bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decision space and participation of primary healthcare facility managers in the Ideal Clinic Realisation and Maintenance programme in two South African provinces
Authors: Muthathi Immaculate Sabelile , Levin Jonathan , Rispel Laetitia C 
Published: November 2019

Abstract
In South Africa, the introduction of a national health insurance (NHI) system is the most prominent health sector reform planned to achieve universal health coverage in the country. Primary health care (PHC) is the foundation of the proposed NHI system. This study draws on policy implementation theory and Bossert’s notion of decision space to analyse PHC facility managers’ decision space and their participation in the implementation of the Ideal Clinic Realisation and Maintenance (ICRM) programme. We conducted a cross-sectional survey among 127 PHC facility managers in two districts in Gauteng and Mpumalanga provinces. A self-administered questionnaire elicited socio-demographic information, the PHC managers’ participation in the conceptualization and implementation of the ICRM programme, their decision space and an optional open-ended question for further comments. We obtained a 100% response rate. The study found that PHC facility managers reported lack of involvement in the conceptualization of the ICRM programme, high levels of participation in implementation [mean score 5.77 (SD ±0.90), and overall decision space mean score of 2.54 (SD ±0.34)]. However, 17 and 21% of participants reported narrow decision space on the critical areas of the availability of essential medicines and on basic resuscitation equipment respectively. The qualitative data revealed the unintended negative consequences of striving for ‘ideal clinic status’, namely that of creating an illusion of compliance with the ICRM standards. The study findings suggest the need for greater investment in the health workforce, special efforts to involve frontline managers and staff in health reforms, as well as provision of adequate resources, and an enabling practice environment.
Should we still perform fresh embryo transfers in ART?
Authors: Blockeel Christophe , Campbell Alison , Coticchio Giovanni , Esler John , Garcia-Velasco Juan A , Santulli Pietro , Pinborg Anja 
Published: November 2019

Abstract
An increasing number of researchers have alluded to the potential benefit of deferring the transfer of embryos produced during assisted reproductive technologies (ARTs) away from ovarian stimulation, using cryopreservation to enable this. The scientific evidence that may justify this recent trend in the use of the so-called ‘freeze-all strategy’ includes early, mostly small randomised controlled trials that have demonstrated an increase in live birth rates after elective embryo cryopreservation in certain patient populations, as well as evidence from cohort studies and retrospective analyses. What are the risks and benefits of freeze-all strategies in ART, who are the patients in whom it is likely to be advantageous, and does the current evidence allow us to identify situations when deciding that a fresh embryo transfer would be counter-productive? ART professionals are often faced with challenging clinical decisions regarding the best course of treatment for their patient. The purpose of this opinion paper is to provide a clinical guide for whether to perform a fresh embryo transfer or to opt for freezing all embryos in specific situations.
Mass Transference Principle: From Balls to Arbitrary Shapes
Authors: Koivusalo Henna , Rams Michał 
Published: November 2019

Abstract
The mass transference principle, proved by Beresnevich and Velani in 2006, is a strong result that gives lower bounds for the Hausdorff dimension of limsup sets of balls. We present a version for limsup sets of open sets of arbitrary shape.
Liver X Receptor Activation Impairs Neutrophil Functions and Aggravates Sepsis
Authors: Souto Fabrício O , Castanheira Fernanda V S , Trevelin Silvia C , Lima Braulio H F , Cebinelli Guilherme Cesar Martelossi , Turato Walter M , Auxiliadora-Martins Maria , Basile-Filho Anibal , Alves-Filho Jose Carlos , Cunha Fernando Q 
Published: November 2019

Abstract

Background
Liver X receptors (LXRs) are nuclear receptors activated by oxidized lipids and were previously implicated in several metabolic development and inflammatory disorders. Although neutrophils express both LXR-α and LXR-β, the consequences of their activation, particularly during sepsis, remain unknown.

Methods
We used the model of cecal ligation and puncture (CLP) to investigate the role of LXR activation during sepsis.

Results
In this study, we verified that LXR activation reduces neutrophil chemotactic and killing abilities in vitro. Mice treated with LXR agonists showed higher sepsis-induced mortality, which could be associated with reduced neutrophil infiltration at the infectious foci, increased bacteremia, systemic inflammatory response, and multiorgan failure. In contrast, septic mice treated with LXR antagonist showed increased number of neutrophils in the peritoneal cavity, reduced bacterial load, and multiorgan dysfunction. More important, neutrophils from septic patients showed increased ABCA1 messenger ribonucleic acid levels (a marker of LXR activation) and impaired chemotactic response toward CXCL8 compared with cells from healthy individuals.

Conclusions
Therefore, our findings suggest that LXR activation impairs neutrophil functions, which might contribute to poor sepsis outcome.
Blind Spots of Traditional Microbiological Tests for Severe Community-Acquired Pneumonia in Adults and Availability of Nonculture Techniques: A Nationwide Survey of Physicians in China
Authors: Zhang Jing , Hu Weiping , Huang Yi , Qu Jieming ,   the Infection Assembly of the Chinese Thoracic Society
Published: November 2019

Abstract

Background
In China, no national survey has been conducted to evaluate physicians’ attitudes and compliance with guidelines in the management of adult patients with community-acquired pneumonia (CAP). Therefore, this study aimed to evaluate physicians’ awareness of the use of microbiological tests in the management of severe CAP (SCAP) and to investigate the availability of nonculture tests in China.

Methods
A nationwide electronic questionnaire survey was conducted among Chinese physicians between March and July 2018, which assessed their viewpoints concerning the issues in the management of SCAP.

Results
A total of 6333 physicians completed this survey, evenly covering all career stages. Among these, 3208 (50.6%) and 1936 (30.6%) had blind spots in the application of blood and sputum cultures in the management of SCAP, respectively. Nonteaching hospital, nonrespirologists, and junior career stage were independently associated with misunderstandings. Regarding nonculture methods, 52.7% of the facilities had no access to polymerase chain reaction-based pathogen detection tests. The accessibility of urinary antigen tests for Streptococcus pneumoniae (42.5%) and Legionella pneumophila (38.5%) was also low. The main barriers were inland and remote region, lower hospital level, and nonteaching hospital.

Conclusions
Insufficient use of sputum and blood cultures, together with low accessibility of major nonculture techniques, were noticeable barriers to achieving microbiological diagnosis of SCAP in China. To help curb the overuse of broad-spectrum antibiotics, further measures should be taken to raise awareness among nonspecialists and promote rapid nonculture tests, especially in nonteaching hospitals and developing regions.
The Politics of Twitter: Emotions and the Power of Social Media
Authors: Duncombe Constance 
Published: November 2019

AbstractSocial media is becoming a key medium through which we communicate with each other: it is at the center of the very structures of our daily interactions. Yet this infiltration is not unique to interpersonal relations. Political leaders, governments, and states operate within this social media environment, wherein they continually address crises and institute damage control through platforms such as Twitter. A question arises here as to what the turn to Twitter means for conventional structures of power and different levels of communication. This article analyses the emotional dynamics of Twitter, illustrating how emotion is implicated in the power of this social media platform. I argue that Twitter can both represent emotions and provoke emotions, which can play an important role in the escalation or de-escalation of conflict. The emotional conditions Twitter facilitates are implicated in how shifts in temporality and functionality of communication have shaped political discourse so significantly.
Minority Family Forest Owners in the United States
Authors: Butler Sarah M , Schelhas John , Butler Brett J 
Published: December 2019

AbstractFamily forest owners own more forestland in the United States than any other group. There have been no national studies of racial and ethnic minority family forest owners in the United States, in spite of increasing attention to diversity in forestry. Using the US Forest Service’s National Woodland Owner Survey data, we sought to better understand minority owners by looking at their characteristics, attitudes, and behaviors. Of the over 4 million family forest ownerships with 10+ ac in the United States, minorities comprise 6.6 percent of the ownerships and own 5.1 percent of the 265 million ac. Although many similarities exist between minority and nonminority owners, such as reasons for owning land and concerns, minority landowners tend to be more regionally located, have smaller forest holdings, are less likely to manage their forests, and are less likely to have participated in assistance programs. Broad insight into the attitudes and behaviors of minority family forest owners can help policymakers, program directors, and outreach coordinators begin to understand the needs of minority landowners, providing this historically underserved group with tools they need to attain their forest management and land-use goals. By increasing minority landowner engagement, we can hopefully slow the loss of land by minority landowners.
Seasonal variation in native hydraulic conductivity between two deciduous oak species
Authors: Mota-Gutiérrez Dilia , Arreola-González Guadalupe , Aguilar-Romero Rafael , Paz Horacio , Cavender-Bares Jeannine , Oyama Ken , Gonzalez-Rodriguez Antonio , Pineda-García Fernando 
Published: November 2019

AbstractAimsMechanisms of plant drought resistance include both tolerance and avoidance. Xylem vulnerability to embolism and turgor loss point are considered traits that confer tolerance, while leaf abscission and deciduousness characterizes the avoidance strategy. While these mechanisms are thought to trade-off expressing a continuum among species, little is known on how variation in the timing and duration of leaf shedding in response to drought affect the relationship between xylem and leaf tolerance. In the present study, we explored the extent to which drought tolerance differs between two oak (Quercus) species that exhibit different leaf shedding behaviours. Particularly, we predicted that Q. deserticola Trel., which loses leaves at the end of the dry season (late-deciduous) and is thus exposed to a greater risk of cavitation, would be more drought tolerant and more conservative in its water use than Q. laeta Liebm., which loses its leaves for only a short period of time in the middle of the dry season (brevideciduous).MethodsThe study was conducted in central Mexico in a single population of each of the two oak species, separated from each other by a distance of 1.58 km, and by an altitudinal difference of 191 m. Quercus deserticola (late deciduous) is more frequent down slope, while Q. laeta (brevideciduous) tends to occur at higher elevations along the gradient. We assessed seasonal differences (rainy versus dry season) in native stem hydraulic conductivity, and tested for variation in xylem vulnerability to cavitation, leaf water use and leaf turgor loss point between the two species.Important FindingsThe two oak species did not differ in traits conferring drought tolerance, including xylem vulnerability to embolism, leaf turgor loss point, or stomatal conductance. However, both species had different performance during the dry season; the brevideciduous species had lower negative impact in the xylem function than the late-deciduous species. Overall, seasonal changes in plant physiological performance between the two oak species were determined by a reduction in the canopy leaf area.
ATBS1-INTERACTING FACTOR 2 negatively regulates dark- and brassinosteroid-induced leaf senescence through interactions with INDUCER OF CBF EXPRESSION 1
Authors: Kim Yoon , Park Seon-U , Shin Dong-Min , Pham Giang , Jeong You Seung , Kim Soo-Hwan 
Published: November 2019

AbstractATBS1-INTERACTING FACTOR 2 (AIF2) is a non-DNA-binding basic helix–loop–helix (bHLH) transcription factor. We demonstrated that AIF2 retards dark-triggered and brassinosteroid (BR)-induced leaf senescence in Arabidopsis thaliana. Dark-triggered BR synthesis and the subsequent activation of BRASSINAZOLE RESISTANT 1 (BZR1), a BR signaling positive regulator, result in BZR1 binding to the AIF2 promoter in a dark-dependent manner, reducing AIF2 transcript levels and accelerating senescence. BR-induced down-regulation of AIF2 protein stability partly contributes to the progression of dark-induced leaf senescence. Furthermore, AIF2 interacts with INDUCER OF CBF EXPRESSION 1 (ICE1) via their C-termini. Formation of the AIF2–ICE1 complex and subsequent up-regulation of C-REPEAT BINDING FACTORs (CBFs) negatively regulates dark-triggered, BR-induced leaf senescence. This involves antagonistic down-regulation of PHYTOCHROME INTERACTING FACTOR 4 (PIF4), modulated through AIF2-dependent inhibition of ICE1’s binding to the promoter. PIF4-dependent activities respond to dark-induced early senescence and may promote BR synthesis and BZR1 activation to suppress AIF2 and accelerate dark-induced senescence. Taken together, these findings suggest a coordination of AIF2 and ICE1 functions in maintaining stay-green traits.
Decrosslinking enables visualization of RNA-guided endonuclease–in situ labeling signals for DNA sequences in plant tissues
Authors: Nagaki K , Yamaji N 
Published: November 2019

AbstractInformation about the positioning of individual loci in the nucleus and the status of epigenetic modifications at these loci in each cell contained in plant tissue increases our understanding of how cells in a tissue coordinate gene expression. To obtain such information, a less damaging method of visualizing DNA in tissue that can be used with immunohistochemistry is required. Recently, a less damaging DNA visualization method using the CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/associated caspase 9) system, named RNA-guided endonuclease–in situ labeling (RGEN-ISL), was reported. This system made it possible to visualize a target DNA locus in a nucleus fixed on a glass slide with a set of simple operations, but it could not be applied to cells in plant tissues. In this work, we have developed a modified RGEN-ISL method with decrosslinking that made it possible to simultaneously detect the DNA loci and immunohistochemistry signals, including histone modification, in various types of plant tissues and species.
A null test to probe the scale dependence of the growth of structure as a test of general relativity
Authors: Franco Felipe Oliveira , Bonvin Camille , Clarkson Chris 
Published: November 2019

ABSTRACT
The main science driver for the coming generation of cosmological surveys is understanding dark energy that relies on testing general relativity on the largest scales. Once we move beyond the simplest explanation for dark energy of a cosmological constant, the space of possible theories becomes both vast and extremely hard to compute realistic observables. A key discriminator of a cosmological constant, however, is that the growth of structure is scale invariant on large scales. By carefully weighting observables derived from distributions of galaxies and a dipole pattern in their apparent sizes, we construct a null test that vanishes for any model of gravity or dark energy where the growth of structure is scale independent. It relies only on very few assumptions about cosmology, and does not require any modelling of the growth of structure. We show that with a survey like the Dark Energy Spectroscopic Instrument (DESI) a scale dependence of the order of 10–20 per cent can be detected at 3σ with the null test, which will drop by a factor of 2 for a survey like the Square Kilometre Array. We also show that the null test is very insensitive to typical uncertainties in other cosmological parameters including massive neutrinos and scale-dependent bias, making this a key null test for dark energy.
Multiple Subpial Transections in Eloquent Cortex for Refractory Epilepsy: 2-Dimensional Operative Video
Authors: Whiting Alexander C , Cavallo Claudio , Rubel Nicholas , Catapano Joshua S , Walker Corey T , Smith Kris A 
Published: November 2019

Abstract
Although the epilepsy refractory to medical therapy can potentially be cured by the resection of epileptogenic tissue, many patients do not qualify for surgery, because epileptogenic tissue can arise from eloquent areas of the brain, where surgical resection would result in severe neurological deficits. Palliative surgical treatments currently used in these situations include deep brain stimulation, responsive neurostimulation, and vagal nerve stimulation.
1
A previously developed technique, multiple subpial transections (MSTs), although used infrequently, is another effective tool.
2
Our patient, a 34-yr-old man, had epilepsy that was refractory to medical management. His preoperative work-up demonstrated a potential seizure focus in the left pars opercularis and left superior temporal gyrus, which was verified using invasive stereoelectroencephalography. Functional magnetic resonance imaging demonstrated a significant verbal and motor function in this region. After informed consent was obtained, the patient underwent a left-sided craniotomy. The central portion of the seizure focus was resected using the subpial technique. The surrounding presumed epileptogenic cortex, which was considered functionally eloquent, was then horizontally disconnected with MSTs. For each transection, a small puncture incision was made in the pia, and a vertical cut was completed using Morrell dissectors.
2
MSTs were performed circumferentially around the entire resection cavity in 5-mm increments. All hemostasis was achieved with irrigation instead of electrocautery, although noncauterizing hemostatic agents are also acceptable. The patient was neurologically intact after the operation and was discharged home on postoperative day 2. He was free of seizures at 11-month follow-up. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.
Scrub typhus in patients with acute febrile illness: a 5-year study from India
Authors: Thakur C K , Chaudhry R , Gupta N , Vinayaraj E V , Singh V , Das B K , Jadon R S , Wig N , Lodha R , Kabra S K , Dey A B , Chhabra M 
Published: November 2019

Abstract

Background
Scrub typhus was once thought to be a disease of rural origin and was confined to specific pockets in South Asia. Early diagnosis and treatment is extremely important as it is associated with high mortality if left untreated.

Aim
To delineate the clinical and molecular epidemiology of scrub typhus in patients presenting with acute febrile illness from various parts of India.

Methods
During the study period of 5 years (October 2013 to October 2018), a total of 1742 patients with acute febrile illness &lt;15 days were enrolled after taking informed consent. Patients were diagnosed using IgM Enzyme-linked immunosorbent assay (ELISA) based on the pre-determined region specific cut offs. Patients with positive IgM ELISA were also subjected to IgM Immunofluorescence assay and nested polymerase chain reaction (PCR) assay. The demographic and relevant clinical details of the patients were documented and analyzed.

Results
A total of 210 (12.1%) patients were diagnosed with scrub typhus. Of these, nested PCR was positive in only 85 patients. Sequencing and phylogenetic analysis showed that the predominant circulating genotypes were Gilliam and Karp. On multivariate analysis, acute respiratory distress syndrome, myocarditis, encephalitis/encephalopathy, jaundice and splenomegaly were significantly more common in those patients who were diagnosed with scrub typhus. A total of 14 patients diagnosed with scrub typhus succumbed to the illness.

Conclusion
Patients with fever, headache, pulmonary manifestations, CNS manifestations, myocarditis, transaminitis or thrombocytopenia presenting in the monsoon and post-monsoon season should be evaluated for scrub typhus irrespective of the geographical location in India.
The Risk of Sexually Transmitted Infections Following First-Episode Schizophrenia Among Adolescents and Young Adults: A Cohort Study of 220 545 Subjects
Authors: Liang Chih-Sung , Bai Ya-Mei , Hsu Ju-Wei , Huang Kai-Lin , Ko Nai-Ying , Chu Hsuan-Te , Yeh Ta-Chuan , Tsai Shih-Jen , Chen Tzeng-Ji , Chen Mu-Hong 
Published: November 2019

Abstract
Young people are disproportionately affected by sexually transmitted infections (STIs). The risk of STIs in young people following first-episode schizophrenia is unknown. This study using Taiwan’s National Health Insurance Research Database enrolled 44 109 adolescents and young adults with first-episode schizophrenia and 176 436 age- and sex-matched controls without schizophrenia from 2001 through 2009 and followed to the end of 2011. New-onset STIs were identified. Survival analysis was performed. Cox regression analysis was used to examine the effects of comorbid substance use disorder (SUD), schizophrenia medications, and schizophrenia severity. The E value for causality of evidence was calculated. We found that young people had a higher risk of STIs following first-episode schizophrenia compared with controls without schizophrenia (hazard ratio [HR] = 2.35, 95% CI = 2.08–2.64); these STIs included human immunodeficiency virus (HIV) (3.70, 2.60–5.28) and syphilis (5.35, 3.96–7.23). They also showed a disproportionate distribution of STIs, with an increased proportion of syphilis (20.4% vs 8.2%) and HIV (9.1% vs 6.0%). When presenting with SUD, the risks of HIV (11.00, 7.02–17.25) and syphilis (9.11, 6.16–13.47) were further increased. The severe schizophrenia group had an extremely high risk of syphilis (41.26, 27.69–61.47) and HIV (7.50, 3.85–14.62). Schizophrenia medications may provide beneficial effects against contracting STIs (0.77, 0.68–0.89). We concluded that following first-episode schizophrenia, young patients are at higher risk of STIs, particularly HIV and syphilis. The risk further increased when subjects presented with SUD or severe schizophrenia. Importantly, antipsychotic treatment may lower the risk of STIs.
Whose Bodies? Bringing Gender Into Interaction Ritual Chain Theory
Authors: Ferguson Todd W 
Published: November 2019

AbstractThe goal of this paper is to bring gender into the theory of interaction ritual chains. While this theory focuses on how bodies emotionally respond within interactions, it ignores how the sex–gender system impacts bodies. The cultural norms for women and men shape how bodies react emotionally in rituals. To demonstrate the need for interaction rituals to account for gender, I explore how gendered feeling rules affect ritual outcomes in religious congregations. Using multilevel regressions to analyze data from the 2001 US Congregational Life Survey, I show that men have lower levels of emotional energy than women. Additionally, the gender ratio has an effect, and individuals who are in congregations with higher percentages of men experience lower levels of emotional energy. This effect is more powerful for men than it is for women. I conclude by stating that interaction ritual theory must account for the gendered identities of its participants.