bluuebunny/crossref_metadata_2025 huggingface dataset:
Do academic motivation and personality influence which students benefit the most from peer-assisted study sessions?
Authors: Cummings Daniel J. , Sheeran Nicola
Published: April 2019

Previous research investigating the relationship between peer-assisted study sessions (also called supplemental instruction or peer-assisted learning) and academic performance has a number of concerns. These include the lack of inclusion of important variables such as academic motivation and personality. This study ( N = 233) investigated how motivation, personality, and control variables (prior subject attempts, number of university semesters completed, prior academic achievement) have an impact on the relationship between peer-assisted study sessions attendance and academic performance for psychology students. The results indicated that peer-assisted study sessions attendance predicted academic performance when controlling for academic motivation, personality, and control variables; however, the magnitude of the relationship was almost halved ( r = .27 to ß = .13). Peer-assisted study sessions attendance mediated the relationship between neuroticism ( κ2 = .04) and prior academic achievement ( κ2 = .05) and academic performance, indicating that participants with these characteristics benefit from the sessions. Finally, adjunct peer-assisted study sessions focused on assessment items appear to be a large part of its efficacy in this sample.
From global policy to tertiary pedagogy: Transformational thresholds for creative arts degrees
Authors: Rowe Nicholas
Published: April 2019

Performing arts teachers, in diverse regions of the world, recognise that globalisation has indelibly influenced how the arts are valued, practiced and taught (Rowe, Martin, Buck, et al., 2018). As illustrated by three key United Nations Education, Science and Culture Organisation (UNESCO) policies on arts and culture in the 21st century (UNESCO, 2003, 2006, 2011), global mandates can present contrasting imperatives, prompting shifts within regional, national and institutional strategies. So how do tertiary arts educators respond to shifts in global policies? After a brief historical analysis of three UNESCO strategic documents associated with arts education, this article considers how the contrasts within these strategies have presented challenging learning moments for arts educationalists. ‘Threshold concept’ theory is presented as a means of framing such learning challenges, to highlight the professional development needs of designers of tertiary curricula. Critically reflecting on the author’s experiences of codesigning tertiary degree programmes in New Zealand, China and Fiji, this article identifies key conceptual thresholds that can challenge tertiary educators when seeking to align institutional teaching practices with contemporary global policies on arts education.
Effect of strip edge temperature drop of electrical steel on profile and flatness during hot rolling process
Authors: Li Yanlin , Cao Jianguo , Qiu Lan , Kong Ning , He Anrui , Zhou Yizhong
Published: April 2019

The purpose of this article is to solve the uneven deformation problem of electrical steel strip caused by high-temperature phase transition during hot rolling process. The hot rolling process of electrical steel strip is built by ABAQUS software, importing the constitutive model of electrical steel. The effect of temperature drop in the edge of electrical steel strip on the profile and flatness of strip is studied. Simulation results show that the strip edge temperature drop has great effect on hot rolling process of electrical steel strip. When electrical steel strip is in single-phase state, the strip edge temperature drop can reduce the strip crown, but also lead to larger rolling pressure and local high point height in the strip edge. When electrical steel strip is in two-phase state, the local high point height in the strip edge does not exist, but the strip edge temperature drop can lead to larger strip crown.
Human–robot interactive control based on reinforcement learning for gait rehabilitation training robot
Authors: Bingjing Guo , Jianhai Han , Xiangpan Li , Lin Yan
Published: April 2019

A human–robot interactive control is proposed to govern the assistance provided by a lower limb exoskeleton robot to patients in the gait rehabilitation training. The rehabilitation training robot with two lower limb exoskeletons is driven by the pneumatic proportional servo system and has two rotational degrees of freedom of each lower limb. An adaptive admittance model is adopted considering its suitability for human–robot interaction. The adaptive law of the admittance parameters is designed with Sigmoid function and the reinforcement learning algorithm. Individualized admittance parameters suitable for patients are obtained by reinforcement learning. Experiments in passive and active rehabilitation training modes were carried out to verify the proposed control method. The passive rehabilitation training experimental results verify the effectiveness of the inner-loop position control strategy, which can meet the demands of gait tracking accuracy in rehabilitation training. The active rehabilitation training experimental results demonstrate that the personal adaption and active compliance are provided by the interactive controller in the robot-assistance for patients. The combined effects of flexibility of pneumatic actuators and compliance provided by the controller contribute to the training comfort, safety, and therapeutic outcome in the gait rehabilitation.
Long-term stroke incidence in proximal thoracic aorta aneurysm survivors
Authors: Hsu Jin-Yi , Su Yuan-Chih , Wang Jen-Hung , Tee Boon Lead
Published: April 2019

Background

Aneurysm of proximal thoracic aorta (pTAA) is an often indolent, yet fatal disease. Although advancements in aneurysmal repair techniques have increased long-term survival rates, studies have proven that there are increases in perioperative risk for stroke incidence after pTAA surgery. Conversely, there is little evidence regarding the long-term stroke incidence in pTAA individuals, which strongly influences the morbidity, mortality, and usage of antithrombotic agents.

Methods

Using the Taiwan National Health Insurance Research Database, a nationwide population-based cohort, we recruited 3013 pTAA survivors hospitalized from 1 January 2000 to 31 December 2012. To ensure study cohort quality, only patients aged 20 years and above who underwent aneurysmal repair surgery are included. The control cohort is identified by matching background features (comorbidities, age, gender) at a 1:4 ratio through the use of frequency matching. The primary outcomes include incidence of ischemic stroke and intracranial hemorrhage one month after aneurysmal repair surgery.

Results

The mortality of pTAA survivors is nearly twice of the matched controls despite aneurysmal repair (28.5 % vs. 15.2%, p < 0.001). Long-term follow-up of participants indicated that pTAA survivors had a higher risk for hemorrhage stroke (adjusted hazard ratio (aHR): 1.93; 95% confidence interval (CI): 1.47–2.53), but no significant increase in risk for ischemic stroke (aHR: 1.07; 95% CI: 0.92–1.25). Hemorrhagic stroke occurrence was found to be associated with age and diabetes mellitus. Comparison on hemorrhagic stroke subtypes between study and matched cohorts showed no statistical differences in intracerebral hemorrhage and subarachnoid hemorrhage.

Conclusions

Despite the advancement of aneurysmal repair surgery, this study suggests that pTAA patients may still face an increased risk of hemorrhage stroke. Further investigation is warranted to provide better long-term care for the pTAA population.
NLRP3 inflammasome in ischemic stroke: As possible therapeutic target
Authors: Alishahi Masoumeh , Farzaneh Maryam , Ghaedrahmati Farhoodeh , Nejabatdoust Armin , Sarkaki Alireza , Khoshnam Seyed Esmaeil
Published: April 2019

Inflammation is a devastating pathophysiological process during stroke, a devastating disease that is the second most common cause of death worldwide. Activation of the NOD-like receptor protein (NLRP3)-infammasome has been proposed to mediate inflammatory responses during ischemic stroke. Briefly, NLRP3 inflammasome activates caspase-1, which cleaves both pro-IL-1 and pro-IL-18 into their active pro-inflammatory cytokines that are released into the extracellular environment. Several NLRP3 inflammasome inhibitors have been promoted, including small molecules, type I interferon, micro RNAs, nitric oxide, and nuclear factor erythroid-2 related factor 2 (Nrf2), some of which are potentially efficacious clinically. This review will describe the structure and cellular signaling pathways of the NLRP3 inflammasome during ischemic stroke, and current evidence for NLRP3 inflammasome inhibitors.
Impact of Built Design on Nighttime Family Presence in the Intensive Care Unit
Authors: Huynh Truong-Giang , Owens Robert L. , Davidson Judy E.
Published: April 2019

Objective:

Determine whether dedicated family space changes family presence at night in the intensive care unit (ICU).

Purpose:

To measure family presence at night before and after moving to an ICU with in-room family space.

Background:

The safeguarding phenomenon families experience may lead to the desire to sit vigil at the bedside. Lack of dedicated family sleep space may exacerbate sleep deprivation for those who wish to be present at night. Sleep deprivation decreases cognition and capacity for decision-making. Traditionally, ICU rooms have not included dedicated family areas or sleep surfaces. National recommendations include designing new hospital ICU rooms with dedicated family space. It is not known if the built design changes family presence at night.

Method:

Family presence was measured for 30 nights pre- and postmove to a newly built ICU with dedicated family space. The policy for open flexible family presence remained the same before and after the move.

Results:

There was a statistically significant increase in proportion of occupied patient rooms with visitors following the move to the new ICU designed with family space (31% difference, x2= 5.675, 95% CI [5.74, 51.29], p = .0172).

Conclusions:

Families utilize the space when available. Further research is needed to quantify quality and quantity of family sleep and impact on decision-making and interactions with the care team. Sleep deprivation may decrease for families who would have remained in the unit without available family space and sleep surface.
Using the pCANvas neck-bridging device in treating a wide-necked aneurysm of the basilar tip
Authors: Sirakov Stanimir , Panayotova Adriana , Sirakov Alexander , Penkov Marin , Minkin Krasimir , Hristov Hristo
Published: April 2019

Background and importance

The endovascular treatment of recurrent wide-necked bifurcation aneurysms at the basilar tip remains very challenging. Many different techniques and devices have emerged in recent years as potential options but results remain less than controversial. The pCANvas is a relatively new device wielding neck-bridging properties with a haemodynamically active membrane acting as blood flow disrupter.

Clinical presentation

We present the clinical case of a patient in whom multiple endovascular and microsurgical attempts failed to achieve the definitive treatment of a large and wide-necked basilar tip aneurysm. The patient underwent successful endovascular implantation of the novel pCANvas device across the recurrent aneurysm neck. The device limited the blood flow to the anerysmal lumen and thus promoted faster thrombosis. Third month follow-up confirmed complete obliteration of the aneurysm.

Conclusion

The application of the pCANvas device offers a potential treatment option in difficult and recurrent aneurysms. The endovascular flow disruption is a relatively new feature aiming to create conditions for intraluminal thrombosis and is certainly promising for the treatment of complex bifurcation aneurysms.
Deformation characteristics of press-formed cylindrical tubes with shallow and hemispherical caps for frontal crash protective structures
Authors: Praveen Kumar A , Sathish Kumar M
Published: April 2019

Thin-walled cylindrical tubes have been extensively used as energy absorbing structures in vehicular frontal structures owing to their superior energy absorption characteristics and effective crashworthiness performance. However, these tubes often exhibit extreme initial peak crushing force under impact, which in turn cause severe harm to the occupants. The present research study examines the effectiveness of harnessing shallow and hemispherical caps over the cylindrical tubes to mitigate the initial peak crushing force of a conventional cylindrical tube under static and impact crushing situations. Through experiments, the effect of caps on the initial peak crushing force and energy absorption characteristics of combined geometry tubes were assessed. Subsequently, coupled finite element simulations for both deep drawing and static crushing events were developed to provide additional insight using LS-DYNA finite element code. The crashworthiness characteristics of the proposed combined geometry tubes were compared with the bare cylindrical tubes and spherical caps and a significant reduction of about 20%–40% in the initial peak crushing force was witnessed. The overall results revealed the possibility of reducing the initial peak crushing force without incriminating the energy absorbing capacity using the combined geometry tubes. Hence, both the proposed cylindrical tubes with caps could be used as impact energy absorbing structures in automotive vehicles.
Circulating biomarkers in chronic thromboembolic pulmonary hypertension
Authors: Zhang Meng , Zhang Yunxia , Pang Wenyi , Zhai Zhenguo , Wang Chen
Published: April 2019

Chronic thromboembolic pulmonary hypertension (CTEPH) is a serious condition characterized with chronic organized thrombi that obstruct the pulmonary vessels, leading to pulmonary hypertension (PH) and ultimately right heart failure. Although CTEPH is the only form of PH that can be cured with surgical intervention, not all patients with CTEPH will be deemed operable. Some CTEPH patients still have a poor prognosis. Therefore, the determination of diagnostic and prognostic biomarkers of CTEPH is of great importance for the early intervention to improve prognosis of patients with CTEPH. Several markers related to multiple mechanisms of CTEPH have been recently identified as circulating diagnostic and prognostic biomarkers in these patients. However, the existing literature review of biomarkers of CTEPH is relatively sparse. In this article, we review recent advances in circulating biomarkers of CTEPH and describe future applications of these biomarkers in the management of CTEPH.
Right heart in pulmonary hypertension: from adaptation to failure
Authors: Ren Xianfeng , Johns Roger A. , Gao Wei Dong
Published: April 2019

Right ventricular (RV) failure (RVF) has garnered significant attention in recent years because of its negative impact on clinical outcomes in patients with pulmonary hypertension (PH). PH triggers a series of events, including activation of several signaling pathways that regulate cell growth, metabolism, extracellular matrix remodeling, and energy production. These processes render the RV adaptive to PH. However, RVF develops when PH persists, accompanied by RV ischemia, alterations in substrate and mitochondrial energy metabolism, increased free oxygen radicals, increased cell loss, downregulation of adrenergic receptors, increased inflammation and fibrosis, and pathologic microRNAs. Diastolic dysfunction is also an integral part of RVF. Emerging non‐invasive technologies such as molecular or metallic imaging, cardiac MRI, and ultrafast Doppler coronary flow mapping will be valuable tools to monitor RVF, especially the transition to RVF. Most PH therapies cannot treat RVF once it has occurred. A variety of therapies are available to treat acute and chronic RVF, but they are mainly supportive, and no effective therapy directly targets the failing RV. Therapies that target cell growth, cellular metabolism, oxidative stress, and myocyte regeneration are being tested preclinically. Future research should include establishing novel RVF models based on existing models, increasing use of human samples, creating human stem cell‐based in vitro models, and characterizing alterations in cardiac excitation–contraction coupling during transition from adaptive RV to RVF. More successful strategies to manage RVF will likely be developed as we learn more about the transition from adaptive remodeling to maladaptive RVF in the future.
Best practice in radiofrequency denervation of the lumbar facet joints: a consensus technique
Authors: Eldabe Sam , Tariq Anisah , Nath Sherdil , Gulve Ashish , Antrobus Hugh , Baloch Mohjir , Buczkowski Piotr , Collighan Neil , Fernandez Tacson , Fritz Ann-Katrin , Humble Stephen , Huygen Frank , Krishnan Murali , Mehta Vivek , Mishra Sailesh , Muthukrishnan Sundar , Snidvongs Saz , Tamosauskas Rokas , Underwood Martin
Published: April 2019

Background:

Radiofrequency denervation is used to treat selected people with low back pain. Recent trials have been criticised for using a sub-optimal intervention technique.

Objectives:

To achieve consensus on a best practice technique for administering radiofrequency denervation of the lumbar facet joints to selected people with low back pain.

Study design:

A consensus of expert professionals in the area of radiofrequency denervation of the lumbar facet joints.

Methods:

We invited a clinical member from the 30 most active UK departments in radiofrequency pain procedures and two overseas clinicians with specific expertise to a 1 day consensus meeting. Drawing on the known anatomy of the medial branch, the theoretical basis of radiofrequency procedures, a survey of current practice and collective expertise, delegates were facilitated to reach consensus on the best practice technique.

Results:

The day was attended by 24 UK and international clinical experts. Attendees agreed a best practice technique for the conduct of radiofrequency denervation of the lumbar facet joints.

Limitations:

This consensus was based on a 1 day meeting of 24 clinical experts who attended and took part in the discussions. The agreed technique has not been subject to input from a wider community of experts.

Conclusions:

Current best practice for radiofrequency denervation has been agreed for use in a UK trial. Group members intend immediate implementation in their respective trusts. We propose using this in a planned Randomised Controlled Trial (RCT) of radiofrequency denervation for selected people with low back pain.
Early intensive treatment to prevent kidney failure in post-traumatic rhabdomyolysis: Case report
Authors: Pezzi Mario , Giglio Anna Maria , Scozzafava Annamaria , Serafino Giuseppe , Maglio Pietro , Verre Mario
Published: April 2019

Traumatic rhabdomyolysis is a clinical and biological syndrome secondary to lysis of striated muscle fibers resulting in extended musculoskeletal damage. An acute muscle damage causes the release of constituent elements of the sarcoplasmic reticulum, such as muscle enzymes, potassium, and myoglobin in plasma circulation; these conditions are at great risk of dangerous systemic complications for life such as hypovolemic shock, hyperkalemia, and acute kidney injury. We describe the case of a patient who suffered a severe musculoskeletal and vascular trauma with elevated creatine kinase values and myoglobinemia treated early with coupled plasma filtration adsorption in order to prevent kidney damage, associated with volume replacement, loop diuretics, and correction of metabolic acidosis.
A Machine Learning Approach to “Revisit” Specialization and Sampling in Institutionalized Practice
Authors: Barth Michael , Emrich Eike , Güllich Arne
Published: April 2019

The question which nature and scope of developmental participation patterns lead to international senior-level success has been controversially discussed in the literature for many years. The present article aimed to extend existing literature in two respects. First, we reviewed studies comparing developmental sport activities of international-level and national-level athletes. The results indicated that comparisons among the highest success levels are infrequent, findings partly varied across studies, while the practice volume in other sports, but not in the athlete’s main sport, mostly distinguished international-level from national-level athletes. Second, a new methodical approach combining decision trees and gradient boosting (conducted under the R environment) was applied to data from a previously published study. It allowed for multivariate, interactive, and nonlinear analysis and was promising to achieve relatively better explanation than earlier, traditional procedures. The results indicate that some formerly found differences between international and national-level athletes in the volume of main-sport and other-sports practice may represent artifacts of uncontrolled age effects, rather than variables factually differentiating success. In the context of the specialization–diversification debate, the present findings suggest that the debate addresses a “production function,” the structure of which is still unknown. Practice-related recommendations on developmental participation patterns are apparently expressions of highly rationalized myths, rather than evidence-based efficient norms.
Morphine promotes neovascularizing retinopathy in sickle transgeneic mice
Authors: Gupta Kalpna , Chen Chunsheng , Lutty Gerard A. , Hebbel Robert P.
Published: April 2019

Neovascularizing retinopathy is a significant complication of sickle cell disease (SCD), occurring more frequently in HbSC than HbSS disease. This risk difference is concordant with a divergence of angiogenesis risk, as identified by levels of pro- vs anti-angiogenic factors in the sickle patient’s blood. Because our prior studies documented that morphine promotes angiogenesis in both malignancy and wound healing, we tested whether chronic opioid treatment would promote retinopathy in NY1DD sickle transgenic mice. After 10 to 15 months of treatment, sickle mice treated with morphine developed neovascularizing retinopathy to a far greater extent than either of the controls (sickle mice treated with saline and wild-type mice treated identically with morphine). Our dissection of the mechanistic linkage between morphine and retinopathy revealed a complex interplay among morphine engagement with its μ opioid receptor (MOR) on retinal endothelial cells (RECs); morphine-induced production of tumor necrosis factor α and interleukin-6 (IL-6), causing increased expression of both MOR and vascular endothelial growth factor receptor 2 (VEGFR2) on RECs; morphine/MOR engagement transactivating VEGFR2; and convergence of MOR, VEGFR2, and IL-6 activation on JAK/STAT3-dependent REC proliferation and angiogenesis. In the NY1DD mice, the result was increased angiogenesis, seen as neovascularizing retinopathy, similar to the retinal pathology occurring in humans with SCD. Therefore, we conclude that chronic opioid exposure, superimposed on the already angiogenic sickle milieu, might enhance risk for retinopathy. These results provide an additional reason for development and application of opioid alternatives for pain control in SCD.
The natural history of vascular and other complications in patients treated with nilotinib for chronic myeloid leukemia
Authors: Minson Adrian G. , Cummins Katherine , Fox Lucy , Costello Ben , Yeung David , Cleary Rebecca , Forsyth Cecily , Tatarczuch Maciek , Burbury Kate , Motorna Olga , Shortt Jake , Fleming Shaun , McQuillan Andrew , Schwarer Anthony , Harrup Rosemary , Holmes Amy , Ratnasingam Sumita , Chan Kah-Lok , Hsu Wei-Hsun , Ashraf Asma , Putt Faye , Grigg Andrew
Published: April 2019

Although second-generation tyrosine kinase inhibitors (TKIs) show superiority in achieving deep molecular responses in chronic myeloid leukemia in chronic phase (CML-CP) compared with imatinib, the differing adverse effect (AE) profiles need consideration when deciding the best drug for individual patients. Long-term data from randomized trials of nilotinib demonstrate an increased risk of vascular AEs (VAEs) compared with other TKIs, although the natural history of these events in response to dose modifications or cessation has not been fully characterized. We retrospectively reviewed the incidence of nilotinib-associated AEs in 220 patients with CML-CP at 17 Australian institutions. Overall, AEs of any grade were reported in 95 patients (43%) and prompted nilotinib cessation in 46 (21%). VAEs occurred in 26 patients (12%), with an incidence of 4.1 events per 100 patient-years. Multivariate analysis identified age (P = .022) and dyslipidemia (P = .007) as independent variables for their development. There was 1 fatal first VAE, whereas the remaining patients either continued nilotinib (14 patients) or stopped it immediately (11 patients). Recurrent VAEs were associated with ongoing therapy in 7 of 14 who continued (with 2 fatal VAEs) vs 1 of 11 who discontinued (P = .04). Nineteen of the 23 evaluable patients surviving a VAE ultimately stopped nilotinib, of whom 14 received an alternative TKI. Dose reduction or cessation because of VAEs did not adversely affect maintenance of major molecular response. These findings demonstrate that in contrast to other AEs, VAEs are ideally managed with nilotinib cessation because of the increased risk of additional events with its ongoing use.
Hematopoietic cytokines mediate resistance to targeted therapy in FLT3-ITD acute myeloid leukemia
Authors: Sung Pamela J. , Sugita Mayumi , Koblish Holly , Perl Alexander E. , Carroll Martin
Published: April 2019

Activating mutations in Fms-like tyrosine kinase 3 (FLT3) occur in ∼30% of adult cases of acute myeloid leukemia (AML). Selective second- and third-generation FLT3 inhibitors have shown significant clinical activity in patients with relapsed FLT3-mutant AML. However, clearance of FLT3-mutant clones does not consistently occur, and disease will progress in most patients after an initial response. This scenario challenges the model of FLT3-mutant AML being oncogene addicted, and it suggests that redundant signaling pathways regulate AML cell survival after FLT3 inhibition. We show that primary FLT3-mutant AML cells escape apoptosis induced by FLT3 inhibition in vitro in the presence of cytokines produced normally in the bone marrow, particularly granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-3 (IL-3). Despite reactivating canonical FLT3-signaling pathways, GM-CSF and IL-3 maintain cell survival without rescuing proliferation. Cytokine-mediated resistance through GM-CSF and IL-3 is dependent on JAK kinase, STAT5, and proviral integration site of Moloney murine leukemia virus (PIM) but not MAPK or mammalian target of rapamycin signaling. Cotreatment with FLT3 inhibitors and inhibitors of JAK or PIM kinases blocks GM-CSF and IL-3 rescue of cell survival in vitro and in vivo. Altogether, these data provide a strong rationale for combination therapy with FLT3 inhibitors to potentially improve clinical responses in AML.
Willingness to Stop Growing Tobacco in Uganda
Authors: Karemani Adelaine , Nuwaha Fred
Published: April 2019

PURPOSE

Tobacco use is the leading cause of premature death worldwide. One aspect of tobacco control is convincing farmers to stop tobacco production. We assessed the willingness of tobacco farmers in Uganda to stop growing tobacco.

METHODS

We conducted a cross-sectional interview survey with an interviewer-administered questionnaire. Participants were active tobacco farmers in 12 villages of Kanungu district (N = 528) and were interviewed in 2013 to assess their willingness to stop growing tobacco.

RESULTS

Most farmers (61.7%) grew tobacco only as a cash crop with no supplemental income. A total of 198 farmers (37.5%) were willing to stop growing tobacco. Ninety-two respondents cited coffee as a potential replacement crop for tobacco and 106 mentioned rice. Barriers to growing replacement crops were that tobacco is highly profitable (n = 172) and that the soil (n = 175) and/or weather (n = 22) cannot sustain any crops other than tobacco. Willingness to stop growing tobacco was 1.32 times as likely among farmers who said that tobacco use causes respiratory diseases and 1.16 times as likely among farmers who received less than less than $300 USD from tobacco sales in the previous season. Agreeing that tobacco is profitable decreased the likelihood of willingness to stop growing tobacco by 36%.

CONCLUSION

Only one in three farmers were willing to stop growing tobacco. To increase their willingness to stop growing tobacco, farmers must be educated on the health consequences of tobacco and we must demonstrate to farmers that other crops may be more profitable than tobacco.
Capacitation of human naïve pluripotent stem cells for multi-lineage differentiation
Authors: Rostovskaya Maria , Stirparo Giuliano G. , Smith Austin
Published: April 2019

Human naïve pluripotent stem cells (PSCs) share features with the pre-implantation epiblast. They therefore provide an unmatched opportunity for characterising the developmental programme of pluripotency in Homo sapiens. Here, we confirm that naïve PSCs do not respond directly to germ layer induction, but must first acquire competence. Capacitation for multi-lineage differentiation occurs without exogenous growth factor stimulation and is facilitated by inhibition of Wnt signalling. Whole-transcriptome profiling during this formative transition highlights dynamic changes in gene expression, which affect many cellular properties including metabolism and epithelial features. Notably, naïve pluripotency factors are exchanged for postimplantation factors, but competent cells remain devoid of lineage-specific transcription. The gradual pace of transition for human naïve PSCs is consistent with the timespan of primate development from blastocyst to gastrulation. Transcriptome trajectory during in vitro capacitation of human naïve cells tracks the progression of the epiblast during embryogenesis in Macaca fascicularis, but shows greater divergence from mouse development. Thus, the formative transition of naïve PSCs in a simple culture system may recapitulate essential and specific features of pluripotency dynamics during an inaccessible period of human embryogenesis.
Novo critério de rateio do fundo de participação dos estados: efetivo ou inócuo?
Authors: Castro Kleber Pacheco de
Published: April 2019

A promulgação da Lei Complementar (LC) nº 143 de 2013 veio atender uma determinação do Supremo Tribunal Federal (STF), que julgou inconstitucional o critério de rateio do Fundo de Participação dos Estados (FPE) previsto na LC nº 62 de 1989. A nova regra – um modelo híbrido, que prevê partilha dinâmica apenas em situações específicas – passou a vigorar em 2016, pouco alterando a distribuição do fundo entre os estados desde então. Se, em um cenário recessivo, o comportamento da distribuição do FPE se deu dessa forma, como ele responderia em outros cenários? É possível obter padrões de comportamento dessa distribuição de acordo com diferentes cenários macroeconômicos futuros. Define-se aí o objetivo deste artigo: verificar como se comportaria o critério de rateio futuro do FPE, a partir da construção de ambientes econômicos diversos – do pessimista ao otimista – e da simulação da distribuição do fundo nesses ambientes. As simulações foram realizadas a partir de expectativas de mercado acerca do comportamento do Produto Interno Bruto (PIB) e do Índice de Preços ao Consumidor Amplo (IPCA) no futuro e sob distintas hipóteses de elasticidade de tributação com relação ao PIB. Os resultados mostraram que as alterações seriam marginais no curto e médio prazos, sendo necessário ao menos um século para efetivar uma transição completa do critério estático para o critério dinâmico de rateio, mesmo considerando o cenário econômico mais favorável possível.
Accountability no regime próprio de previdência dos servidores municipais de diferentes estruturas institucionais
Authors: Louzano João Paulo de Oliveira , Tavares Bruno , Martins Fabrícia Júnia de Oliveira , Costa Thiago de Melo Teixeira da
Published: April 2019

O presente trabalho tem por objetivo discutir como accountability normativa manifesta-se no Regime Próprio de Previdência Social (RPPS) com diferentes estruturas institucionais. Para o alcance dos objetivos deste trabalho, foi analisado um fundo previdenciário, um instituto de previdência e uma secretaria municipal. Na descrição dos dados, foi verificado o percentual de itens atendidos pelos RPPS do total possível para cada um dos constructos, sendo que os critérios não exigíveis à gestão de determinados RPPS não foram considerados no cálculo desse percentual. Os resultados apontam que, apesar de haver diferenças visíveis no desempenho das unidades gestoras dos RPPS aqui analisadas, as três alcançaram indicadores satisfatórios.
A simple formula for enumerating comparisons in trials and network meta-analysis
Authors: Shokraneh Farhad , Adams Clive E.
Published: April 2019

We present use of a simple formula to calculate the number of pairwise comparisons of interventions within a single trial or network meta-analyses. We used the data from our previous network meta-analysis to build a study-based register and enumerated the direct pairwise comparisons from the trials therein. We then compared this with the number of comparisons predicted by use of the formula and finally with the reported number of comparisons (indirect or direct) within the network meta-analysis. A total of 133 trials of 8 interventions were selected which included 163 comparisons. The network of these showed 16 unique direct comparisons. The formula predicted an expected 28 indirect or direct comparisons and this is the number that were indeed reported. The formula produces an accurate enumeration of the potential comparisons within a single trial or network meta-analysis. Its use could help transparency of reporting should a shortfall occur between comparisons actually used and the potential total.
Advancing contraceptive security, availability, and choice in Malawi using a quality improvement methodology
Authors: Gausman Jewel , Schmitt Megan E. , Wickstrom Jane
Published: April 2019

Many initiatives to improve contraceptive security (CS) rightly focus on strengthening national and regional systems. However, local health facilities are often under-resourced and lack technical capacity that feed into the larger supply chain. This study’s objective was to assess whether changes in facility CS indicators were associated with participation in 2014-2016 implementation and scale-up of a quality improvement methodology—Client-Oriented, Provider efficient services (COPE®) for Contraceptive Security—in 60 facilities across 10 districts of Malawi. The intervention included facility self-assessment guides and action plans to address local challenges.

Results showed significant improvements in facilities having both a trained provider and contraceptive supplies. The percentage of health centers with all requirements for implant services increased significantly, including implant removal (from 26.5%; 95% CI: 14.9-41.1 to 77.6%; 95% CI: 63.4-88.2, p<.001). Health centers (from 0.0%; 95% CI: 0.0-7.3 to 10.2%; 95% CI: 3.4-22.2, p<0.05) and hospitals (from 45.5%; 95% CI: 16.7-76.7 to 90.9%; 95% CI: 58.7-99.8, p<0.05) significantly improved in the percentage of facilities able to insert intrauterine devices. Hospitals improved their ability to offer female sterilizations (27.2%; 95% CI: 6.0-61.0 to 63.6%; 95% CI: 30.7-89.1, p<0.05) and male sterilizations. Low performing health centers showed significant improvement in staff capacity, logistics management information systems, equipment, and total CS performance. The percentage of facilities placing emergency orders for contraceptives during the three months prior to an assessment showed a decreasing, non-significant trend among hospitals but was significant among health centers (from 69.2%; 95% CI: 54.6-81.7 to 36.7%; 95% CI: 23.4-51.7; p<0.001). Facility staff commitment was associated with action item completion. Improvements tended to be sustained over time. Community engagement is thought to be important to intervention success.

COPE for CS may be an effective intervention and future research/programs can build off of this preliminary programmatic experience when seeking to address last mile challenges.
Generation of human midbrain organoids from induced pluripotent stem cells
Authors: Mohamed Nguyen-Vi , Mathur Meghna , da Silva Ronan V. , Beitel Lenore K. , Fon Edward A. , Durcan Thomas M.
Published: April 2019

The development of brain organoids represents a major technological advance in the stem cell field, a novel bridge between traditional 2D cultures and in vivo animal models. In particular, the development of midbrain organoids containing functional dopaminergic neurons producing neuromelanin granules, a by-product of dopamine synthesis, represents a potential new model for Parkinson’s disease. To generate human midbrain organoids, we introduce specific inductive cues, at defined timepoints, during the 3D culture process to drive the stem cells towards a midbrain fate. In this method paper, we describe a standardized protocol to generate human midbrain organoids (hMOs) from induced pluripotent stem cells (iPSCs). This protocol was developed to demonstrate how human iPSCs can be successfully differentiated into numerous, high quality midbrain organoids in one batch. We also describe adaptations for cryosectioning of fixed organoids for subsequent histological analysis.
Adopting a logical framework model to help achieve a balanced and healthy vaccine R&D portfolio
Authors: Lalani Bhoomi , Sobti Sourabh
Published: April 2019

Vaccines are currently the 5th biggest therapy area with global sales for prophylactic and therapeutic vaccines to be ~ $30B, which is expected to increase to $45B by 2024. Immunization is globally recognized as one of the best investments to improve health, with impact lasting beyond saving 2-3M lives every year with benefits accrued over a lifetime.

Enterprise value of any R&D company is a cumulative sum of its projects and proprietary technologies. Hence organizations need to continuously evaluate their portfolios to review the health of projects as changes in external environment may impact project viability. Simultaneously, addition of any new project in a company’s portfolio is a significant investment and needs to be evaluated using an objective multi-parametric framework. In this pursuit, Hilleman Labs, an equal joint venture by MSD and Wellcome Trust, has created a logical framework to evaluate potential vaccine candidates before they are added to the portfolio.
The Use of the Teachers Professional Competencies Research Results in Improving the Quality of the Supplementary Vocational Education
Authors: Худовердова С. , Khudoverdova S. , Сабельникова-Бегашвили Н. , Sabel'nikova-Begashvili N. , Дамианова Е. , Damianova E.
Published: April 2019

This article discusses the issues of improvement of professional skill of pedagogical workers; substantiates the role of additional professional education in the formation of the continuous professional growth of the teacher; the diagnostics of the level of professional teachers’ competence research is given.
As histórias que podem ser contadas: a feminização da epidemia HIV/AIDS e a produção de narrativas científicas
Authors: Duarte Larissa Costa , Rhoden Fabiola
Published: April 2019

Desde sua eclosão na década de 1980 na forma de epidemia, a AIDS tem sido principalmente associada a homossexuais masculinos: inicialmente partindo da literatura médica, essa visão espalhou-se também para o público leigo e mantém-se viva no imaginário popular, ainda que, a partir da década de 1990, tenha havido um movimento para reconhecer a parcela cada vez mais vitimada pela síndrome: mulheres heterossexuais. A essa progressão, deu-se o nome de feminização do HIV/AIDS, uma narrativa sobre uma suposta mudança no perfil da epidemia. Neste artigo, analisamos o fenômeno de feminização da doença partindo de uma reflexão sobre como a epidemia foi produzida pela medicina desde os seus anos iniciais. Na tentativa de compreender os processos pelos quais algumas narrativas científicas – que se constituíram, em determinado momento, como uma alternativa possível dentre uma variedade de versões – se estabeleceram como mais factuais que as demais, analisamos desde estratégias de produção textual e discursiva até estruturas históricas de opressão de minorias sociais.
What enables or prevents women with depressive symptoms seeking help in the postnatal period?
Authors: Newman Tabitha Claire , Hirst Janet , Darwin Zoe
Published: April 2019

Background

Perinatal mental health problems affect approximately 20% of women. The most common condition is postnatal depression; however, many women do not seek help.

Aims

To identify and synthesise evidence on factors that enable or prevent help-seeking in women with depressive symptoms in the postnatal period.

Methods

A qualitative systematic review was conducted using electronic databases and pre-determined eligibility criteria.

Findings

Thematic synthesis of the included studies (n=4) identified the following themes: the influence of healthcare services, the influence of others and the influence of women themselves. Help-seeking was shaped by women's ability to recognise their symptoms, the reactions (experienced or anticipated) of others and the organisation of services.

Conclusion

An improved interface between maternity and mental health services and enhanced health professional interactions are needed. However, meaningful change may require empowering women's self-assessment and public health messages to improve understanding of postnatal depression.
New routes to parenthood
Authors: Winter George F
Published: April 2019

Recognition of gender fluidity, gender dysphoria and transgender people is increasing, and with it, debates on reproductive rights. Is science and technology keeping up? George Winter investigates
Chronic pododermatitis and interdigital furunculosis in dogs
Authors: Nuttall Tim
Published: April 2019

Chronic pododermatitis with interdigital furunculosis is a common and frustrating problem in dogs. It is characterised by the presence of recurrent interdigital furunculosis. It is a multifactorial condition with primary, predisposing and perpetuating causes that lead to the secondary infections. Almost any skin disease can trigger the initial inflammation, but atopic dermatitis, adverse food reactions and abnormal conformation are the most common. Predisposing factors such as short hairs, excess weight, and altered weight bearing may lead to the development of the interdigital furunculosis. Perpetuating changes prevent resolution; these include weight bearing on haired skin, conjoined pads, new pad formation, deep tissue pockets, ingrown hairs and sinus tracts. All of the contributing factors in each case must be identified and managed. Supportive care includes analgesia, weight loss, using boots, keeping the interdigital skin clean, and using lubricating creams. Secondary bacterial and/or Malassezia spp. infections should be managed with appropriate topical and/or systemic antimicrobials. Bacterial infections can be deep, mixed and/or antimicrobial resistant, and culture and antimicrobial susceptibility testing must be used to select effective drugs. Chronic inflammatory changes can be managed with topical or systemic glucocorticoids, topical 0.1% tacrolimus, ciclosporin or cytotoxic drugs. Chronic proliferative changes are poorly responsive to medical management alone, therefore surgical fusion or laser podoplasties should be considered. Long-term treatment of the primary, predisposing and perpetuating problems is required to maintain remission and prevent recurrence.
Rabbit neutering
Authors: Perpiñán David
Published: April 2019

Rabbits are commonly presented in clinical practice for neutering. While castrating males and performing ovariohysterectomies in females may be considered routine surgical procedures, the veterinary surgeon should discuss with the owner regarding ethical issues, indications and expectations of the procedure, and possible alternatives, prior to performing the surgery. Pre-operative preparation of the patient, surgical techniques and postoperative care are described in this article.
La Educación para el Desarrollo Sostenible en la universidad boliviana. Percepciones del profesorado
Authors: Litzner Ordóñez Lorena Ivonne , Rieß Werner
Published: April 2019

El desarrollo sostenible es, hoy por hoy, uno de los principios rectores fundamentales dentro de la educación en general, y se constituye en tarea y desafío para la educación superior en particular. La educación superior para el desarrollo sostenible (ESDS) tiene la función de transmitir y desarrollar conocimientos, competencias, valores y actitudes que empoderen y motiven a los estudiantes a contribuir activamente con el desarrollo sostenible. El presente estudio empírico sobre el statu quo de la ESDS en Bolivia tiene como objetivo identificar las distintas variables del proceso de enseñanza-aprendizaje desde la perspectiva de los docentes universitarios; a saber, aspectos personales, aspectos curriculares, tanto de contenido como metodológicos, y aspectos estructurales e institucionales. Los resultados constituyen un esfuerzo en busca de operacionalizar la educación para el desarrollo sostenible (EDS) en la educación universitaria, con el objetivo ulterior de generar nuevas perspectivas para su conceptualización, implementación e institucionalización en el contexto universitario boliviano.
Violencia escolar en bachillerato: algunas estrategias para su prevención desde diferentes perspectivas
Authors: González Medina Mario Alberto , Treviño Villarreal Diana Carolina
Published: April 2019

La violencia escolar es una acción que se ha venido manifestando a través de los años y esta ha afectado la vida de quienes la han padecido. Específicamente, el bachillerato es vulnerable a la violencia y va generando consecuencias negativas en los estudiantes, tanto en el ámbito escolar como en el personal. Es por ello que el objetivo del presente trabajo es determinar los factores que se relacionan con dicha violencia en estudiantes de este nivel, con la finalidad de contribuir a su prevención. El tipo de estudio fue no experimental, transversal, descriptivo y correlacional. La muestra estuvo conformada por 4.822 estudiantes. Se utilizaron los resultados de las Evaluaciones de Logro referidas al Sistema Educativo Nacional (ELSEN) y del cuestionario de contexto, ambos correspondientes al Plan Nacional para la Evaluación de los Aprendizajes (PLANEA) 2017. Se hizo una revisión exhaustiva de la literatura y de ahí se derivaron los factores propuestos en un modelo teórico. Se determinó la cantidad de alumnos que sufría de violencia escolar con base en su sexo y el tipo de escuela. Fueron aplicadas las pruebas t de student y la U de Mann-Whitney para evidenciar uno de los aspectos adversos que padecían los alumnos que experimentaban violencia escolar. Fue aplicada la técnica de modelaje con ecuaciones estructurales para verificar empíricamente el modelo teórico. Entre los hallazgos, se encontró una relación directa de la Violencia con los factores Emociones, Metas, Laboral y Relaciones, e indirecta con Actitud, Padres y Bienes. En conclusión, y tomando como base los resultados arrojados y las revisiones de diferentes autores, la violencia escolar está presente, no obstante, puede ser prevenida si se toman en cuenta los factores propuestos.