Prevalence of Novel Candidate Sjogren Syndrome Autoantibodies in the Dry Eye Assessment and Management (DREAM) Study.

PurposeTo evaluate the prevalence of novel candidate Sjogren syndrome (SS) autoantibodies [salivary protein-1 (SP-1), parotid secretory protein, carbonic anhydrase 6] in the DRy Eye Assessment and Management (DREAM) cohort, a study evaluating the effectiveness of omega-3 fatty acid supplements for the treatment of dry eye.MethodsParticipants underwent ocular surface examinations and serological testing for traditional and novel SS autoantibodies. Dry eye assessment and management participants were categorized into the following 3 groups: 1) no history of SS or other autoimmune diseases and negative traditional SS autoantibodies (n = 352); 2) no history of SS but a history of other autoimmune diseases (n = 66); and 3) those who met the 2012 American College of Rheumatology SS classification criteria (n = 52).ResultsEleven percent had a history of SS, and 6% of those without a history of SS most likely had undiagnosed SS. The SS group had a higher prevalence of SP-1 autoantibodies than the group without SS or other autoimmune diseases (33% vs. 19%; P = 0.02) but had no difference in carbonic anhydrase 6 (P = 0.31) or parotid secretory protein autoantibodies (P = 0.33). Participants who were positive for the traditional autoantibodies alone or positive for both traditional and novel autoantibodies had the highest scores for corneal (P = 0.002) and conjunctival staining (P < 0.001).ConclusionsData from this multicenter, prospective study demonstrated that one of the novel candidate autoantibodies, SP-1, is associated with underlying SS and that novel autoantibodies may be associated with worse ocular surface disease. Future longitudinal studies are needed to evaluate their utility in screening patients with dry eye for SS

Accounting for quality improvement during the conduct of embedded pragmatic clinical trials within healthcare systems: NIH Collaboratory case studies

Embedded pragmatic clinical trials (ePCTs) and quality improvement (QI) activities often occur simultaneously within healthcare systems (HCSs). Embedded PCTs within HCSs are conducted to test interventions and provide evidence that may impact public health, health system operations, and quality of care. They are larger and more broadly generalizable than QI initiatives, and may generate what is considered high-quality evidence for potential use in care and clinical practice guidelines. QI initiatives often co-occur with ePCTs and address the same high-impact health questions, and this co-occurrence may dilute or confound the ability to detect change as a result of the ePCT intervention. During the design, pilot, and conduct phases of the large-scale NIH Collaboratory Demonstration ePCTs, many QI initiatives occurred at the same time within the HCSs. Although the challenges varied across the projects, some common, generalizable strategies and solutions emerged, and we share these as case studies. KEY LESSONS: Study teams often need to monitor, adapt, and respond to QI during design and the course of the trial. Routine collaboration between ePCT researchers and health systems stakeholders throughout the trial can help ensure research and QI are optimally aligned to support high-quality patient-centered care

Unifications of Dual-Class Shares in Germany Empirical Evidence on the Effects ofRelated Changes in Ownership Structure, Market Value, and Bid-Ask Spreadsnce from the German Stock Market

This paper examines the unification of non-voting preference shares into a one share-one vote structure using a sample of all German dual-class companies from 1987 until 2003. We test several hypotheses with regard to the reasons for the abolition of preference shares. First, as the separation of ownership and control is viewed as a means of keeping control over a firm, a detailed analysis of changes in the ownership structure of firms abolishing their preference shares is performed. Indeed, family firms losing the majority of control by unifying their share classes seem to restrain from this step by selling controlling blocks before the unification. Second, dualclass firms may comprise higher agency costs due to the violation of the one share-one vote rule and, thus, face higher costs of equity capital. We apply two methods for estimating changes in the cost of capital of unifying firms : (i) we perform an event study to examine the market reaction to the announcement of share class unifications and (ii) we investigate bid-ask spreads before and after the unification computed from intraday trading data to analyze liquidity effects on the cost of capital associated with the unification. In sum, the unification of dual-class preference shares into single -class voting shares seems to be strictly shareholder value increasing. Dual-class firms seem to be able to significantly reduce their cost of capital through unification, because of increases in firm value as well as a substantial reduction in bid-ask spreads.dual-class shares, share class unification, cost of capital, event study,announcement effects, bid-ask spreads, liquidity

Summer and winter MgCO3 levels in the skeletons of Arctic bryozoans

In the Arctic, seasonal patterns in seawater biochemical conditions are shaped by physical, chemical, and biological processes related to the alternation of seasons, i.e. winter polar night and summer midnight sun. In summertime, CO2 concentration is driven by photosynthetic activity of autotrophs which raises seawater pH and carbonate saturation state (Ω). In addition, restriction of photosynthetic activity to the euphotic zone and establishment of seasonal stratification often leads to depth gradients in pH and Ω. In winter, however, severely reduced primary production along with respiration processes lead to higher CO2 concentrations which consequently decrease seawater pH and Ω. Many calcifying invertebrates incorporate other metals, in addition to calcium, into their skeletons, with potential consequences for stability of the mineral matrix and vulnerability to abrasion of predators. We tested whether changes in seawater chemistry due to light-driven activities of marine biota can influence the uptake of Mg into calcified skeletons of Arctic Bryozoa, a dominant faunal group in polar hard-bottom habitats. Our results indicate no clear differences between summer and winter levels of skeletal MgCO3 in five bryozoan species despite differences in Ω between these two seasons. Furthermore, we could not detect any depth-related differences in MgCO3 content in skeletons of selected bryozoans. These results may indicate that Arctic bryozoans are able to control MgCO3 skeletal concentrations biologically. Yet recorded spatial variability in MgCO3 content in skeletons from stations exhibiting different seawater parameters suggests that environmental factors can also, to some extent, shape the skeletal chemistry of Arctic bryozoans

Testing the Question-Behavior Effect of Self-Administered Surveys Measuring Youth Drug Use

Concern that asking about a specific behavior could elicit that behavior is often cited as a reason that communities and schools should not administer surveys about youth drug use. In this study, we investigated if this question-behavior effect exists related to substance use. We examined if simply asking a student about their current drug use leads to an increase in drug use 1 year later. This study tests the validity of the question-behavior effect on youth drug use in a longitudinal panel of 2,002 elementary school students. The sample of students was drawn from the Community Youth Development Study, a community-randomized test of the Communities That Care prevention system. If the prevalence of self-reported drug use in sixth grade in a sample surveyed in fifth and sixth grades was higher than in an accretion sample surveyed only in sixth grade, the difference could indicate a question-behavior effect. Results from logistic regression analyses did not provide any evidence of a question-behavior effect on 30-day or lifetime prevalence of alcohol, tobacco, inhalant, or marijuana use reported in sixth grade. Asking youth about drug use in a survey did not increase the rates of self-reported drug use measured 1 year later. The absence of evidence of a question-behavior effect should ease concerns of communities and schools when administering surveys asking youth about their drug use

Arctic Sensitivity? Suitable Habitat for Benthic Taxa Is Surprisingly Robust to Climate Change

Arctic marine ecosystems are often assumed to be highly vulnerable to ongoing climate change, and are expected to undergo significant shifts in structure and function. Community shifts in benthic fauna are likely to result from changes in key physico-chemical drivers, such as ocean warming, but there is little ecological data on most Arctic species to support any specific predictions as to how vulnerable they are, or how future communities may be structured. We used a species distribution modeling approach (MaxEnt) to project changes over the 21st century in suitable habitat area for different species of benthic fauna by combining presence observations from the OBIS database with environmental data from a coupled climate-ocean model (SINMOD). Projected mean % habitat losses over taxonomic groups were small (0–11%), and no significant differences were found between Arctic, boreal, or Arcto-boreal groups, or between calcifying and non-calcifying groups. However, suitable habitat areas for 14 of 78 taxa were projected a change by over 20%, and several of these taxa are characteristic and/or habitat-forming fauna on some Arctic shelves, suggesting a potential for significant ecosystem impacts. These results highlight the weakness of general statements regarding vulnerability of taxa on biogeographic or presumed physiological grounds, and suggest that more basic biological data on Arctic taxa are needed for improved projections of ecosystem responses to climate change