bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental illness and addictions: Our responsibility to support the family
Authors: Kean Jessica
Published: August 2019

Mental health and addictions is a field within the realms of social work practice that appears to be consistently growing. This article seeks to discuss the importance of social work practice with the families that come into contact with mental health and addiction services. It will also draw attention to the questions of whether social workers are effectively supporting and engaging family and how we can work alongside or in partnerships with family. It will seek to highlight the importance of having a clear understanding of the experiences of the family who have been affected by mental illness or addiction in order to more effectively work towards recovery.
Whanau meetings in the hospital: Uncovering the unique role of social workers
Authors: Haultain Linda , Thompson Andrew , Loli Matalau , Herd Joanne , Comber Susan
Published: August 2019

Social workers in health care settings frequently play a major role in working with patients, families and other health professionals to utilise family meetings to improve communication and outcomes. This article describes a quality related project undertaken by a group of hospital social workers to explore effective social work practice in family meetings. The study identifies five essential practice activities as significant in supporting effective whanau meeting practice.
Competence and risk in older adults: A social work perspective
Authors: Farrelly Mary
Published: August 2019

In more than 15 years of working with older people, in community settings and in health, one of the more common triggers for social work involvement centred around issues of competency – the capacity of the older person to continue to exercise autonomy and self determination in any or all facets of his/her life. Social workers operate within defined ethical guidelines, one of which is to recognise and uphold the dignity of the individual and the individual’s right to autonomy. However, often there is tension between the twin values of upholding this right to autonomy and the duty of care when working with older people where there is a question of impaired cognition and decision-making capacity. This article explores that tension in terms of the social work response.
Why continence matters: A social work perspective
Authors: Matthews Doug
Published: August 2019

The International Continence Association defines urinary incontinence (UI) as the involuntary leakage of urine (Abrams, et al., 2003; Getliffe & Thomas, 2007). UI is a symptom or a collection of symptoms, not a disease (Hope, 2007; Perry, 2008). UI is widely underreported and undertreated (Fonda & Newman, 2006; Getliffe & Thomas, 2007; Lara & Nancy, 1994). These circumstances reflect (at least in part) reluctance among many health care workers to face UI squarely (Hope, 2007; Locher, Burgio, Goode, Roth & Rodriguez, 2002). Part of this reluctance may be attributable to lack of skills and knowledge (Getliffe & Thomas, 2007; Hope, 2007; Locher et al, 2002). Reflective practitioners must also recognise, and guard against, being influenced by their own life experiences and beliefs (Phillips, Ray & Marshall, 2006) and by erroneous and unhelpful beliefs in the society at large (Brashler, 2006; Getliffe & Thomas, 2007; Hope 2007). Moreover, the failure of persons suffering chronic conditions to be ‘cured’ can elicit negative reactions from health workers (Brashler, 2006).Ageism, defined as ‘a set of beliefs, attitudes, social institutions, and acts that denigrate individuals or groups based on their chronological age’ negatively impacts on older persons’ health and well-being (Whitbourne, 2005, p. 51; see also Butler, 1975; Myers & Schwiebert, 1996; Wilson, Ruch, Lymbery, & Cooper, 2008). The beliefs of individuals, families and groups too often do not reflect the reality that most persons with UI can be helped (Fonda, 2006: Getliffe & Thomas, 2007; Naughtin & Schofield, 2009; Locher, et al., 2002). This article addresses how health care social workers can contribute to delivering this central message to clients, whanau and other caregivers.
The Social Work Alert System: An account of a new initiative in the emergency department at Middlemore Hospital
Authors: Todman Angela , Mulitalo-Lauta Pa’u Tafaogalupe
Published: August 2019

This article discusses a new initiative within the Emergency Department and the wider Middlemore Hospital in South Auckland, namely a Social Work Alert System (SWAS) that enhances delivery of quality care for patients. The SWAS is defined as a social work process that identifies patients who may be at risk due to past or present circumstances so that they may be reviewed and psychosocially assessed by a social worker. For the purposes of this article, a scenario is used to illustrate how the SWAS operates involving a pregnant mother who came to hospital through the Emergency Department.
Guest commentary
Authors: Pack Margaret
Published: August 2019

Introduction to mental health and well-being section.
Multiple holding: A model for supervision in the context of trauma and abuse
Authors: Virtue Claire , Fouché Christa
Published: August 2019

This paper reports on a grounded theory study involving eight practitioners; four supervisees and four supervisors took part in individual interviews and two separate focus groups.The core finding of the research is that multiple holding is needed to provide adequate support for professionals working with trauma and abuse. Multiple holding is a term for the processes practitioners can use to enable them to remain working in the field of trauma and abuse and includes relational supervision, knowledge and skills and the use of resources outside the supervision relationship. The identified outside resources are: spirituality; personal therapy; collegiality; and training specific to trauma and abuse. Supervisors need to be part of a chain of holding where they in turn are held by their own supervisors, who, in turn, in an ongoing sequence, are also held in a chain of supervision and holding. Being able to choose a supervisor was found to be important to build a high level of trust in the supervisee/supervisor relationship.
Dialectical Behaviour Therapy: A social work intervention?
Authors: Cooper Brent , Parsons Jane
Published: August 2019

This article introduces the mental health treatment, Dialectical Behaviour Therapy (DBT) as a dynamic and challenging therapy well suited to a critical social work perspective. From the authors’ experience of providing DBT in a tertiary health setting over the past three years, the connections between DBT and social work will be espoused with the central tenet being the demonstration that psychiatric social workers are highly skilled once trained in this modality
The Wellness Recovery Action Plan (WRAP): Effectiveness with Chinese consumers
Authors: Zhang Wenli , Wong Suet Yi , Li Yanbing , Yeh Hong-Shiow , Zhao Yue
Published: August 2019

Education and knowledge have always been prized life quests for Chinese. The question however, is whether Western-style mental health education is acceptable to Chinese mental health consumers and whether it is useful in improving their knowledge and understanding of mental health and the process of recovery. Whilst there has been a plethora of psychoeducational material published, most offer passive learning or require little educator/learner interaction, let alone active participation.The aim of this paper is to present a pilot research on the acceptability, the applicability and the effectiveness of the Western concept of mental health recovery including the Wellness Recovery Action Plan (WRAP) programme in improving the effectiveness of recovery among the members of Bo Ai She (BAS), a Chinese mental health consumers’ self-help organisation in New Zealand.Qualitative research methods were used to undertake this research. Eight members of BAS and three professional mental health workers were interviewed, and proceedings from discussions in two focus groups comprising consumers and their family members have been included to form the data base.Key findings from this research affirmed that the WRAP programme has played a significant role in recovery for Chinese consumers in BAS. The results also suggested areas which needed to be modified in order to become a cultural-appropriate programme in Chinese mental health consumers’ recovery.
Social work clinical leadership in allied health
Authors: Fry Kim
Published: August 2019

One of the main issues in the health environment today is the need for clinical leadership. This includes the leadership of social work within the grouping ‘allied health’. Over recent years Allied Health Directors have emerged within District Health Boards (DHBs) and the author currently holds one of these positions and is the only social worker to do so. Social workers are the largest profession within the allied health group and have the knowledge, skills and attributes to provide direction within this group of many different professions. The challenges of defining and uniting allied health provides social workers with many opportunities, however we need to market and position ourselves strategically in our organisations. This article provides a case study of the Allied Health Director role at MidCentral Health and will examine how the role came about, the context of the organisation and the organisation’s current structure. Key issues in defining allied health will be explored including the tensions and concerns among professionals of being viewed as a generic group. There are challenges and opportunities for social work within the health environment and this brief paper explores how we can both utilise and develop our skills, knowledge and practice to provide allied health with unity and direction.
Parenting adopted children and supporting adoptive parents: Messages from research
Authors: Gibbs Anita
Published: August 2019

This article considers adoption from the perspective of parents, especially the strategies that they employ to enhance attachments and build positive parent-child relationships. The article draws particularly on recent New Zealand research regarding intercountry adoptive parenting, as well as overseas literature on good adoptive parenting practice generally in domestic and intercountry adoption. It also considers the research on methods of supporting parents who adopt and whether there are gaps in legislation, policy or practice in New Zealand that could be closed by borrowing from good examples in the literature, and, or current practice examples. The author is an adoptive parent of Russian-born children and is actively involved in adoptive parent support networks.
Interventions available to adolescents and young adults bereaved by familial cancer: a systematic literature review
Authors: Ing Veronica , Patterson Pandora , Szabo Marianna , Allison Kimberley R
Published: August 2019

Objectives

To assess the availability and efficacy of interventions open to adolescents and young adults (AYAs; 15-25 years) bereaved by a parent’s or sibling’s cancer.

Methods

A systematic review of peer-reviewed literature on interventions available to AYAs bereaved by a parent’s or sibling’s cancer was conducted through searches of six online databases (PsycINFO, Medline, Scopus, Embase, SWAB and Web of Science Core Collection).

Results

Database and reference searches yielded 2985 articles, 40 of which were included in the review. Twenty-two interventions were identified that were available for bereaved young people. However, only three were specific to young people bereaved by familial cancer, and none were specific to AYAs. Interventions primarily provided opportunities for participants to have fun, share their experiences and/or memorialise the deceased; psychoeducation about bereavement, grief and coping was less common. Only six interventions had been satisfactorily evaluated, and no intervention targeted or analysed data for AYAs separately. Overall, some evidence suggested that interventions (especially those that were theoretically grounded) had positive effects for bereaved young people. However, benefits were inconsistently evidenced in participants’ self-reports and often only applied to subgroups of participants (eg, older youths and those with better psychological well-being at baseline).

Conclusions

Considering the very limited number of interventions specific to bereavement by familial cancer and the lack of interventions targeting AYAs specifically, it is unclear whether currently available interventions would benefit this population. The population of AYAs bereaved by familial cancer is clearly under-serviced; further development and evaluation of interventions is needed.
Contemporary biochemical analysis of normal pericardial fluid
Authors: Imazio Massimo , Biondo Andrea , Ricci Davide , Boffini Massimo , Pivetta Emanuele , Brucato Antonio , Giustetto Carla , De Ferrari Gaetano Maria , Rinaldi Mauro
Published: August 2019

Objective

Biochemical analysis of pericardial fluid (PF) is commonly performed for the initial assessment of PF, and the results are usually interpreted according to Light’s traditional criteria for the differential diagnosis of transudates versus exudates. However, Light’s criteria have been formulated for the biochemical analysis of pleural fluid. The aim of the present paper is to evaluate the normal composition of PF in candidates for cardiac surgery.

Methods

Cohort study with analysis of PF from candidates for cardiac surgery. Exclusion criteria were previous pericardial disease or cardiac surgery, prior myocardial infarction within 3 months, systemic disease (eg, systemic inflammatory diseases, uremia) or drug with potentiality to affect the pericardium.

Results

Fifty patients (mean age was 67 years; 95% CI 64 to 71, 29 males, 58.0%) were included in the present analysis. Levels of small molecules were similar in blood and PF. Total proteins in PF was, on average, 0.5 times lower than corresponding plasma levels (p=0.041), while the level of pericardial lactate dehydrogenase was, on average, 1.06 times higher than plasma (p=0.55). Moreover, mononuclear cells were more concentrated in PF than plasma (p=0.17). Traditional Light’s criteria misclassified all PFs as exudates.

Conclusions

Traditional Light’s criteria misclassified normal PFs in candidates for cardiac surgery as exudates. This study suggests their futility for the biochemical analysis of PF in clinical practice.
Sudden cardiac death in families with premature cardiovascular disease
Authors: Bruikman Caroline , de Ronde Maurice W J , Amin Ahmed , Levy Sonja , Lof Pien , de Ruijter Ursula , Hovingh Kees , Tan Hanno L , Pinto-Sietsma Sara-Joan
Published: August 2019

Objective

Sudden cardiac death (SCD) in families with premature atherosclerosis (PAS) is generally attributed to lethal arrhythmias during myocardial infarction. Yet, such arrhythmias may also arise from non-ischaemic inherited susceptibility. We aimed to test the hypothesis that Brugada syndrome is prevalent among families with PAS in which SCD occurred.

Methods

We investigated all patients who underwent Ajmaline testing to screen them for Brugada syndrome because of unexplained familial SCD in the Amsterdam University Medical Centers between 2004 and 2017. We divided the cohort into two groups based on a positive family history for PAS. All individuals with a positive Ajmaline test were screened for SCN5A-mutation.

Results

In families with SCD and PAS, the prevalence of positive Ajmaline test was similar to families with SCD alone (22% vs 19%). The number of SCD cases in families with SCD and PAS was higher (2.34 vs 1.63, p<0.001) and SCD occurred at older age in families with SCD and PAS (42 years vs 36 years, p<0.001), while the prevalence of SCN5A mutations was lower (3% vs 18%, p<0.05).

Conclusions

Brugada syndrome has a similar prevalence in families with SCD and PAS as in families with SCD alone, although SCD in families with SCD and PAS occurs in more family members and at older age, while SCN5A mutations in these families are rare. This suggests that the SCD occurring in families with PAS could be related to an underlying genetic predisposition of arrhythmias, with a different genetic origin. It could be considered to screen families with SCD and PAS for Brugada syndrome.
Outcomes of patients with severe tricuspid regurgitation and congestive heart failure
Authors: Kadri Amer N , Menon Vivek , Sammour Yasser M , Gajulapalli Rama D , Meenakshisundaram Chandramohan , Nusairat Leen , Mohananey Divyanshu , Hernandez Adrian V , Navia Jose , Krishnaswamy Amar , Griffin Brian , Rodriguez Leonardo , Harb Serge C , Kapadia Samir
Published: August 2019

Objectives

A substantial number of patients with severe tricuspid regurgitation (TR) and congestive heart failure (CHF) are medically managed without undergoing corrective surgery. We sought to assess the characteristics and outcomes of CHF patients who underwent tricuspid valve surgery (TVS), compared with those who did not.

Methods

Retrospective observational study involving 2556 consecutive patients with severe TR from the Cleveland Clinic Echocardiographic Database. Cardiac transplant patients or those without CHF were excluded. Survival difference between patients who were medically managed versus those who underwent TVS was compared using Kaplan-Meier survival curves. Multivariate analysis was performed to identify variables associated with poor outcomes.

Results

Among a total of 534 patients with severe TR and CHF, only 55 (10.3%) patients underwent TVS. Among the non-surgical patients (n=479), 30% (n=143) had an identifiable indication for TVS. At 38 months, patients who underwent TVS had better survival than those who were medically managed (62% vs 35%; p<0.001). On multivariate analysis, advancing age (HR: 1.23; 95% CI 1.12 to 1.35 per 10-year increase in age), moderate (HR: 1.39; 95% CI 1.01 to 1.90) and severe (HR: 2; 95% CI 1.40 to 2.80) right ventricular dysfunction were associated with higher mortality. TVS was associated with lower mortality (HR: 0.44; 95% CI 0.27 to 0.71).

Conclusion

Although corrective TVS is associated with better outcomes in patients with severe TR and CHF, a substantial number of them continue to be medically managed. However, since the reasons for patients not being referred to surgery could not be ascertained, further randomised studies are needed to validate our findings before clinicians can consider surgical referral for these patients.
In vivo alpha-V beta-3 integrin expression in human aortic atherosclerosis
Authors: Jenkins William S , Vesey Alex T , Vickers Anna , Neale Anoushka , Moles Catriona , Connell Martin , Joshi Nikhil Vilas , Lucatelli Christophe , Fletcher Alison M , Spratt James C , Mirsadraee Saeed , van Beek Edwin JR , Rudd James HF , Newby David E , Dweck Marc R
Published: August 2019

Objectives

Intraplaque angiogenesis and inflammation are key promoters of atherosclerosis and are mediated by the alpha-V beta-3 (αvβ3) integrin pathway. We investigated the applicability of the αvβ3-integrin receptor-selective positron emission tomography (PET) radiotracer 18F-fluciclatide in assessing human aortic atherosclerosis.

Methods

Vascular 18F-fluciclatide binding was evaluated using ex vivo analysis of carotid endarterectomy samples with autoradiography and immunohistochemistry, and in vivo kinetic modelling following radiotracer administration. Forty-six subjects with a spectrum of atherosclerotic disease categorised as stable (n=27) or unstable (n=19; recent myocardial infarction) underwent PET and CT imaging of the thorax after administration of 229 (IQR 217–237) MBq 18F-fluciclatide. Thoracic aortic 18F-fluciclatide uptake was quantified on fused PET-CT images and corrected for blood-pool activity using the maximum tissue-to-background ratio (TBRmax). Aortic atherosclerotic burden was quantified by CT wall thickness, plaque volume and calcium scoring.

Results

18F-Fluciclatide uptake co-localised with regions of increased αvβ3integrin expression, and markers of inflammation and angiogenesis. 18F-Fluciclatide vascular uptake was confirmed in vivo using kinetic modelling, and on static imaging correlated with measures of aortic atherosclerotic burden: wall thickness (r=0.57, p=0.001), total plaque volume (r=0.56, p=0.001) and aortic CT calcium score (r=0.37, p=0.01). Patients with recent myocardial infarction had greater aortic 18F-fluciclatide uptake than those with stable disease (TBRmax1.29 vs 1.21, p=0.02).

Conclusions

In vivo expression of αvβ3integrin in human aortic atheroma is associated with plaque burden and is increased in patients with recent myocardial infarction. Quantification of αvβ3integrin expression with 18F-fluciclatide PET has potential to assess plaque vulnerability and disease activity in atherosclerosis.
Left atrial dimension and cardiovascular outcomes in patients with and without atrial fibrillation: a systematic review and meta-analysis
Authors: Froehlich Lorin , Meyre Pascal , Aeschbacher Stefanie , Blum Steffen , Djokic Daniela , Kuehne Michael , Osswald Stefan , Kaufmann Beat A , Conen David
Published: August 2019

Objective

The prognostic value of left atrial (LA) dimensions may differ between patients with and without atrial fibrillation (AF).

Methods

MEDLINE and EMBASE were searched for studies that investigated the association between LA echocardiographic parameters measured by transthoracic echocardiography and cardiovascular outcomes in patients with or without AF. Data were independently abstracted by two reviewers and pooled using random-effects meta-analysis. The primary outcome was incident stroke or thromboembolic events. Secondary outcomes were heart failure, all-cause mortality and major adverse cardiac events (MACE).

Results

Twenty-three studies of patients with AF (14 939 patients) and 68 studies of patients without AF (50 720 patients) in this systematic review. Increasing LA diameter was significantly associated with stroke and thromboembolic events in patients without AF (risk ratio (RR) 1.38, 95% CI 1.02 to 1.87; p=0.03), but not in patients with AF (RR 1.02, 95% CI 0.98 to 1.07; p=0.27; p for difference=0.05). Increasing LA diameter index was significantly associated with MACE in patients with AF (RR 1.13, 95% CI 1.09 to 1.17; p<0.001) and in patients without AF (RR 2.98, 95% CI 1.90 to 4.66; p<0.001), with stronger effects in non-AF populations (p for difference <0.001). Greater LA volume index was significantly associated with the risk of MACE in patients with AF (RR 1.01, 95% CI 1.00 to 1.02; p=0.03) and in non-AF populations (RR 1.08, 95% CI 1.05 to 1.10; p<0.001), the association being stronger in individuals without AF (p for difference <0.001).

Conclusions

Larger LA parameters were associated with various adverse cardiovascular events. Many of these associations were stronger in individuals without AF, highlighting the potential importance of LA myopathy.
Evaluation of the efficacy of a virtual reality-based safety training and human factors training method: study protocol for a randomised-controlled trial
Authors: Nykänen Mikko , Puro Vuokko , Tiikkaja Maria , Kannisto Henriikka , Lantto Eero , Simpura Frans , Uusitalo Jose , Lukander Kristian , Räsänen Tuula , Teperi Anna-Maria
Published: August 2019

Background

The construction industry has a high risk of occupational accidents and injuries. More randomised controlled trials are needed to identify effective techniques for improving the occupational safety of construction sector workers. New technologies such as virtual reality (VR) offer the potential to develop engaging learning tools for safety training. Although the number of VR applications in occupational safety training is increasing, only a few studies have evaluated the learning outcomes of VR safety training. Furthermore, previous studies indicate that learning to recognise human factors at work has positive outcomes for safety skills. However, there is lack of knowledge regarding the efficacy of human factors-related training in the construction industry.

Objective

To evaluate the efficacy and the implementation process of a VR-based safety training and a human factors-related safety training.

Methods

In Finland, 8 study organisations and approximately 130 construction sector workers will participate in a randomised controlled trial. The study participants will be randomly assigned to one of four intervention arms: (1) immersive VR safety training alone, (2) lecture-based safety training alone, (3) combined immersive VR safety training and HF Tool training or (4) combined lecture-based safety training and HF Tool training. We will test the efficacy of the safety training processes in these four arms. Randomisation of study participants is stratified by work experience. Baseline assessment will take place before randomisation. The short-term follow-up measurements of all study participants will be conducted immediately after the VR safety training and lecture-based safety training. The study participants will complete second measurements immediately after the HF Tool training approximately 1 month after previous safety training. The second measurement of the intervention arms 1 and 2 study participants will be conducted during the same week as that of the intervention arms 3 and 4 participants, who will not take part in the HF Tool training. Finally, semistructured individual interviews will be conducted to evaluate the learning process.

Outcome measures

Outcome measures include safety knowledge, safety locus of control, safety self-efficacy, perceived control over safety issues, safety-related outcome expectancies, safety motivation and safety performance.

Discussion

Study results will provide knowledge on the efficacy of VR safety training and human factors-related safety training. Furthermore, study provides knowledge on pedagogical techniques that can be used to guide future intervention plans and development.

Trial registration number

ISRCTN55183871.
Drowning mortality in children aged 0–14 years in Victoria, Australia: detailed epidemiological study 2001–2016
Authors: Chang Susan Soon Mee , Ozanne-Smith Joan
Published: August 2019

Background

Major reductions in child drowning mortality rates have been observed historically in Victoria, Australia, for the period 1863–2000. Despite this trend, drowning remains the leading cause of unintentional child death in Victoria. This study investigates the residual fatal drowning problem in the Victorian child population (0–14 years) for the period 2001–2016.

Aims

Describe the epidemiology of child drowning deaths in the Victorian population in 2001–2016; investigate risk factors and direct antecedents to these deaths.

Methods

Population-based retrospective case data were extracted from the National Coronial Information System for 16 years (January 2001–December 2016), and case-by-case analysis was conducted. Associated factors were determined using univariate and Poisson analyses.

Results

88 of 97 cases had information available for analysis, pools were the most frequent location (30%); 70% of all cases occurred between 08:00 and 17:00; most victims were not deliberately in the body of the water (73%), for example, the pool. Supervision lapses included carers leaving the room when the child was in the bath (16/18), siblings left to supervise the child in private pools (7/23), inadequate pool fences (8/23) or faulty/open gates (4/23), or neighbours’ pool spa (4/23). Delays in finding the child occurred when searches occurred elsewhere, before the body of water (21/88) and when carers were asleep (5/88). Fourteen of the 88 children had an intellectual disability or predisposing medical condition. The grouped Poisson analysis demonstrated that age 0–4 years, male gender and rural place of residence were significant. A downward trend in drowning rate continued in this period.

Discussion and conclusions

A case-by-case analysis of a drowned population of children identified details of risk factors and antecedents not previously described. Missing data on antecedents were common, likely resulting in undercounting. Further enhancements to systematic data collection are needed. The results support a systems approach to drowning prevention.
Cholangiolar pattern and albumin in situ hybridisation enable a diagnosis of intrahepatic cholangiocarcinoma
Authors: Brackett Diane G , Neyaz Azfar , Arora Kshitij , Masia Ricard , Mattia Anthony , Zukerberg Lawerence , Misdraji Joseph , Goyal Lipika , Zhu Andrew X , Ferrone Cristina R , Yilmaz Omer H , Deshpande Vikram
Published: August 2019

Aims

The histological distinction of intrahepatic cholangiocarcinoma (ICC) from metastatic adenocarcinoma remains a challenge. The primary goal was to evaluate the diagnostic value of morphology and albumin expression in the diagnosis of ICC.

Methods

We evaluated morphological patterns in 120 ICCs and 677 non-hepatic adenocarcinomas and performed in situ hybridisation (ISH) stain for albumin in the former cohort (retrospective cohort). We also identified 119 samples from primary and metastatic lesions, the validation cohort, in which albumin ISH was performed as part of the diagnostic workup. Targeted sequencing was performed on selected cases. We also mined existing expression profiling data including cases from The Cancer Genome Atlas (TCGA) (41 760 unique samples).

Results

In the retrospective cohort, 45% of ICCs and <1% of non-hepatic adenocarcinomas showed a cholangiolar pattern; albumin ISH was positive in 93% of ICCs with significant intratumorous heterogeneity. In the validation cohort, 29% of ICCs showed a cholangiolar pattern and 88% expressed albumin, while all metastatic non-hepatic neoplasms were negative (n=37) (sensitivity 88% and specificity 100%). Targetable genetic alterations (IDHmutations andFGFR2fusions) were identified in 31% of ICCs (10 of 32). An analysis of the TCGA data validated the specificity of the albumin assay.

Conclusions

The cholangiolar pattern and albumin RNA ISH distinguishes ICC from metastatic adenocarcinoma with high specificity. Given the high prevalence of targetable mutations in ICC, albumin RNA ISH is an essential component in the workup of tumours of uncertain origin. A specific diagnosis of ICC could trigger molecular testing and uncover targetable genetic alterations.
Subthalamic suppression defines therapeutic threshold of deep brain stimulation in Parkinson’s disease
Authors: Milosevic Luka , Kalia Suneil K , Hodaie Mojgan , Lozano Andres , Popovic Milos R , Hutchison William
Published: August 2019

Introduction

Subthalamic deep brain stimulation (DBS) is beneficial when delivered at a high frequency. However, the effects of current amplitude and pulse width on subthalamic neuronal activity during high-frequency stimulation have not been investigated.

Methods

In 20 patients with Parkinson’s disease each undergoing subthalamic DBS, we recorded single-unit subthalamic activity using one microelectrode, while a separate microelectrode was used to deliver 5–10 s trains of stimulation at 100 Hz using varying current amplitudes and pulse widths (44 neurons investigated).

Results

Analysis of variance tests confirmed significant (p<0.001) main effects of both current amplitude and pulse width on subthalamic neuronal firing during stimulation and on poststimulus inhibitory silent periods. Prolonged silent periods were often followed by postinhibitory rebound burst excitations. Additionally, a significant (p<0.0001) correlation was found between neuronal firing and total electrical energy delivered (TEED). With TEED values≤31.2 µJ/s (associated with DBS parameters of ≤2.0 mA, 130 Hz stimulation frequency and 60 µs pulse width, assuming 1 kΩ impedance), neuronal firing was sustained at a rate of 32.4%±3.3% (mean±SE), while with values>31.2 µJ/s, neurons fired at only 4.3%±1.2%.

Conclusions

Neuronal suppression is likely an important mechanism of action of therapeutically beneficial subthalamic DBS, which may underlie clinically relevant behavioural changes.
Ethnic variations in sexual partnerships and mixing, and their association with STI diagnosis: findings from a cross-sectional biobehavioural survey of attendees of sexual health clinics across England
Authors: Aicken Catherine RH , Wayal Sonali , Blomquist Paula , Fabiane Stella , Gerressu Makeda , Hughes Gwenda , Mercer Catherine H
Published: August 2019

Objectives

Ethnic differences in partnership types and sexual mixing patterns may contribute to elevated STI diagnosis rates among England’s Black Caribbean (BC) population. We examined the differences between BC and White British/Irish (WBI) sexual health clinic (SHC) attendees’ reported partnerships and sexual mixing, and whether these differences could explain ethnic inequalities in STI, focusing on attendees reporting only opposite-sex partners (past year).

Methods

We surveyed attendees at 16 SHCs across England (May to September 2016), and linked their survey responses to routinely collected data on diagnoses of bacterial STI or trichomoniasis ±6 weeks of clinic attendance (‘acute STI’). Behaviourally-heterosexual BC and WBI attendees (n=1790) reported details about their ≤3 most recent opposite-sex partners (past 3 months, n=2503). We compared BC and WBI attendees’ reported partnerships and mixing, in gender-stratified analyses, and used multivariable logistic regression to examine whether they independently explained differences in acute STI.

Results

We observed differences by ethnic group. BC women’s partnerships were more likely than WBI women’s partnerships to involve age-mixing (≥5 years age difference; 31.6% vs 25.5% partnerships, p=0.013); BC men’s partnerships were more often ‘uncommitted regular’ (35.4% vs 20.7%) and less often casual (38.5% vs 53.1%) than WBI men’s partnerships (p<0.001). Acute STI was higher among BC women than WBI women (OR: 2.29, 95% CI 1.24 to 4.21), with no difference among men. This difference was unaffected by partnerships and mixing: BC women compared with WBI women adjusted OR: 2.31 (95% CI 1.30 to 4.09) after adjusting for age and partner numbers; 2.15 (95% CI 1.07 to 4.31) after additionally adjusting for age-mixing, ethnic-mixing and recent partnership type(s).

Conclusion

We found that differences in sexual partnerships and mixing do not appear to explain elevated risk of acute STI diagnosis among behaviourally-heterosexual BC women SHC attendees, but this may reflect the measures used. Better characterisation of ‘high transmission networks’ is needed, to improve our understanding of influences beyond the individual level, as part of endeavours to reduce population-level STI transmission.
Influence of field technique, density, and sex on home range and overlap of the southern red-backed vole (Myodes gapperi)
Authors: Tisell Honora B. , Degrassi Allyson L. , Stephens Ryan B. , Rowe Rebecca J.
Published: August 2019

Home range is shaped by an individual’s interactions with the environment and conspecifics, and both size and placement may vary in response to population fluctuations. The method used to collect locational data may also affect home-range estimates. We examined the effect of density, sex, and field method on home range of southern red-backed voles (Myodes gapperi (Vigors, 1830)) inhabiting eastern hemlock (Tsuga canadensis (L.) Carrière) forests. Twelve mark–recapture grids were used to census M. gapperi from 2014 to 2017. In 2017, individuals were radio-collared. Home-range size, core-area size, and shared space were calculated using kernel density estimators from both mark–recapture and radiotelemetry data. Density effects on home range and core area were analyzed and differences between sex and field method were compared. We found (i) density did not affect home-range size, (ii) male home range was larger than female home range, (iii) females shared space more frequently and to a greater extent with males than other females, and (iv) home-range estimates were not significantly different between mark–recapture and radiotelemetry. Male home range, however, was larger under radiotelemetry and may reflect a truncation effect when mark–recapture grid size is smaller than male home range.
Statistical Significance
Authors: Cox D.R.
Published: August 2019

A broad review is given of the role of statistical significance tests in the analysis of empirical data. Four main types of application are outlined. The first, conceptually quite different from the others, concerns decision making in such contexts as medical screening and industrial inspection. The others assess the security of conclusions. The article concludes with an outline discussion of some more specialized points.
Impacts of Different Physical Parameterization Configurations on Widespread Heavy Rain Forecast over the Northern Area of Vietnam in WRF-ARW Model
Authors: Du Duc Tien , Hoang Duc Cuong , Hole Lars Robert , Hoang Lam , Luong Thi Thanh Huyen , Mai Khanh Hung
Published: August 2019

This study investigates the impacts of different physical parameterization schemes in the Weather Research and Forecasting model with the ARW dynamical core (WRF-ARW model) on the forecasts of heavy rainfall over the northern part of Vietnam (Bac Bo area). Various physical model configurations generated from different typical cumulus, shortwave radiation, and boundary layer and from simple to complex cloud microphysics schemes are examined and verified for the cases of extreme heavy rainfall during 2012–2016. It is found that the most skilled forecasts come from the Kain–Fritsch (KF) scheme. However, relating to the different causes of the heavy rainfall events, the forecast cycles using the Betts–Miller–Janjic (BMJ) scheme show better skills for tropical cyclones or slowly moving surface low-pressure system situations compared to KF scheme experiments. Most of the sensitivities to KF scheme experiments are related to boundary layer schemes. Both configurations using KF or BMJ schemes show that more complex cloud microphysics schemes can also improve the heavy rain forecast with the WRF-ARW model for the Bac Bo area of Vietnam.
Epidemiology of Plague: Problems with the Use of Mathematical Epidemiological Models in Plague Research and the Question of Transmission by Human Fleas and Lice
Authors: Benedictow Ole J.
Published: August 2019

This article addresses the recent use of mathematical epidemiological SIR or SEIR models in plague research. This use of S(E)IR models is highly problematic, but the problems are not presented and considered. Serious problems show in that such models are used to “prove” that historical plague was a (1) Filoviridae disease and (2) a bacterial disease caused by Yersinia pestis which was transmitted by human fleas and lice. (3) They also support early-phase transmission (by fleas). They purportedly consistently disprove (4) the conventional view that plague is/was a rat-and-rat-flea-borne disease. For these reasons, the focus is on methodological problems and on empirical testing by modern medical, entomological, and historical epidemiological data. An important or predominant vectorial role in plague epidemics for human fleas and lice requires that several necessary conditions are satisfied, which are generally not considered by advocates of the human ectoparasite hypothesis of plague transmission: (1) the prevalence and levels of human plague bacteraemia (human plague cases as sources of infection of feeding human ectoparasites); (2) the general size of blood meals ingested by human fleas and lice; (3) the consequent number of ingested plague bacteria; (4) the lethal dose of bacteria for 50% of a normal sample of infected human beings, LD50; and (5) efficient mechanism of transmission by lice and by fleas. The factual answers to these crucial questions can be ascertained and shown to invalidate the human ectoparasite hypothesis. The view of the standard works on plague has been corroborated, that bubonic plague, historical and modern, is/was a rat-and-rat-flea-borne disease caused by Yersinia pestis. These conclusions are concordant with and corroborate recent studies which, by laboratory experiments, invalidated the early-transmission hypothesis as a mechanism of transmission of LDs to humans in plague epidemics and removed this solution to the problem of transmission by human fleas.
Adenoid Cystic Carcinoma of the Bartholin’s Gland: A Diagnostic Dilemma
Authors: Lo Charmaine C. W. , Leow Jerome B. Y. , Naing K. , Jaaback Ken , Thachil Thanuja
Published: August 2019

Adenoid cystic carcinomas of the Bartholin’s gland are extremely rare and are often misdiagnosed. There are currently no definite treatment guidelines. This article describes the case of a 33-year-old female who was managed at our centre for adenoid cystic carcinoma of the Bartholin’s gland. She presented with a prolonged history of a vulvar lesion which was eventually diagnosed as adenoid cystic carcinoma of the Bartholin’s gland. She was subsequently treated with wide local excision of the primary and inguinal lymph node dissection followed by adjuvant radiotherapy and chemotherapy. She had gross perineural invasion on MRI imaging. The present case highlights the diagnostic dilemma in this extremely rare cancer and the literature further explores the natural history and treatment options.
Noninvasive Identification of Immune-Related Biomarkers in Hepatocellular Carcinoma
Authors: Li Ling , Zhao Huijia , Chen Binyao , Huang Kang , Hao Zhuowen , Fan Zhipeng , Sun Gongpeng , Wu Jianguo , Li Ning , Ye Qifa , Yue Jiang
Published: August 2019

Primary liver carcinoma is one of the most common malignant tumors with a poor prognosis. This study aims to uncover the potential mechanisms and identify core biomarkers of hepatocellular carcinoma (HCC). The HCC gene expression profile GSE49515 was chosen to analyze the differentially expressed genes from purified RNA of peripheral blood mononuclear cells, including 10 HCC patients and 10 normal individuals. GO and KEGG pathway analysis and PPI network were used, and the enrichment of the core genes out of 15 hub genes was evaluated using GEPIA and GSEA, respectively. We employed flow cytometry to count mononuclear cells to verify our opinions. In this analysis, 344 DEGs were captured, including 188 upregulated genes and 156 downregulated genes; besides that, 15 hub genes were identified. GO analysis and KEGG analysis showed the DEGs were particularly involved in immune response, antigen processing and presentation, and infection and inflammation. The PPI network uncovered 2 modules were also mainly involved in immune response. In conclusion, our analysis disclosed the immune subversion was the major signature of HCC associated closely with JUN, VEGFA, TNFSF10, and TLR4, which could be novel noninvasive biomarkers in peripheral blood and targets for early diagnosis and therapy of HCC.
Accounting for Tube Hematocrit in Modeling of Blood Flow in Cerebral Capillary Networks
Authors: Botkin Nikolai D. , Kovtanyuk Andrey E. , Turova Varvara L. , Sidorenko Irina N. , Lampe Renée
Published: August 2019

The aim of this paper consists in the derivation of an analytic formula for the hydraulic resistance of capillaries, taking into account the tube hematocrit level. The consistency of the derived formula is verified using Finite Element simulations. Such an effective formula allows for assigning resistances, depending on the hematocrit level, to the edges of networks modeling biological capillary systems, which extends our earlier models of blood flow through large capillary networks. Numerical simulations conducted for large capillary networks with random topologies demonstrate the importance of accounting for the hematocrit level for obtaining consistent results.
Molecular Characterization of a Multidrug-Resistant Klebsiella pneumoniae Strain R46 Isolated from a Rabbit
Authors: Wu Fei , Ying Yuanyuan , Yin Min , Jiang Yi , Wu Chongyang , Qian Changrui , Chen Qianqian , Shen Kai , Cheng Cong , Zhu Licheng , Li Kewei , Xu Teng , Bao Qiyu , Lu Junwan
Published: August 2019

To investigate the mechanisms of multiple resistance and the horizontal transfer of resistance genes in animal pathogens, we characterized the molecular structures of the resistance gene-related sequences in a multidrug-resistant Klebsiella pneumoniae strain R46 isolated from a rabbit. Molecular cloning was performed to clone the resistance genes, and minimum inhibitory concentrations (MICs) were measured to determine the resistance characteristics of the cloned genes and related strains. A conjugation experiment was conducted to assess the transferability of the resistance plasmids. Sequencing and comparative genomic methods were used to analyze the structures of the resistance gene-related sequences. The K. pneumoniae R46 genome consisted of a chromosome and three resistance plasmids named pR46-27, pR46-42, and pR46-270, respectively. The whole genome encoded 34 antibiotic resistance genes including a newly identified chromosome-encoded florfenicol resistance gene named mdfA2. pR46-270, besides encoding 26 antibiotic resistance genes, carried four clusters of heavy metal resistance genes and several virulence-related genes or gene clusters. The plasmid-encoded resistance genes were mostly associated with mobile genetic elements. The plasmid with the most similarity to the floR gene-harboring plasmid pR46-27 was pCTXM-2271, a plasmid from Escherichia coli. The results of this work demonstrated that the plasmids with multidrug resistance genes were present in animal-derived bacteria and more florfenicol resistance genes such as mdfA2 could be present in bacterial populations. The resistance genes encoded on the plasmids may spread between the bacteria of different species or genera and cause the resistance dissemination.
Study on the Effect of Ginsenosides Rb on Blood of Tumor Mice
Authors: Zheng Mengmeng , Zheng Wenxiu , Wang Wei , Guo Hong , Cao Hui , Cui Xiaowei , Wang Shanshan , Han Chunchao
Published: August 2019

Objective. The blood of cancer patients is in a state of hypercoagulability, easily leading to thrombosis. Anemia is also a complication of tumors. Anemia and thrombosis affect the treatment of tumor patients. Methods. Ginsenosides Rb were extracted from the stems and leaves of American ginseng using water-saturated ethanol and ethyl acetate in silica gel column. Tumor mice model was established by injecting H22 hepatocellular carcinoma cells into the axilla of mice. Mice were randomly divided into 6 groups: normal control group, model control group, positive control group, low dose group (7 mg/kg), middle dose group (14 mg/kg), and high dose group (35 mg/kg). After 18 days, the blood was obtained by picking the eyeball of mice. The levels of red blood cells (RBC), hemoglobin (HGB), neutrophils/lymphocytes radio (NLR), platelets (PLT), platelet distribution width (PDW), fibrinogen (FIB), and D-Dimer (D-D) were measured and compared in each group of mice. Results. The content of obtained ginsenosides Rb reached 90.05%. This extraction process was simple and reliable. Middle dose of ginsenosides Rb could significantly increase RBC and HGB levels (P<0.05). Moreover, ginsenosides Rb could significantly reduce NLR, PLT, PDW, FIB, and D-D (P<0.01). Conclusion. ginsenosides Rb could significantly improve anaemia and hypercoagulation of blood in cancer mice. Ginsenosides Rb are a potential anticoagulant and antianemia drug in treating cancer.