bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Social Interactive Learning through Dual Brain Stimulation
Authors: Pan Yafeng , Novembre Giacomo , Song Bei , Zhu Yi , Hu Yi
Published: September 2019

Social interactive learning denotes the ability to acquire new information from a conspecific – a prerequisite for cultural evolution and survival. As inspired by recent neurophysiological research, here we tested whether social interactive learning can be augmented by exogenously synchronizing oscillatory brain activity across an instructor and a learner engaged in a naturalistic song-learning task. We used a dual brain stimulation protocol entailing the trans-cranial delivery of synchronized electric currents in two individuals simultaneously. When we stimulated inferior frontal brain regions, with 6 Hz alternating currents being in-phase between the instructor and the learner, the dyad exhibited spontaneous and synchronized body movement. Remarkably, this stimulation also led to enhanced learning performance. A mediation analysis further disclosed that interpersonal movement synchrony acted as a partial mediator of the effect of dual brain stimulation on learning performance, i.e. possibly facilitating the effect of dual brain stimulation on learning. Our results provide a causal demonstration that inter-brain synchrony is a sufficient condition to improve real-time information transfer between pairs of individuals.

Significance

The study of social behavior, including but not limited to social learning, is undergoing a paradigm shift moving from single- to multi-person brain research. Yet, nearly all evidence in this area is purely correlational: inter-dependencies between brains’ signals are used to predict success in social behavior. For instance, inter-brain synchrony has been shown to be associated with successful communication, cooperation, and joint attention. Here we took a radically different approach. We stimulated two brains simultaneously, hence manipulating inter-brain synchrony, and measured the resulting effect upon behavior in the context of a social learning task. We report that frequency- and phase-specific dual brain stimulation can lead to the emergence of spontaneous synchronized body movement between an instructor and a learner. Remarkably, this can also augment learning performance.
MicroRNA-210 Knockout Alters Dendritic Density and Behavioural Flexibility
Authors: Watts Michelle , Williams Gabrielle , Lu Jing , Nithianantharajah Jess , Claudianos Charles
Published: September 2019

MicroRNAs exert post-transcriptional control over eukaryotic genomes and are integral for regulating complex functions in neurodevelopment, neuroplasticity and cognitive processing. The microRNA-210 (miR-210) is a highly-conserved, hypoxia-regulated miRNA that has been shown to be dysregulated in Alzheimer’s Disease. We have recently also identified a significant enrichment of neurodegenerative diseases among miR-210 targets within the human transcriptome. To further elucidate the role of miR-210 in neuronal function and cognitive behaviour, we utilised conditional miR-210 knockout mice to characterise miR-210 regulation and function in primary hippocampal neurons and measured visual discrimination and reversal learning using rodent touchscreen assays. We found that miR-210 expression was induced by neuronal activation and loss of neuronal miR-210 increased oxidative metabolism and ROS production as well as dendritic density and branchingin vitro. We also found that loss of miR-210 in knockout mice increased behavioural flexibility and reduced perseverative responding during reversal learning which required updating of information and feedback. These data support a conserved, activity-dependent role for miR-210 in cognitive function through modulation of neuronal metabolism.
Two distinct trophectoderm lineage stem cells from human pluripotent stem cells
Authors: Mischler Adam , Karakis Victoria , Mahinthakumar Jessica , Carberry Celeste , San Miguel Adriana , Rager Julia , Fry Rebecca , Rao Balaji M.
Published: September 2019

Trophoblasts are the principal cell type of the placenta. The use of human trophoblast stem cells (hTSCs) as a model for studies of early placental development is hampered by limited genetic diversity of existing hTSC lines, and constraints on using human fetal tissue or embryos needed to generate additional cell lines. Here we report the derivation of two distinct stem cells of the trophectoderm lineage from human pluripotent stem cells. The first is a CDX2- stem cell equivalent to primary hTSCs – they both exhibit identical expression of key markers, are maintained in culture and differentiate under similar conditions, and share high transcriptome similarity. The second is a CDX2+ putative human trophectoderm stem cell (hTESC) with distinct cell culture requirements and differences in gene expression and differentiation relative to hTSCs. Derivation of hTSCs and hTESCs from pluripotent stem cells significantly enables construction of models for normal and pathological placental development.
Assessing the utility of MAGNETO to control neuronal excitability in the somatosensory cortex
Authors: Kole Koen , Zhang Yiping , Jansen Eric J. R. , Brouns Terence , Bijlsma Ate , Calcini Niccolo , Yan Xuan , da Silva Lantyer Angelica , Celikel Tansu
Published: September 2019

Magnetic neuromodulation has outstanding promise for the development of novel neural interfaces without direct physical intervention with the brain. Here we tested the utility of Magneto in the adult somatosensory cortex by performing whole-cell intracellular recordings in vitro and extracellular recordings in freely moving mice. Results show that magnetic stimulation does not alter subthreshold membrane excitability or contribute to the generation of action potentials in virally transduced neurons expressing Magneto.
High content analysis of granuloma histology and neutrophilic inflammation in adult zebrafish infected with Mycobacterium marinum
Authors: Cheng Tina , Kam Julia Y , Johansen Matt D , Oehlers Stefan H
Published: September 2019

Infection of zebrafish with natural pathogen Mycobacterium marinum is a useful surrogate for studying the human granulomatous inflammatory response to infection by Mycobacterium tuberculosis. The adaptive immune system of the adult stage zebrafish offers an advance on the commonly used embryo infection model as adult zebrafish form granulomas with striking similarities to human-M. tuberculosis granulomas. Here, we present workflows to perform high content analyses of granulomas in adult zebrafish infected with M. marinum by cryosectioning to take advantage of strong endogenous transgenic fluorescence adapted from common zebrafish embryo infection tools. Specific guides to classifying granuloma necrosis and organisation, quantifying bacterial burden and leukocyte infiltration of granulomas, and visualizing extracellular matrix remodelling and foam cell formation are also provided. We use these methods to characterize neutrophil recruitment to M. marinum granulomas across time and find an inverse relation to granuloma necrosis suggesting granuloma necrosis is not a marker of immunopathology in the natural infection system of the adult zebrafish-M. marinum pairing. The methods can be easily translated to studying the zebrafish adaptive immune response to other chronic and granuloma-forming pathogens.
Quantifying the tradeoff between sequencing depth and cell number in single-cell RNA-seq
Authors: Svensson Valentine , da Veiga Beltrame Eduardo , Pachter Lior
Published: September 2019

The allocation of a sequencing budget when designing single cell RNA-seq experiments requires consideration of the tradeoff between number of cells sequenced and the read depth per cell. One approach to the problem is to perform a power analysis for a univariate objective such as differential expression. However, many of the goals of single-cell analysis requires consideration of the multivariate structure of gene expression, such as clustering. We introduce an approach to quantifying the impact of sequencing depth and cell number on the estimation of a multivariate generative model for gene expression that is based on error analysis in the framework of a variational autoencoder. We find that at shallow depths, the marginal benefit of deeper sequencing per cell significantly outweighs the benefit of increased cell numbers. Above about 15,000 reads per cell the benefit of increased sequencing depth is minor. Code for the workflow reproducing the results of the paper is available at https://github.com/pachterlab/SBP_2019/.
Embryonic expression patterns of panarthropod Teneurin-m/odd Oz genes suggest a possible function in segmentation
Authors: Janssen Ralf
Published: September 2019

Background

A hallmark of arthropods is their segmented body, and the so-called Drosophila segmentation gene cascade that controls this process serves as one of the best-studied gene regulatory networks. An important group of segmentation genes is represented by the pair-rule genes (PRGs). One of these genes was thought to be the type-II transmembrane protein encoding gene Tenascin-m (Ten-m (aka odd Oz)). Ten-m, however, does not have a pair-rule function in Drosophila, despite its characteristic PRG-like expression pattern. A recent study in the beetle Tribolium castaneum showed that its Ten-m gene is not expressed like a segmentation gene, and hence is very unlikely to have a function in segmentation.

Results

In this study, I present data from a range of arthropods covering the arthropod tree of life, and an onychophoran, representing a closely related group of segmented animals. At least one ortholog of Ten-m/odz in each of these species is expressed in the form of transverse segmental stripes in the ectoderm of forming and newly formed segments – a characteristic of genes involved in segmentation.

Conclusions

The new expression data support the idea that Ten-m orthologs after all may be involved in panarthropod segmentation.
The impact of the Greek economic recession on workplace learning
Authors: Papakonstantinidis Stavros
Published: September 2019

Purpose

The paper aims to examine the impact of the Greek economic recession on workplace learning. Specifically, it surveys the views of Greek business professionals regarding whether workplace learning could be used as a competitive advantage in achieving business success.

Design/methodology/approach

The paper follows a qualitative research method and discusses the findings of semi-structured interviews with professionals in various industries in Greece.

Findings

This study provides evidence of an overall reluctance to adopt formal learning strategies. Although hiring and retaining the best talent at work is seen as a competitive advantage, Greek professionals do not attribute success to formal workplace learning. Instead, digitalization of informal learning becomes essential for acquiring new knowledge.

Social implications

In the first few years of Greece’s economic recovery, companies aim to keep their budgets low in anything that seems luxurious and ultimately unnecessary. The paper discusses some implications of the implementation of digitalized informal learning in business.

Originality/value

This study is the first to explore how Greek professionals from various business sectors and managerial levels view workplace learning during the initial years of the country’s economic recovery.
Effect of Carcass Chilling on the Palatability Traits and Safety of Fresh Red Meat
Authors: Zhang Yimin , Mao Yanwei , Li Ke , Luo Xin , Hopkins David L.
Published: September 2019

Chilling procedures have been widely used in livestock abattoirs since the development of refrigeration systems. The major criteria when applying chilling regimes is not only complying with regulations, but economic concerns, and also meat safety and quality assurance requirements. Given recent developments, an updated review is required to guide the industry to choose the best chilling method and to inspire the development of new approaches to chilling. Thus in this paper, the quality and microbial safety of beef, lamb, pork, venison, and bison resulting from different chilling treatments has been reviewed, as well as the underlying mechanism(s) for the different impacts on meat quality traits as a result of different chilling regimes. The effect of fast chilling on the tenderness of beef and lamb is a focus, as some new findings, have recently been reported, while multistep chilling is highlighted as it incorporates the advantages of fast chilling to reduce carcass weight loss, resulting in similar quality improvements as found with slow chilling. It is, suggested, that if spray chilling can be combined with the second phase of multi‐step chilling, it will benefit the meat industry in terms of both meat quality and safety. Future studies should focus on combinations of chilling methods with new technologies, such as medium voltage electrical stimulation, muscle stretching, or ultrasound and so on, to move meat quality and safety to a new level.
Using Regulatory Sandboxes to Support Responsible Innovation in the Humanitarian Sector
Authors: Martin Aaron , Balestra Giulia
Published: September 2019

The global regulatory community continues to explore new approaches to supervising innovation. Among these, so‐called ‘regulatory sandboxes’ are proving to be particularly appealing to the financial sector as it seeks to promote technological and data‐driven innovation. These ‘playgrounds’ for innovation are also spreading to other regulated sectors such as telecommunications, data protection, energy, and environmental protection, allowing participants to test new business models and technologies under the supervision of regulators while the applicable rules are temporarily relaxed. Regulators can provide targeted guidance to sandbox participants, including help with understanding how an innovation fits within the existing regulatory framework. As of July 2019, at least 50 sandboxes were either in operation or under consideration globally. Significantly, many of these are based in countries that host large numbers of displaced persons. This commentary explores the potential role for sandboxes in promoting responsible humanitarian innovation. Through a review of the literature, we discuss the stated benefits of the sandbox approach while also acknowledging notable risks and challenges to their sustained deployment. We then reflect on how the humanitarian sector might engage regulators and other stakeholders through sandboxes to develop and catalyze innovations that better serve those affected by humanitarian crises, including the displaced.
Measuring fidelity to behavioural support delivery for smoking cessation and its association with outcomes
Authors: Dogar Omara , Boehnke Jan R. , Lorencatto Fabiana , Sheldon Trevor A. , Siddiqi Kamran
Published: September 2019

Background and aims

Behavioural support increases smoking cessation in clinical settings, but effect sizes differ among providers, due possibly to variations in delivery. This study evaluates a measure (‘fidelity index’) intended to capture fidelity to delivery of content‐ and interaction‐based items of a behavioural support (BS) for smoking cessation and the association of fidelity with quit rates.

Methods

A fidelity index for scoring the adherence and quality domains of a specific BS intervention, ‘5As for quit’, was developed by classifying the intervention components using the taxonomy of behaviour change techniques. The index was applied to code 154 BS sessions audiotaped among 18 chest clinics in Pakistan to assess their fidelity and explore reliability of coding. The association between intervention fidelity and successful quit achieved by the same providers in a previous study was explored using regression analysis.

Results

The index represented two domains: adherence to delivery of content‐based activities of 5As (37 items) and quality of interaction‐based activities (eight items). The intercoder reliability was good for content‐based (average Krippendorff's α = 0.80) and moderate for interaction‐based (average Krippendorff's α = 0.66) items. Approximately 70% (intraclass correlation coefficient: adherence scores = 0.72, quality scores = 0.71) of variation in BS delivery was contributed by providers, which increased to 97% (g‐coefficient: adherence scores = 0.973, quality scores = 0.974) after accounting for other sources of variation. Higher quit rates were positively associated with average quality scores [risk ratio = 2.15; 95% confidence interval (CI) = 1.43–3.24], but negatively associated with average adherence scores (risk ratio = 0.55; 95% CI = 0.40–0.77) within services.

Conclusions

The fidelity index is a reliable measure for quantifying intervention fidelity of delivering smoking cessation behavioural support. Recommended revisions of the fidelity index include incorporation of additional interaction‐based items, such as the relational techniques used in motivational interviewing.
Partnering with people with dementia and their care partners, aged care service experts, policymakers and academics: A co‐design process
Authors: Goeman Dianne P. , Corlis Megan , Swaffer Kate , Jenner Valerie , Thompson Jennifer F. , Renehan Emma , Koch Susan
Published: September 2019

Objective

To describe the co‐design process in a project that “evaluated how the key worker role can best support people living with dementia in the community setting.”

Methods

People with dementia, care‐partners, aged‐care service experts, policymakers and academics utilised a co‐design process to undertake a systematic literature review and a qualitative evaluation study.

Results

The development of a successful co‐design process that includes people living with dementia and their care‐partners (“consumers”) at all stages of the research process and addresses their individual needs.

Conclusions

The co‐design approach utilised in this project provided support, for consumers living in the community to be fully involved in the research design, conduct and plans for dissemination and implementation of the findings. Consequently, the research outcomes are based on solid evidence and consumer need. Additionally, a successful model for supporting consumers to facilitate their involvement in all aspects of the research process, was developed.
How do people with dementia and family carers value dementia‐specific quality of life states? An explorative “Think Aloud” study
Authors: Ratcliffe Julie , Hutchinson Claire , Milte Rachel , Nguyen Kim‐Huong , Welch Alyssa , Caporale Tessa , Corlis Megan , Comans Tracy
Published: September 2019

Objective

To investigate the decision‐making processes applied by people with dementia and family carers participating in using health economic approaches to value dementia‐specific quality of life states.

Methods

People with dementia (n = 13) and family carers (n = 14) participated in valuing quality of life states using two health economic approaches: Discrete Choice Experiment (DCE) and Best Worst Scaling (BWS). Participants were encouraged to explain their reasoning using a “Think Aloud” approach.

Results

People with dementia and family carers adopted a range of decision‐making strategies including “anchoring” the presented states against current quality of life, or simplifying the decision‐making by focusing on the sub‐set of attributes deemed most important. Overall, there was strong evidence of task engagement for BWS and DCE.

Conclusions

Health economic valuation approaches can be successfully applied with people with dementia and family carers. These data can inform the assessment of benefits from their perspectives for incorporation within economic evaluation.
Putting the consumer in the driver's seat: A visual journey through the Australian health‐care system as experienced by people living with dementia and their carers
Authors: Fitzgerald Janna Anneke , Curry Joanne , Olde Meierink Angelique , Cully Ashley
Published: September 2019

Objective

To better understand the individual journeys of people living with dementia and their carers through the Australian health‐care system.

Methods

Stories were collected from 25 participants, through five face‐to‐face workshops, across Australia. This produced 18 visual storyboards and a range of opportunities for improvement, which were then synthesised into an aggregated “ideal‐journey” model.

Results

Several issues were identified: long lead times to diagnosis; diverse experiences of treatment and support; and little coordination of care or thought for its impact on the consumer. Information about services, their purpose and eligibility criteria was difficult to obtain, and potential care pathways were largely unexplained. Much of the carer support received was reactive rather than proactive.

Conclusions

A better understanding of the current health‐care pathway of dementia is essential for the design and delivery of future health‐care services. It is vital to include the consumer voice in future research and allocation of health‐care resources.
Short‐term repeatability of electrocardiographic criteria of left ventricular hypertrophy
Authors: Meyer Michelle L. , Soliman Elsayed Z. , Drager Dominique , Heiss Gerardo
Published: September 2019

Background

Left ventricular hypertrophy (LVH) is a marker of cardiac end‐organ damage and a risk factor for cardiovascular morbidity and mortality. Although clinical trials and cohort studies commonly use the electrocardiogram (ECG) for LVH assessment, the repeatability of ECG‐LVH criteria has not been sufficiently examined. Therefore, we evaluated the repeatability of ECG‐LVH criteria.

Methods

Participants (n = 63) underwent two standard ECGs at each of two visits, two weeks apart. The ECGs were processed centrally to calculate Cornell voltage (CV) LVH, Cornell voltage product (CVP) LVH, Sokolow–Lyon (SL) LVH, and Sokolow–Lyon product (SLP) LVH. We also used the waveforms measurements contributing to these LVH criteria as continuous variables, referred to here as CV‐index, CVP‐index, and SL‐index. We calculated the intraclass correlation coefficient (ICC), minimal detectable change (95% confidence), and the prevalence‐adjusted bias‐adjusted kappa (PABAK).

Results

ICCs (95% confidence intervals (CI)) were 0.97 (0.96, 0.98) for CV‐index, 0.97 (0.95, 0.98) for CVP‐index, and 0.93 (0.90, 0.96) for log of SL‐index. Minimal detectable change between repeat measures of CV‐index, CVP‐index, and log of SL‐index were ≥236.7 mV, ≥26.7 mV, and ≥0.09 mV, respectively. The within‐visit PABAK was 1 for all ECG‐LVH criteria, except for the first visit SLP‐LVH (PABAK = 0.93). Between‐visit PABAK ranged from 0.83 to 0.97 across LVH criteria.

Conclusions

CV, CVP, and SL ECG‐LVH as continuous variables have excellent repeatability, and as binary variables have excellent within‐visit agreement and good between‐visit agreement. These results alleviate concerns about the repeatability the ECG‐LVH use in clinical trials and epidemiologic studies.
Wellens’ syndrome and finding of multiple coronary cameral fistulae: Is it time to discard this term?
Authors: Ibarrola Martin
Published: September 2019

Wellens’ syndrome refers to electrocardiographic (ECG) abnormalities in the precordial T‐wave segment, which are associated with critical stenosis of the proximal left anterior descending (LAD) coronary artery. According to medical literature, this ECG abnormality is of paramount importance because this syndrome represents a preinfarction stage of coronary artery disease; however, same ECG pattern can also be seen in other conditions. Coronary fistula occurs due to anomalous communications between a coronary artery and a cardiac chamber or other vessel in the vicinity of the heart. We report a case of multiple coronary artery fistulae to the left ventricle in a 74‐year‐old woman who had a 2‐year history of intermittent atypical chest pain and exercise dyspnea with positive criteria mimicking Wellens’ syndrome without coronary atherosclerosis.
Correlation properties of heart rate variability during endurance exercise: A systematic review
Authors: Gronwald Thomas , Hoos Olaf
Published: September 2019

Background

Non‐linear measures of heart rate variability (HRV) may provide new opportunities to monitor cardiac autonomic regulation during exercise. In healthy individuals, the HRV signal is mainly composed of quasi‐periodic oscillations, but it also possesses random fluctuations and so‐called fractal structures. One widely applied approach to investigate fractal correlation properties of heart rate (HR) time series is the detrended fluctuation analysis (DFA). DFA is a non‐linear method to quantify the fractal scale and the degree of correlation of a time series. Regarding the HRV analysis, it should be noted that the short‐term scaling exponent alpha1 of DFA has been used not only to assess cardiovascular risk but also to assess prognosis and predict mortality in clinical settings. It has also been proven to be useful for application in exercise settings including higher exercise intensities, non‐stationary data segments, and relatively short recording times.

Method

Therefore, the purpose of this systematic review was to analyze studies that investigated the effects of acute dynamic endurance exercise on DFA‐alpha1 as a proxy of correlation properties in the HR time series.

Results

The initial search identified 442 articles (351 in PubMed, 91 in Scopus), of which 11 met all inclusion criteria.

Conclusions

The included studies show that DFA‐alpha1 of HRV is suitable for distinguishing between different organismic demands during endurance exercise and may prove helpful to monitor responses to different exercise intensities, movement frequencies, and exercise durations. Additionally, non‐linear DFA of HRV is a suitable analytical approach, providing a differentiated and qualitative view of exercise physiology.
Clinically significant incidental QTc prolongation is subject to within‐individual variability
Authors: Gueta Itai , Klempfner Robert , Markovits Noa , Halkin Hillel , Segev Shlomo , Rott David , Peled Yael , Loebstein Ronen
Published: September 2019

Background

Prolonged QTc interval observed in daily practice is often deemed to be drug induced and might result in drug discontinuation, with possible therapeutic consequences. However, whether clinically significant prolonged QTc may be due to within‐individual variability occurs has yet to be described.

Methods

A retrospective cohort study documenting within‐individual QTc variability in subjects attending annual routine medical evaluation. At each visit, QT interval was measured and corrected for heart rate using Bazett and three other commonly used formulae. Outcome measures were rates of ΔQTc ≥60 msec, absolute QTc ≥500 msec and QTc ≥25% from baseline.

Results

A total of 188 subjects [54 (29%)] females were recruited. Mean age at first ECG was 54 ± 12.8 years with mean time interval of 12.2 ± 1.1 months between measurements. Mean Bazett QTc was higher compared to the other 3 formulae: 412 ± 20 vs. 400 ± 16 msec. Using Bazett formula, 18/188 (9.6%) and 5/188 (2.7%) subjects showed at least one measurement with ΔQTc ≥60 msec and QTc ≥500 msec, respectively. Of the former, 5/18 (27.8%) showed QTc ≥25% prolongation. In multivariate analysis, QTc ≥500 msec was significantly associated with number of measurements (HR: 5.01, 95%CI: 1.21–20.78, p = .026) with no effect of other known confounders. Lower rates were demonstrated with the other three formulae.

Conclusion

In clinical practice, significant prolonged QTc may be attributed to within‐individual variability, particularly when adjusting the QT interval with Bazett correction. This should be taken into consideration when decisions on changing current drug regimens are to be made.
Ten‐year evolution of a massive transfusion protocol in a level 1 trauma centre: have outcomes improved?
Authors: van der Meij Jessica E. , Geeraedts Jr Leo M. G. , Kamphuis Saskia J. M. , Kumar Nimmi , Greenfield Tony , Tweeddale Geoff , Rosenfeld David , D'Amours Scott K.
Published: September 2019

Background

We aimed to evaluate the evolution and implementation of the massive transfusion protocol (MTP) in an urban level 1 trauma centre. Most data on this topic comes from trauma centres with high exposure to life‐threatening haemorrhage. This study examines the effect of the introduction of an MTP in an Australian level 1 trauma centre.

Methods

A retrospective study of prospectively collected data was performed over a 14‐year period. Three groups of trauma patients, who received more than 10 units of packed red blood cells (PRBC), were compared: a pre‐MTP group (2002–2006), an MTP‐I group (2006–2010) and an MTP‐II group (2010–2016) when the protocol was updated. Key outcomes were mortality, complications and number of blood products transfused.

Results

A total of 168 patients were included: 54 pre‐MTP patients were compared to 47 MTP‐I and 67 MTP‐II patients. In the MTP‐II group, fewer units of PRBC and platelets were administered within the first 24 h: 17 versus 14 (P = 0.01) and 12 versus 8 (P < 0.001), respectively. Less infections were noted in the MTP‐I group: 51.9% versus 31.9% (P = 0.04). No significant differences were found regarding mortality, ventilator days, intensive care unit and total hospital lengths of stay.

Conclusion

Introduction of an MTP‐II in our level 1 civilian trauma centre significantly reduced the amount of PRBC and platelets used during damage control resuscitation. Introduction of the MTP did not directly impact survival or the incidence of complications. Nevertheless, this study reflects the complexity of real‐life medical care in a level 1 civilian trauma centre.
Clinicopathological factors associated with positive circumferential margins in rectal cancers
Authors: Pasch James A. , MacDermid Ewan , Pasch Lachlan B. , Premaratne Chatika , Fok Kar Yin , Kotecha Krishna , El Khoury Toufic , Barto Walid
Published: September 2019

Background

Positive circumferential resections are associated with local disease recurrence and reduced survival in rectal cancer. We studied a cohort of consecutive rectal cancer resections to assess for clinicopathological differences and survival in patients with positive and negative circumferential margins.

Methods

Rectal cancers were identified from a retrospective histopathology database of colorectal resections performed at five western Sydney hospitals from 2010 to 2016. Univariate and multivariate analysis with binary logistic regression were performed on histopathology data matched with survival times from the New South Wales Registry of Births Deaths and Marriages.

Results

A total of 502 rectal cancer patients were identified including 66 (13.1%) with involved circumferential margins. Patients with positive and negative circumferential margins had a similar distribution of age, gender and use of neoadjuvant radiotherapy. Tumours with involved circumferential margin comprised 98.5% T3 and T4 disease of which 51.5% received neoadjuvant radiotherapy. These were significantly associated with metastatic disease, increasing tumour size, circumferential and perforated tumours on univariate analysis. Multivariate analysis identified abdomino‐perineal resection (odds ratio (OR) 3.35; P = 0.003), en‐bloc multivisceral resection (OR 2.56; P = 0.032), T4 stage (OR 6.99; P < 0.001), perineural (OR 5.61; P < 0.001) and vascular invasion (OR 2.46; P = 0.022) as independent risk factors. Five‐year survival was significantly worse for patients with involved circumferential margins (26% versus 69%; P < 0.001).

Conclusion

Circumferential margin status reflects not only technical success but also aggressive disease phenotypes which require adjuvant therapy. Further work is needed to determine whether omission of radiotherapy has had an effect on long‐term outcomes in some of our at‐risk patients.
How I manage severe von Willebrand disease
Authors: Leebeek Frank W. G. , Atiq Ferdows
Published: September 2019

Von Willebrand disease (VWD) is the most common inherited bleeding disorder. Most patients with mild and moderate VWD can be treated effectively with desmopressin. The management of severe VWD patients, mostly affected by type 2 and type 3 disease, can be challenging. In this article we review the current diagnosis and treatment of severe VWD patients. We will also discuss the management of severe VWD patients in specific situations, such as pregnancy, delivery, patients developing alloantibodies against von Willebrand factor and VWD patients with recurrent gastrointestinal bleeding. Moreover, we review emerging treatments that may be applied in future management of patients with severe VWD.
Long non‐coding RNA MYOSLID functions as a competing endogenous RNA to regulate MCL‐1 expression by sponging miR‐29c‐3p in gastric cancer
Authors: Han Yuying , Wu Nan , Jiang Mingzuo , Chu Yi , Wang Zhiyang , Liu Hao , Cao Jiayi , Liu Hanming , Xu Bing , Xie Xin
Published: September 2019

Objective

Long non‐coding RNA (lncRNA) has become an important regulator of many human malignancies. However, the biological role and clinical significance of most lncRNA in gastric cancer (GC) remain unclear.

Methods

We investigate the biological function, mechanism of action and clinical expression of lncRNA MYOSLID in GC. First, we analysed the differential expression of lncRNA MYOSLID in GC tissues and non‐cancerous tissues by analysing the sequencing data obtained from The Cancer Genome Atlas. Subsequently, we verified that lncRNA MYOSLID regulates the proliferation and apoptosis of GC cells by acting as a ceRNA against miR‐29c‐3p. The nude mouse xenograft was used to further confirm the functional significance of lncRNA MYOSLID in vivo.

Results

We found for the first time that the expression of lncRNA MYOSLID was significantly up‐regulated in GC tissues, and the up‐regulation of lncRNA MYOSLID in GC was correlated with tumour size, AJCC stage, depth of invasion and survival time. In addition, apoptosis and growth arrest can be induced in vitro after knockdown of lncRNA MYOSLID, which inhibits tumorigenesis in mouse xenografts in vivo. Further in‐depth studies revealed that lncRNA MYOSLID acts as a ceRNA of miR‐29c‐3p, resulting in de‐repression of its downstream target gene MCL‐1.

Conclusion

The lncRNA MYOSLID‐miR‐29c‐3p‐MCL‐1 axis plays a key role in the development of GC. Our findings may provide potential new targets for the diagnosis and treatment of human GC.
When qualitative data contradict quantitative data: diabetes distress in the Chinese‐Canadian community
Authors: Xia A. , Yau K. W. , Tang T. S.
Published: September 2019

Aims

To use both quantitative and qualitative approaches to characterize the diabetes distress profile of Chinese‐Canadians with Type 2 diabetes and to better understand their experience of living with diabetes.

Methods

We recruited 40 Chinese‐Canadian adults with Type 2 diabetes who completed a Mandarin‐ or Cantonese‐language diabetes education programme in Richmond, British Columbia. Using a mixed‐methods sequential explanatory research design, participants first completed a 15‐item Chinese version of the Diabetes Distress Scale, which included three subscales: emotional burden, regimen‐related distress, and physician distress. The self‐report survey was followed by a semi‐structured interview that addressed the following diabetes‐related topics: perspectives towards the healthcare team, emotional health, diabetes‐related concerns and stressors, diabetes diagnosis experience, and sources of social support and diabetes education.

Results

The mean (sd) scores for total distress 1.5 (0.5), emotional burden 1.7 (0.7), regimen‐related distress 1.4 (0.5), and physician distress 1.4 (0.9), fell within the ‘low distress’ range (< 2.0). Qualitative analysis of semi‐structured interviews showed that some participants were dissatisfied with diabetes care providers and experienced emotional challenges, particularly early in their diagnosis. Other themes that emerged included eating distress, fear of complications, language barriers, and medication concerns.

Conclusions

Not only did the qualitative findings from semi‐structured interviews capture aspects of diabetes distress that were not included in the quantitative survey, it also uncovered inconsistencies between the two datasets. To more accurately understand the diabetes distress experience of any ethnic community, both quantitative and qualitative approaches contribute unique value.
Does market power discipline CEO power? An agency perspective
Authors: Jaroenjitrkam Anutchanat , Yu Chia‐Feng (Jeffrey) , Zurbruegg Ralf
Published: September 2019

We examine how product market competition (PMC) shapes chief executive officer's (CEO) power. Using various measures to capture both PMC and CEO power, our analyses, which include a quasi‐natural experiment, find evidence that CEOs have less power when the product market is more competitive. Furthermore, the impact of PMC on CEO power is more pronounced for firms with entrenched management, lower CEO ownership, lower analyst coverage, and for firms experiencing good ‘luck’ (windfall performance). Our results suggest that market power can act as a substitute for corporate governance in disciplining CEO power, particularly when prone to agency problems.
Feedback in Couple and Family Therapy: A Randomized Clinical Trial
Authors: Tilden Terje , Wampold Bruce E. , Ulvenes Pål , Zahl‐Olsen Rune , Hoffart Asle , Barstad Bente , Olsen Iris A. , Gude Tore , Pinsof William M. , Zinbarg Richard E. , Nilssen Harald H. , Håland Åshild T.
Published: September 2019

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC (“treatment as usual” or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed.
Formation of large carbonate concretions in black cherts in the Gufeng Formation (Guadalupian) at Enshi, South China
Authors: Wei Hengye , Tang Zhanwen , Qiu Zhen , Yan Detian , Bai Maquzong
Published: September 2019

The formation of carbonate concretions is a cementation process which passively infills the pore spaces within sediments. They record the original environments of deposition and diagenetic conditions of the host rocks. Little is known about the precise mechanisms responsible for the precipitation of carbonate concretions. The most common host rocks are mudstones/shales, sandstones, and limestones. This study presents an example of large carbonate concretions from an unusual host rock, the black bedded cherts of the Gufeng Formation (Guadalupian) at Enshi on the northern Yangtze Platform, South China. Petrographic observations (X‐ray diffraction, optical microscopy, scanning electron microscopy) and multiple geochemical analyses (pyrite‐ and carbonate‐associated‐sulfate (CAS)‐sulfur isotopes, carbon isotopes) indicate that (a) the studied carbonate concretion are mainly composed of micritic calcite with subordinate dolomite; (b) the concretions may have been mainly formed in the bacterial sulfate reduction (BSR) zone during very early diagenesis near the sediment–water surface; (c) the paleo‐bottom water overlying the sediments during formation of the concretions was mainly euxinic; and (d) the growth of the studied concretions proceeded via a pervasive model, where later cementation phase initiated in the lower part of the concretions and progressed upward.
Imbalanced sex ratios and housing prices in the U.S.
Authors: Kuroki Masanori
Published: September 2019

This paper investigates whether imbalanced local sex ratios are associated with housing prices in the U.S. at the county level during the period 2000–2017, based on the hypothesis that the importance for men of advertising financial resources by spending more on housing increases in the marriage market where there is a scarcity of women. The results indicate that an increase of 0.1 in sex ratio is associated with approximately a 2% increase in housing prices, suggesting that men may allocate more resources toward mating effort by increasing their spending on housing when there is an abundance of men. There is little evidence that the positive association was greater during the housing bubble.
Hypnic Headache Due to Hypoglycemia: A Case Report
Authors: Silva‐Néto Raimundo Pereira , Soares Adriana Almeida , Peres Mário Fernando Prieto
Published: September 2019

Hypnic headache (HH) is a rare primary headache disorder and pathophysiology is still poorly understood. It is considered a chronobiological disorder in almost all published cases. Few secondary cases have been described so far. We report a case of a 64‐year‐old woman presenting headaches exclusively during sleep and fulfilling the diagnostic criteria for HH, but a 72‐hour glucose monitoring showed hypoglycemia episodes related to the onset of headaches. To our knowledge, this is the first report of symptomatic HHs associated with hypoglycemia and it suggests direct evidence of HH due to a metabolic disorder.
Caries incidence and risk assessment during a five‐year period in adolescents living in south‐eastern Sweden
Authors: Karlsson Frida , Stensson Malin , Jansson Henrik
Published: September 2019

Objectives

The aim was to examine the caries incidence in adolescents using the Public Dental Service (PDS) during a 5‐year period in relation to their caries experience at baseline and risk classification.

Methods

A 5‐year retrospective cohort study based of the dental records from 17 PDS clinics in south‐eastern Sweden was conducted; 159 individuals born in 1997 were included, and their caries risk was classified at 12 and 17 years of age. Caries prevalence and documented risk groups were assessed at baseline and after 5 years.

Results

The increment of caries (both initial and manifest caries) was higher, to a statistically significant degree, after 5 years in adolescents who were recorded as caries‐free at baseline compared to individuals with caries at baseline (P < .001). In individuals with caries at baseline, the greatest increment of caries was found at approximal sites (P < .001). At baseline, individuals were classified as low (94%), medium (6%) and high risk (0%). After 5 years, the figures were 74%, 20% and 6%, respectively. Although classified in a low‐caries risk group, 9% had ≥6 decayed or filled surfaces at baseline, and 23% did after 5 years. Approximately 62% of individuals were registered as caries‐free at baseline, and 45% were after 5 years.

Conclusions

There was an increase in caries over 5 years, especially among adolescents without caries experience at baseline. The majority of adolescents had the same risk classification after 5 years. Further research with a larger sample size is needed to evaluate risk assessment for caries.
The effect of microwave heating on the microstructure and the mechanical properties of reaction‐bonded boron carbide
Authors: Dutto Mathieu , Goeuriot Dominique , Saunier Sébastien , Sao‐Joao Sergio , Marinel Sylvain , Frage Nachum , Hayun Shmuel
Published: September 2019

Reaction‐bonded boron carbide composites were fabricated by both microwave (under Ar/10% H2) and conventional heating (under vacuum or Ar/10% H2). Silicon carbide (SiC) formation occurred in all cases and was slightly favored in the case of microwave heating under Ar/H2. The resulting microstructures were influenced by the heating process and atmosphere; the SiC existed in the form of needles with conventional heating under vacuum. SiC small polygonal grains were present after microwave heating under Ar/H2. Both the atmosphere and the electromagnetic field influence the SiC morphology. Despite this difference, the hardness and toughness of composites obtained by both heating techniques were similar.
Do surgical patients' characteristics and behaviours affect nurses' pain management decisions? A qualitative inquiry
Authors: Shoqirat Noordeen , Mahasneh Deema , Singh Charleen , Al Hadid Lourance
Published: September 2019

Background

Despite a growing body of literature investigating the impact of patients' age and sex differences on pain, there is little research on how patients' characteristics and behaviours affect nurses' pain management decisions.

Aim

This study examined surgical nurses' views and experiences toward pain management in relation to the patients' characteristics and behaviours in a Jordanian university hospital.

Methods

Focus group discussions (n = 4) were used with a convenience sample of 27 female Registered Nurses.

Results

The study revealed differences in postoperative pain management related to patients' characteristics. Male patients were seen as more tolerant of postoperative pain than female patients and thus required less nursing attention. As a consequence, nurses might assess female surgical patients inaccurately or judgementally. Nurses label female patients as “demanding” or “over‐sensitive” without intending to be judgemental. Nurses also reported that patients accompanied by relatives received quicker nursing responses and closer monitoring than unaccompanied patients.

Conclusions

If patients' pain following surgery is to be treated effectively, health care policymakers and educators should work together to eliminate and prevent potential biases that might lead to disparities in pain management.
Safety attitudes, perceived organizational culture and knowledge of the physiologically deteriorating patient among mental health nurses: Cross‐sectional, correlational study
Authors: Dickens Geoffrey L. , Salamonson Yenna , Ramjan Lucie , Steel Kelly , Everett Bronwyn
Published: September 2019

Mental health nurses have traditionally lagged in terms of physical healthcare skills and have been found to have poorer cultural safety‐related attitudes relative to other nurses. Organizational culture, including safety‐related culture, is associated with important aspects of care quality. The aim of the current study was to examine the relationships between safety‐related attitudes, physical healthcare‐related knowledge and organizational culture among mental health nurses. By doing so, the intention was to inform decisions about interventions to improve attitudes and care related to severe physiological deterioration among mental health nurses. The study design was cross‐sectional and correlational. The safety‐related attitudes of N = 133 nurses from the inpatient mental health services of one Local Health District in New South Wales, Australia, were examined in terms of a range of potential predictor variables of safety attitudes (Safety Attitudes Questionnaire) including individual organizational‐perceiver type (Organisational Climate Assessment Inventory), knowledge of emergency medical healthcare (Lambeth In situ Training Questionnaire), use and perception of medical emergency teams (purpose‐designed questionnaire) and a range of demographic variables. Regression analyses revealed that those who perceived the organization to have a primarily market‐oriented culture had poorer safety‐related attitudes than those who perceived a more clan‐type culture. Number of years qualified was negatively associated with safety attitudes. To our knowledge, this is the first study in mental health which demonstrates a link between organizational culture‐perception and safety attitudes related to physical healthcare. Results suggest that, among nurses, individuals have quite different perceptions of the organizational culture. In turn, this suggests that the ‘one‐size fits all’ approach to changing organizational culture may be inappropriate.