parameters maximise the detection of clinically relevant SSI rate increases while minimising false alarms.

Design

Systematic retrospective data analysis and empirical optimisation.

Methods

We analysed 12 years of data on 13 surgical procedures from a network of 58 community hospitals. Statistically significant SSI rate increases (signals) at individual hospitals initially were identified using 50 different SPC chart variations (Shewhart or exponentially weighted moving average, 5 baseline periods, 5 baseline types). Blinded epidemiologists evaluated the clinical significance of 2709 representative signals of potential outbreaks (out of 5536 generated), rating them as requiring ‘action’ or ‘no action’. These ratings were used to identify which SPC approaches maximised sensitivity and specificity within a broader set of 3600 individual chart variations (additional baseline variations and chart types, including moving average (MA), and five control limit widths) and over 32 million dual-chart combinations based on different baseline periods, reference data (network-wide vs local hospital SSI rates), control limit widths and other calculation considerations. Results were validated with an additional year of data from the same hospital cohort.

Results

The optimal SPC approach to detect clinically important SSI rate increases used two simultaneous MA charts calculated using lagged rolling baseline windows and 1 SD limits. The first chart used 12-month MAs with 18-month baselines and best identified small sustained increases above network-wide SSI rates. The second chart used 6-month MAs with 3-month baselines and best detected large short-term increases above individual hospital SSI rates. This combination outperformed more commonly used charts, with high sensitivity (0.90; positive predictive value=0.56) and practical specificity (0.67; negative predictive value=0.94).

Conclusions

An optimised combination of two MA charts had the best performance for identifying clinically relevant small but sustained above-network SSI rates and large short-term individual hospital increases.
‘Whatever you cut, I can fix it’: clinical supervisors’ interview accounts of allowing trainee failure while guarding patient safety
Authors: Klasen Jennifer M , Driessen Erik , Teunissen Pim W , Lingard Lorelei A
Published: November 2019

Background

Learning is in delicate balance with safety, as faculty supervisors try to foster trainee development while safeguarding patients. This balance is particularly challenging if trainees are allowed to experience the educational benefits of failure, acknowledged as a critical resource for developing competence and resilience. While other educational domains allow failure in service of learning, however, we do not know whether or not this strategy applies to clinical training.

Methods

We conducted individual interviews of clinical supervisors, asking them whether they allowed failure for educational purposes in clinical training and eliciting their experiences of this phenomenon. Participants’ accounts were descriptively analysed for recurring themes.

Results

Twelve women and seven men reported 48 specific examples of allowing trainee failure based on their judgement that educational value outweighed patient risk. Various kinds of failures were allowed: both during operations and technical procedures, in medication dosing, communication events, diagnostic procedures and patient management. Most participants perceived minimal consequences for patients, and many described their rescue strategies to prevent an allowed failure. Allowing failure under supervision was perceived to be important for supporting trainee development.

Conclusion

Clinical supervisors allow trainees to fail for educational benefit. In doing so, they attempt to balance patient safety and trainee learning. The educational strategy of allowing failure may appear alarming in the zero-error tolerant culture of healthcare with its commitment to patient safety. However, supervisors perceived this strategy to be invaluable. Viewing failure as inevitable, they wanted trainees to experience it in protected situations and to develop effective technical and emotional responses. More empirical research is required to excavate this tacit supervisory practice and support its appropriate use in workplace learning to ensure both learning and safety.
Factors associated with civilian and police officer injury during 10 years of officer-involved shooting incidents
Authors: Paddock Ellen , Jetelina Katelyn Kassarjian , Bishopp Stephen A , Gabriel Kelley Pettee , Reingle Gonzalez Jennifer Marie
Published: November 2019

Background

Previous officer-involved shooting (OIS) research has focused primarily on antecedents to fatal shootings, with few studies investigating injury more broadly. Our study examined the factors associated with fatal or non-fatal injury to both civilians and officers during OIS incidents, to better understand how harm might be reduced in the most extreme law enforcement scenarios.

Methods

Data included 281 officers involved in 177 unique shooting incidents recorded by Dallas Police Department between 2005 and 2015. Bivariate logistic regression and multivariable generalised estimation equation analyses were used to investigate incident characteristics associated with fatal or non-fatal injury to civilians and officers.

Results

Civilian injury occurred in 61% and officer injury in 14% of unique OIS incidents. In adjusted models, multiple shooting officers increased the odds of injury to both civilians (adjusted OR (AOR): 3.22, 95% CI 1.39 to 7.50) and officers (AOR 4.73, 95% CI 1.64 to 13.65). Odds of civilian injury were also significantly higher during the daytime and among non-Hispanic white compared with non-Hispanic black and Hispanic/Latina/o civilians, although a majority of OIS incidents (79%) involved non-Hispanic black or Hispanic/Latino/a civilians. Odds of officer injury were significantly higher for detectives compared with patrol (AOR=9.32, 95% CI 1.85 to 47.03) and during off-duty versus on-duty shootings (AOR=5.23, 95% CI 1.37 to 19.99).

Conclusions

Both civilians and officers are at risk for injury during OIS incidents, though to different degrees and with unique risk factors. Additional research is needed to understand whether these results are replicated elsewhere and to further understand the mechanisms of injury.
Emergent magnetic structures and dynamics in thin films: a review of some recent results
Authors: De’Bell K.
Published: November 2019

The emergence of mesoscopic structures and the role of slow dynamics in thin magnetic films is an area of considerable interest. The role played by defect mediated dynamic processes is a current area of experimental and theoretical research that is essential to the understanding of the properties of these films. This research is driven by both the potential applications of thin magnetic films, and the fundamental questions and new physics that they point to. This brief review provides an overview of some recent experimental work on both epitaxial magnetic films and on meta-material magnetic films. An overview of some corresponding results from theory and simulation studies is also given. The article concludes with a summary and some forward-looking speculations and questions regarding these systems.
Weathering history and landscape evolution of Western Ghats (India) from
40
Ar/
39
Ar dating of supergene K–Mn oxides
Authors: Jean A. , Beauvais A. , Chardon D. , Arnaud N. , Jayananda M. , Mathe P. E.
Published: November 2019

Laterites preserved on both sides of the Western Ghats Escarpment of Peninsular India have formed by long-term lateritic weathering essentially after India–Seychelles continental break-up following Deccan Traps emplacement (
c.
63 myr ago). Supergene manganese ores of the Western Ghats were formed on Late Archean manganese protores. Among Mn oxides composing the ores, cryptomelane (K-rich Mn oxide) was characterized and dated by
40
Ar/
39
Ar geochronology. Measured ages complement those previously obtained in other South Indian manganese ores from the hinterland plateau and further document three major weathering periods,
c.
53–44,
c.
39–22 and
c.
14–10 Ma, the last being documented for the first time in India. These periods coincide with global palaeoclimatic proxies and date the lateritic weathering of three successive palaeolandscapes of the Western Ghats that evolved under slow denudation (
c.
8 m Ma
−1
) over the last 44 myr and were mostly incised during the Neogene (<22 Ma). This indicates that the Western Ghats are a relict of a South Indian plateau preserved at the headwaters of very long east-flowing river systems and above the Western Ghats Escarpment. Topography and denudation history of this landscape do not require Neogene tilt of the Peninsula as recently proposed.

Supplementary material:
Full details of field and sample description, methods and analytical data including electron probe microanalyses of cryptomelane, and isotopic analyses and degassing spectra of irradiated cryptomelane grains are available at
https://doi.org/10.6084/m9.figshare.c.4726661