bluuebunny/crossref_metadata_2025 huggingface dataset:
MicroRNA-497-5p Functions as a Modulator of Apoptosis by Regulating Metadherin in Ovarian Cancer
Authors: Liu Chunyan , Bordeaux Anne , Hettich Stanka , Han Suhui
Published: February 2020

Ovarian cancer (OC) has a high mortality rate among women worldwide. However, even with the advances in detection and therapeutics, the number of cases is increasing worldwide. Increasingly, microRNAs (miRNAs), including miR-497-5p, have been implicated in the progression of many cancers, but the role of miR-497-5p in OC remains unknown. The purpose of this study was to investigate the underlying molecular mechanism of miR-497-5p in OC. Herein, we find that miR-497-5p is down-regulated in OC tissues, and overexpression of miR-497-5p enhances apoptosis in OC cells. The increased apoptosis was correlated with enhanced expression of apoptosis-related proteins. MiR-497-5p directly bound the 3’-untranslated region of metadherin (MTDH), leading to the reduction of MTDH in mRNA and protein levels. Moreover, MTDH knockout promoted the apoptosis of OC cells. Taken together, we conclude that miR-497-5p contributes to cell apoptosis in OC by regulating MTDH.
Capacity for reform: the changing roles of apprenticeship in three Nordic countries
Authors: Nyen Torgeir , Tønder Anna Hagen
Published: February 2020

Despite similar societal systems that have given rise to the concept of a Nordic model, the vocational education and training (VET) systems in the Nordic countries are strikingly diverse. This article provides an analysis of why the role of apprenticeship in the Danish, Norwegian and Swedish VET systems evolved along different paths from the late 1970s until the present (2020). During this period, the most fundamental changes took place in Norway, as apprenticeship was established in most VET programmes through a major reform in 1994. Sweden took the opposite course in the 1990s and instead strengthened the statist and school-based nature of its system. In Denmark, a dual system with apprenticeship where the social partners have a decisive influence has remained largely intact. We argue that differing policy positions taken by organised labour are important in order to explain the three countries’ different trajectories over the last 40 years.
Impact of Completing CLEFT-Q Scales That Ask About Appearance on Children and Young Adults: An International Study
Authors: Klassen Anne F. , Dalton Louise , Goodacre Timothy E. E. , Harman Karen E. , Slator Rona , Tsangaris Elena , Courtemanche Douglas J. , Goldstein Jesse , Allen Gregory C. , Mahony Aisling O. , Riff Karen W. Y. Wong
Published: February 2020

Objective:

To describe the impact of completing the CLEFT-Q appearance scales on patients with cleft lip and/or palate and to identify demographic and clinical characteristics and CLEFT-Q scores associated with reporting a negative impact.

Design:

International cross-sectional survey.

Setting:

Recruitment took place between October 2014 and November 2016 at 30 craniofacial clinics located in 12 countries.

Patients:

Aged 8 to 29 years with cleft lip and/or palate.

Main Outcome Measure(s):

Participants were asked 4 questions to evaluate the impact of completing the field test version of a patient-reported outcome measure (the CLEFT-Q) that included 154 items, of which 79 (51%) asked about appearance (of the face, nose, nostrils, teeth, lips, jaws, and cleft lip scar).

Results:

The sample included 2056 participants. Most participants liked answering the CLEFT-Q (88%) and the appearance questions (82%). After completing the appearance scales, most participants (77%) did not feel upset or unhappy about how they look, and they felt the same (67%) or better (23%) about their appearance after completing the questionnaire. Demographic and clinical variables associated with feeling unhappy/upset or worse about how they look included country of residence, female gender, more severe cleft, anticipating future cleft-specific surgeries, and reporting lower (ie, worse) scores on CLEFT-Q appearance and health-related quality-of-life scales.

Conclusion:

Most participants liked completing the CLEFT-Q, but a small minority reported a negative impact. When used in clinical practice, CLEFT-Q scale scores should be examined as soon as possible after completion in order that the clinical team might identify patients who might require additional support.
Centralization impact and cost-saving study in a Moroccan hospital’s centralized unit of chemotherapy preparation
Authors: Adade Casimir A , Benabbes Majda , Belahcen Mohammed J , Rahali Younes
Published: February 2020

Purpose

The purpose of this study was to assess the cost saved and the amount of drug wasted when compounding anticancer drugs in the centralized unit for chemotherapy preparation. A secondary objective was to estimate the centralization impact of activities related to the preparation of chemotherapies.

Methods

This was a two-month, single-centre, prospective study conducted at the National Oncology Institute in Rabat. The cost saved and the amount of drug wasted were calculated using a standardized data collection sheet (the prescribed dose, the amount of drug deployed, the amount remaining after compounding, the amount of drug saved and the drug wastage). The centralization impact was calculated using the amount of drug wasted in the centralized unit for chemotherapy preparation and a theoretical amount of drug wasted without centralization of preparation.

Results

During the study period, the total amount of drug saved was 249,959.5 mg (7.2% of drug used), which represented 96,657 USD. The amount of drug wasted was 89,290.5 mg or 42275.5 USD. The drug waste per dilution and per drug was 6.4 mg [1.6-16.1]. While the potential savings over one year (580,000 USD) reached 13.9% of the cytostatic drugs budget for 2018, the potential drug waste cost reached 6.1%. The centralization impact is estimated at an average of 79.5% ± 13.7% waste reduction.

Conclusion

The outcome of our study showed that the grouping of prescriptions in centralized unit for chemotherapy preparation could result in significant savings on the amount of drugs deployed. The centralization of cytostatic preparations is of economic interest.
Prospective evaluation of drug–drug interactions in ambulatory cancer patients initiated on prophylactic anticoagulation
Authors: Ng Hank K , Rogala Britny G , Ades Steven , Schwartz Joanna R , Ashikaga Takamaru , Vacek Pamela , Holmes Chris E
Published: February 2020

Introduction

Drug options for VTE prophylaxis are increasing for ambulatory cancer patients and data regarding anticoagulant-drug interactions and their relationship to VTE and bleeding are needed to improve care.

Methods

Over one year, 108 cancer patients with high VTE risk were prospectively identified. Potential anticoagulant-drug interactions were ascertained by chart review and graded on need for intervention. Providers selected anticoagulant prophylaxis based on potential drug interactions and patient-provider discussion. A cross-sectional analysis was performed thereafter to evaluate VTE and bleeding endpoints within one year of anticoagulant initiation.

Results

The average number of potential drug interactions per patient was higher for warfarin than others (3.04 vs. 1.28 (apixaban), 1.02 (rivaroxaban), and 0.98 (LMWH)). The severity of the interactions based on grade was, for apixaban: 1.6% grade X, 50.8% grade D, and 47.5% grade C; for rivaroxaban: 2.1% grade X, 64.9% grade D, 33.0% grade C; for LMWH, 0% grade X, 66.7% grade D, 33.3% grade C; and for warfarin, 0% grade X, 29.4% grade D, 70.6% grade C. At the end of the investigational period, 11 bleeds and 7 VTEs were reported. Drug combinations significantly associated with an increased bleeding risk were crizotinib with apixaban or rivaroxaban and PPIs with warfarin. The use of sulfamethoxazole-trimethoprim with warfarin was associated with an increased VTE risk.

Conclusions

DOACs had fewer DDIs than warfarin, although interaction severity differed between anticoagulants. Some anticoagulant-drug interactions were associated with bleeding or VTE. Although not powered for analysis, DDI severity did not affect bleeding rates and inversely correlated with VTE risk.
Experience With Ceftolozane-Tazobactam for the Treatment of Serious Pseudomonas aeruginosa Infections in Saudi Tertiary Care Center
Authors: Bosaeed M , Ahmad A , Alali A , Mahmoud E , Alswidan L , Alsaedy A , Aljuhani S , Alalwan B , Alshamrani M , Alothman A
Published: February 2020

Introduction:

Multidrug-resistant Pseudomonas aeruginosa isolates have multiple resistance mechanisms, and there are insufficient therapeutic options to target them. Ceftolozane-tazobactam is a novel antipseudomonal agent that contains a combination of an oxyimino-aminothiazolyl cephalosporin (ceftolozane) and a β-lactamase inhibitor (tazobactam).

Methods:

A single-center retrospective observational study between January 2017 and December 2018 for patients who had been diagnosed with carbapenem-resistant P aeruginosa infections and treated with ceftolozane-tazobactam for more than 72 hours. We assessed clinical success based on microbiological clearance as well as the clinical resolution of signs and symptoms of infection.

Results:

A total of 19 patients fit the inclusion criteria, with a median age was 57 years, and 53% were female. The types of infections were nosocomial pneumonia, acute bacterial skin, and skin structure infections; complicated intra-abdominal infections; and central line–associated bloodstream infections. All of the isolates were resistant to both meropenem and imipenem. The duration of therapy was variable (average of 14 days). At day 14 of starting ceftolozane-tazobactam, 18 of 19 patients had a resolution of signs and symptoms of the infection. Only 14 of 19 patients (74%) had proven microbiological eradication observed at the end of therapy. During therapy, there was no adverse event secondary to ceftolozane-tazobactam, and no Clostridium difficile infection was identified. The 30-day mortality rate was 21% (4/19).

Conclusions:

Multidrug-resistant P aeruginosa infection is associated with high mortality, which would potentially be improved using a new antibiotic such as ceftolozane-tazobactam. Studies are required to explain the role of combination therapy, define adequate dosing, and identify the proper duration of treatment.
Mobile phones and the news: How UK mainstream news broadcasting is stalling the video revolution
Authors: Hadland Adrian , Borges-Rey Eddy , Cameron Jackie
Published: February 2020

From the mid-2000s, a sudden surge in the use of mobile phone footage by national and international broadcasters was widely anticipated as the precursor to a revolutionary change in the generation and dissemination of news. In the wake of events such as the London bombings of 2005, user-generated content bureaux and hubs were established by major media organizations from the British Broadcasting Corporation and CNN to Al Jazeera while new software and hardware was developed. The potential for covering virtually any news development from at least one of the world’s seven billion mobile phones suggested a whole new phase of broadcast journalism was imminent. This study of news bulletins by three United Kingdom-based broadcasters – Channel 4, the BBC and ITV – establishes a new methodology for the identification of mobile phone content in broadcasting. It also finds that a decade later, mobile phone footage has not lived up to its early potential.
Measuring psychological outcomes in paediatric settings: Making outcomes meaningful using client-defined perspectives
Authors: Flannery Halina , Jacob Jenna
Published: February 2020

There is a growing drive to develop and implement patient-reported outcome measures within paediatric health services, particularly for young people living with chronic health conditions; however, there is little consensus on how best to do this in meaningful ways within psychological services working alongside medical teams. This reflective commentary considers some of the challenges of collecting psychological outcome measures in paediatric services and considers alternative approaches to making outcome measurement meaningful. All measures have their limitations; however, they become meaningless if they are not used in meaningful and considered ways with young people. Client-defined outcome measurement, such as goal-based outcome measures, alongside other types of measurement, can capture outcomes of meaning to young people living with chronic health conditions, and can enable them to feed into a shared decision-making process.
From cubicles to open space: An analysis of gendered meanings of workspace
Authors: Peteri Virve , Lempiäinen Kirsti , Kinnunen Merja
Published: February 2020

This article analyses office spaces and their gendered meanings, specifically concentrating on informal spaces such as coffee rooms, corridors and so-called chill-out areas. The analysis draws on feminist research on space and Henri Lefebvre’s theory of social space, which focuses on how lived space in the workplace is signified and contested. The ethnographic material was gathered in office environments during the 1980s, 1990s and 2010s. The analysis shows that opening up the office space invites new sorts of management of work tasks, social relations and embodiment. The authors suggest that the aim of fostering and capitalizing on informal encounters and spaces – which were typical for women workers in industrial offices – may paradoxically decrease direct meetings and communication in the post-industrial office.
Telemonitoring readiness among Austrian diabetic patients: A cross-sectional validation study
Authors: Muigg Domenik , Duftschmid Georg , Kastner Peter , Modre-Osprian Robert , Haluza Daniela
Published: February 2020

Digitalized healthcare services offer remote and cost-effective treatment of diabetes patients. Thus, the present online study analyzed the readiness to use telemonitoring among Austrian diabetes patients. We developed and validated a German version of the patient telehealth readiness assessment tool and performed quantitative context analysis of free-text comments on perceived barriers and benefits of telemonitoring. Participants (n = 41, 42.6% females) achieved a medium average readiness level for telemonitoring. The three top benefits were intensified care, shorter travel and waiting times, and better therapy adjustment. The top three barriers were data privacy issues, loss of personal communication and focus on blood sugar, and teledoctor competence. Diabetes patients represent a suitable target group for remote treatment opportunities. However, a shift from traditional face-to-face medical care to exclusive telemonitoring treatment from diagnosis to consultation and treatment requires fundamental new legal framework conditions.
Skin deep: Callout strategies, influencers, and racism in the online beauty community
Authors: Lawson Caitlin E
Published: February 2020

In recent years, the Western online beauty community has been embroiled in multiple racist scandals that have resulted in callout campaigns against various influencers and cosmetic companies. Through a multiplatform discourse analysis of two such scandals, this project explores how influencers, brands, and audiences utilize the affordances and norms of social media platforms to manage their roles and relationships throughout these callout campaigns. Four key strategies emerge: curation, critique, reframing, and silence. Despite the efforts of some audiences and influencers, these four strategies elided the broader social implications of brand and influencer racism as members of the community responded to the drama more than they critiqued the marginalization of people of color. Overall, this project provides insight into the dynamics at work in callout campaigns, theorizing the ways in which actors work to balance visibility, risk, labor, and control.
Beyond the gender (dis)empowerment dichotomy: The mobile phone as social catalyst for gender transformation in the Global South
Authors: Pei Xin , Chib Arul
Published: February 2020

Over the past two decades, increasing attention has been drawn to gender impacts arising from adoption and usage of information and communication technologies (ICTs), the mobile phone especially, by marginalized women in the Global South. Grounded in the theory of structuration, our study challenges techno-determinism and structural functionalism embodied in a prevailing gender (dis)empowerment dichotomy, and instead reveals the contextually situated and dynamically negotiated techno-socio relationships. It allows for examination of the mobile phone in the interactions between agency of women to get empowered and their situated gendered social power structures. While the phone reinforces structural constraints via facilitating access, surveillance, and intervention from those of higher patriarchal statuses, it simultaneously enables women’s strategic responses involving avoidance, accommodation, and collaboration. The constraining yet empowering processes conceptually make the functioning of the mobile phone as socially catalyzing the development of self-consciousness by women, and furthermore, the clustering of awakening individuals toward emergent female collective power.
Decision support model in the determination of rural touristic destination attractiveness in the Brčko District of Bosnia and Herzegovina
Authors: Puška Adis , Šadić Sead , Maksimović Aleksandar , Stojanović Ilija
Published: February 2020

In order for a tourist to visit a location, it has to be attractive. Destination attractiveness can be examined in several ways. One of them is offered by this study, which has examined destination attractiveness based on resources available in certain rural settlements. Based on a case study carried out in the Brčko District of Bosnia and Herzegovina (Brčko District), a model will be developed to test for rural tourism destination attractiveness. Examination of tourist destination attractiveness in the area of the Brčko District was conducted with a decision model based on the Decision EXpert method and expert decision-making. For that purpose, six rural settlements in the area of the Brčko District were examined with respect to destination attractiveness. Results obtained using this model showed that rural settlement Bijela has a “very good” attractiveness, rural settlements Brezik, Brezovo Polje, and Gornji Zovik have “good” attractiveness, while rural settlements Ražljevo and Maoča have “middle” attractiveness. The results obtained by applying this model have shown the need for improvement of touristic offer in order to make it more attractive. In order to improve attractiveness of a tourist destination, we need to strengthen human potential in this area and improve tourist infrastructure and make more effort to preserve the environment. The application of the used model has given good results in examination of tourist destination attractiveness and it should be applied for other branches of tourism in the future studies.
The microcontact model of joint surfaces with waviness and asperity interaction
Authors: Li Ling , Pei Xiyong , Chu Wei , Cai Anjiang
Published: February 2020

The joint surfaces have a significant effect on the behavior of mechanical structures. Strong demand exists for the development of a model that can include the contact characteristics of joint surfaces. In this article, a new contact model considering asperity interaction and surface waviness is proposed. The roughness and waviness of the surface are separated by the Fourier series, and a contact model for an asperity is first established to obtain the displacement caused by asperity interaction. The joint surface is then treated as the contact between a rough surface and a smooth waviness to obtain a new model which considers asperity interaction and surface waviness. Simulation results show that when the normal load is fixed, the contact deformation decreases with the increasing radius of the waviness peak, but increases with the increasing surface roughness. In addition, asperity interaction will lead to a lower contact stiffness and a larger real contact area. Compared with other models, the results obtained from the proposed model are closer to the experimental results.
Differentiating leader hubris and narcissism on the basis of power
Authors: Asad Sarosh , Sadler-Smith Eugene
Published: February 2020

Hubris and narcissism overlap, and although extant research explores relationships between them in terms of characteristics, attributes, and behaviours, we take a different view by analysing their differences in relation to power and leadership. Drawing on a psychology of power perspective, we argue that narcissistic and hubristic leaders relate to and are covetous of power for fundamentally different reasons. Using the metaphor of intoxication, hubrists are intoxicated with positional power and prior success, but for narcissists, power facilitates self-intoxication and represents a means of maintaining a grandiose self-view. Unbridled hubris and narcissism (i.e. searching for and facilitated by unfettered power) have important ramifications for leadership research and practice. Leadership discourse, preoccupied with and predicated on positive aspects of leadership, should assess these two potent aspects of leadership because misuse of power by hubristic and narcissistic leaders can create conditions for, or directly bring about, destructive and sometimes catastrophic unintended outcomes for organizations and society.
Effects of sevoflurane and desflurane on the nociceptive responses of substantia gelatinosa neurons in the rat spinal cord dorsal horn: An in vivo patch-clamp analysis
Authors: Inada Yosuke , Funai Yusuke , Yamasaki Hiroyuki , Mori Takashi , Nishikawa Kiyonobu
Published: February 2020

Background

Volatile anesthetics suppress noxiously evoked activity in the spinal dorsal horn, which could contribute in part to analgesia, immobility. Modulation of excitatory and inhibitory synaptic transmission in substantia gelatinosa neurons could lead to the suppression of dorsal horn activity; however, this phenomenon has not yet been investigated fully.

Methods

In urethane-anesthetized rats, extracellular activity of dorsal horn neurons (action potentials) and excitatory/inhibitory postsynaptic currents in substantia gelatinosa neurons were recorded using extracellular and in vivo patch-clamp techniques, respectively, to assess the spontaneous and the noxious-evoked activity. Sevoflurane or desflurane at concentrations ranging from 0.1 to 2 minimum alveolar concentration was administered by inhalation. Hot- and cold-plate tests were performed to assess nociceptive responses during the inhalation of volatile anesthetics at lower anesthetic doses (0.1–0.5 minimum alveolar concentration).

Results

At anesthetic doses (1 and 2 minimum alveolar concentration), both sevoflurane and desflurane decreased the frequency of action potentials in the dorsal horn and the activities of excitatory postsynaptic currents in substantia gelatinosa neurons during pinch stimulation and decreased the activities of spontaneous and miniature excitatory postsynaptic currents. Inhibition of the frequencies was more prominent than that of amplitudes in spontaneous and miniature excitatory postsynaptic currents at these anesthetic doses. However, at subanesthetic doses (0.1 and 0.2 minimum alveolar concentration), desflurane facilitated action potentials and excitatory postsynaptic currents. Inhibitory postsynaptic currents were inhibited by both anesthetics at anesthetic doses (1 and 2 minimum alveolar concentration). Hot- or cold-plate tests showed hyperalgesic effects of desflurane at subanesthetic doses (0.1 and 0.2 minimum alveolar concentration) and a dose-dependent analgesic effect of sevoflurane.

Conclusions

Sevoflurane and desflurane at anesthetic doses suppressed dorsal horn activity mainly via inhibition of excitatory postsynaptic currents in substantia gelatinosa neurons, which would contribute to their analgesic properties. Presynaptic mechanisms were likely in excitatory postsynaptic currents inhibition. Desflurane but not sevoflurane may have a hyperalgesic effect at subanesthetic doses.
What’s in a Task? Complications in the Study of the Task-Unrelated-Thought Variety of Mind Wandering
Authors: Murray Samuel , Krasich Kristina , Schooler Jonathan W. , Seli Paul
Published: February 2020

In recent years, the number of studies examining mind wandering has increased considerably, and research on the topic has spread widely across various domains of psychological research. Athough the term mind wandering has been used to refer to various cognitive states, researchers typically operationalize mind wandering in terms of task-unrelated thought (TUT). Research on TUT has shed light on the various task features that require people’s attention and on the consequences of task inattention. Important methodological and conceptual complications do persist, however, in current investigations of TUT. We argue that these complications may be dampening the development of a more nuanced scientific account of TUT. In this article, we outline three of the more prominent methodological and conceptual complications in the literature on TUT and discuss potential directions for researchers to take as they move forward in their investigations of TUT.
Multidisciplinary reliability analysis of turbine blade with shape uncertainty by Kriging model and free-form deformation methods
Authors: Yang Fan , Xu Zhimin
Published: February 2020

This work presents an integrated approach for the multidisciplinary reliability analysis of turbine blades with shape uncertainty, including the metamodel, the free-form deformation, and the Monte Carlo simulation. The multidisciplinary analysis of turbine blade includes fluid, structure, and thermal analyses, which is time-consuming during integration with multidisciplinary reliability analysis. The metamodel is constructed by adaptive sampling to reduce computational cost. The shape uncertainty with small size changes in reliability analysis should be considered. The geometry-based multidisciplinary analysis may fail to capture the small size changes during the geometry and mesh regeneration process. The main contribution of this article is to introduce the free-form deformation in multidisciplinary reliability analysis to overcome the aforementioned problems. The mesh-based method supported by free-form deformation is proposed. Failure probability analysis of the multidisciplinary blade system is performed using the Monte Carlo simulation and the surrogate model. Through the numerical simulation, it is found that the failure probability increases as the blade shape uncertainty becomes larger. The methodology in this article provides a valuable and applicative way to calculate the risk of blade in multidisciplinary system.
Stereo three-dimensional particle image velocimetry measurement and aerodynamic force analysis of non-spinning soccer balls
Authors: Hiratsuka Masaki , Ito Shinichiro , Miyasaka Keita , Konno Akihisa
Published: February 2020

A knuckle shot, resulting from non-spinning kicking, is an essential technique in soccer. The irregular flight path of the knuckle shot is caused by the aerodynamic force from the three-dimensional twin vortices generated in the wake behind the ball. However, the detailed behavior of the twin vortices and relation between the jet flow and the acting forces on the balls is still not understood. In addition, a more thorough understanding of the effect of ball panels on the formation of twin vortices and jet flow is important to develop balls with high controllability. To study the effect of the ball panel shape on the flight path, stereo three-dimensional particle image velocimetry wake flow measurements and synchronized force measurements were performed on various soccer balls. It was confirmed that the aerodynamic force on the ball is produced by the jet flow generated by the vortices in the wake flow. The directions of the force followed the changes of the jet flow, and the magnitude of the force was strongly associated with the flow rate of the jet. Moreover, the shape of the ball panels, especially the groove volume, determines the critical Reynolds number and the fluttering of the balls.
Impact of a Concha Bullosa on Nasal Airflow Characteristics in the Setting of Nasal Septal Deviation: A Computational Fluid Dynamics Analysis
Authors: Li Lifeng , Zang Hongrui , Han Demin , Ramanathan Murugappan , Carrau Ricardo L. , London Nyall R.
Published: February 2020

Background

A concha bullosa (CB) of the middle turbinate is frequently observed on the nondeviated side of patients with a nasal septal deviation (NSD). However, the impact of the CB on nasal airflow characteristics in patients with NSD has been incompletely defined.

Objective

The purpose of this study was to evaluate the impact of a CB in patients with NSD on nasal airflow characteristics using a computational fluid dynamics (CFD) approach.

Methods

Twenty patients with NSD and a unilateral CB of the middle turbinate on the nondeviated side (study group) were recruited. Another 20 patients with NSD without the formation of a CB (control group) were also enrolled. Using CFD, the maximal airflow velocity, nasal resistance, maximal wall shear stress, and minimal temperature in the bilateral nostrils of each group were assessed. Moreover, the volume of the nasal tract, surface area-to-volume ratio, and the total nasal resistance were compared between the study and control groups.

Results

In the study group, no significant differences of airflow dynamics between the bilateral nasal cavities were observed. In the control group, however, there were statistically significant differences for maximal airflow velocity, nasal resistance, maximal wall shear stress, and minimal airflow temperature between the bilateral nostrils. The surface area-to-volume ratio and total nasal resistance in the study group was significantly higher and the nasal volume was significantly decreased than that in the control group.

Conclusion

CB of the middle turbinate on the nondeviated side of patients with NSD rendered airflow characteristics more evenly distributed between the bilateral nostrils as assessed by CFD. From an aerodynamics perspective, a CB may represent a compensatory action to normalize airflow dynamics. However, a CB may also result in constriction of the ipsilateral nasal cavity.
Cariprazine as a treatment across the bipolar I spectrum from depression to mania: mechanism of action and review of clinical data
Authors: Stahl Stephen M. , Laredo Sarah , Morrissette Debbi Ann
Published: February 2020

Cariprazine is one of the newest dopamine-serotonin partial agonists, also known as ‘atypical’ second generation antipsychotics. Originally approved for acute and maintenance treatment of schizophrenia as well as for acute mania and mixed mania/depression, cariprazine has now been approved for bipolar I depression. Additionally, post hoc analyses of bipolar I depressed subjects show that both those with and those without concurrent manic features were improved following treatment with cariprazine. Maintenance studies are in progress in bipolar disorder, as are studies to augment antidepressants in unipolar major depressive episodes insufficiently responsive to treatment. Here, we review specifically the efficacy and safety data of cariprazine in bipolar I disorder and discuss the hypothesized mechanism of action of cariprazine and how it could theoretically be linked to caprazine’s broad therapeutic actions across the mood disorder spectrum.
Exercise intolerance and fatigue in chronic heart failure: is there a role for group III/IV afferent feedback?
Authors: Angius Luca , Crisafulli Antonio
Published: February 2020

Exercise intolerance and early fatiguability are hallmark symptoms of chronic heart failure. While the malfunction of the heart is certainly the leading cause of chronic heart failure, the patho-physiological mechanisms of exercise intolerance in these patients are more complex, multifactorial and only partially understood. Some evidence points towards a potential role of an exaggerated afferent feedback from group III/IV muscle afferents in the genesis of these symptoms. Overactivity of feedback from these muscle afferents may cause exercise intolerance with a double action: by inducing cardiovascular dysregulation, by reducing motor output and by facilitating the development of central and peripheral fatigue during exercise. Importantly, physical inactivity appears to affect the progression of the syndrome negatively, while physical training can partially counteract this condition. In the present review, the role played by group III/IV afferent feedback in cardiovascular regulation during exercise and exercise-induced muscle fatigue of healthy people and their potential role in inducing exercise intolerance in chronic heart failure patients will be summarised.
Assessing the Astana Peace Process for Syria: Actors, Approaches, and Differences
Authors: Cengiz Sinem
Published: February 2020

Since 2011, numerous peace initiatives have been initiated out by several actors to end the Syrian civil war in a peaceful way. This article presents the “Astana Peace Process” brokered by Russia, Turkey, and Iran in early 2017 as a case study of a mediation and examines its predecessors to understand the reasons for the failures of those attempts and develops an assessment of the Astana peace process itself. To gain a better understanding of the Astana peace process, this article incorporates the efforts of main actors, their approaches, and the context of the war. In doing so, the article begins by describing the background of the civil war and then uses traditional concepts in mediation theory to elucidate the limitations of the unsuccessful attempts. Next, it investigates how the Astana peace process was different and the driving factors that encouraged the states to engage in this process and argues that Astana peace process’s overall effectiveness is likely to remain limited due to the conflicting interests of the mediators.
The Long Road to Benefits Management: Toward an Integrative Management Model
Authors: Svejvig Per , Schlichter Bjarne Rerup
Published: February 2020

This article reports on a four-year action research study, where the aims were to study benefits management at a detailed, practical level and to evaluate the benefits management practices applied. Synthesizing the insights from the study shows that the approach is dependent on the context and that the action research process was a challenging endeavor, but also that the project was successful with respect to improving performance. We provide a structured evaluation of the practiced process to uncover weaknesses and improve future interventions by suggesting an integrative management model with three layers: instrumental, practical, and reflective.
Exploring Student Perceptions of Their Readiness for Project Work: Utilizing Social Cognitive Career Theory
Authors: Burga Ruben , Leblanc Joshua , Rezania Davar
Published: February 2020

A changing labor market is leading to an increased prevalence in project work. In this study, we explore student perceptions of project work. We find that these emerging adults prefer leadership positions, are concerned with social values, and view project work as essential preparation for the workplace. Utilizing a social cognitive career theory lens, we find that the goals, interests, and self-efficacy beliefs of emerging adults align with the needs of project management, but there is a lack of technical knowledge on project processes. Framing the question from the viewpoint of students who will be entering the workforce at the end of their programs of study, we see that students embrace the concepts inherent in project work. The implication for human resource managers is that emerging adults believe that they can succeed in project work, but technical skills are needed to help them succeed in formal project management roles. We provide recommendations, discuss limitations, and suggest future research directions.
Immune profile differences between chronic GVHD and late acute GVHD: results of the ABLE/PBMTC 1202 studies
Authors: Schultz Kirk R. , Kariminia Amina , Ng Bernard , Abdossamadi Sayeh , Lauener Madeline , Nemecek Eneida R. , Wahlstrom Justin T. , Kitko Carrie L. , Lewis Victor A. , Schechter Tal , Jacobsohn David A. , Harris Andrew C. , Pulsipher Michael A. , Bittencourt Henrique , Choi Sung Won , Caywood Emi H. , Kasow Kimberly A. , Bhatia Monica , Oshrine Benjamin R. , Flower Allyson , Chaudhury Sonali , Coulter Donald , Chewning Joseph H. , Joyce Michael , Savasan Sureyya , Pawlowska Anna B. , Megason Gail C. , Mitchell David , Cheerva Alexandra C. , Lawitschka Anita , Azadpour Shima , Ostroumov Elena , Subrt Peter , Halevy Anat , Mostafavi Sara , Cuvelier Geoffrey D. E.
Published: February 2020

Human graft-versus-host disease (GVHD) biology beyond 3 months after hematopoietic stem cell transplantation (HSCT) is complex. The Applied Biomarker in Late Effects of Childhood Cancer study (ABLE/PBMTC1202, NCT02067832) evaluated the immune profiles in chronic GVHD (cGVHD) and late acute GVHD (L-aGVHD). Peripheral blood immune cell and plasma markers were analyzed at day 100 post-HSCT and correlated with GVHD diagnosed according to the National Institutes of Health consensus criteria (NIH-CC) for cGVHD. Of 302 children enrolled, 241 were evaluable as L-aGVHD, cGVHD, active L-aGVHD or cGVHD, and no cGVHD/L-aGVHD. Significant marker differences, adjusted for major clinical factors, were defined as meeting all 3 criteria: receiver-operating characteristic area under the curve ≥0.60, P ≤ .05, and effect ratio ≥1.3 or ≤0.75. Patients with only distinctive features but determined as cGVHD by the adjudication committee (non-NIH-CC) had immune profiles similar to NIH-CC. Both cGVHD and L-aGVHD had decreased transitional B cells and increased cytolytic natural killer (NK) cells. cGVHD had additional abnormalities, with increased activated T cells, naive helper T (Th) and cytotoxic T cells, loss of CD56bright regulatory NK cells, and increased ST2 and soluble CD13. Active L-aGVHD before day 114 had additional abnormalities in naive Th, naive regulatory T (Treg) cell populations, and cytokines, and active cGVHD had an increase in PD-1− and a decrease in PD-1+ memory Treg cells. Unsupervised analysis appeared to show a progression of immune abnormalities from no cGVHD/L-aGVHD to L-aGVHD, with the most complex pattern in cGVHD. Comprehensive immune profiling will allow us to better understand how to minimize L-aGVHD and cGVHD. Further confirmation in adult and pediatric cohorts is needed.
α1-Antitrypsin deficiency and chronic respiratory disorders
Authors: Cazzola Mario , Stolz Daiana , Rogliani Paola , Matera Maria Gabriella
Published: February 2020

α1-antitrypsin deficiency (AATD) is a hereditary disorder associated with a risk of developing liver disease and pulmonary emphysema, and other chronic respiratory disorders (mainly asthma and bronchiectasis); Z variant is the commonest deficient variant of AAT. Determining AAT concentration in serum or plasma and identifying allelic variants by phenotyping or genotyping are fundamental in the diagnosis of AATD. Initial evaluation and annual follow-up measurement of lung function, including post-bronchodilator forced expiratory volume in 1 s and gas transfer inform on disease progression. Lung densitometry is the most sensitive measure of emphysema progression, but must not be use in the follow-up of patients in routine clinical practice. The exogenous administration of purified human serum-derived AAT is the only approved specific treatment for AATD in PiZZ. AAT augmentation therapy is not recommended in PiSZ, PiMZ or current smokers of any protein phenotype, or in patients with hepatic disease. Lung volume reduction and endoscopic bronchial valve placement are useful in selected patients, whereas the survival benefit of lung transplant is unclear. There are several new lines of research in AATD to improve the diagnosis and evaluation of the response to therapy and to develop genetic and regenerative therapies and other treatments.
Digital imaging-assisted quantification of H3K27me3 immunoexpression in luminal A/B-like, HER2-negative, invasive breast cancer predicts patient survival and risk of recurrence
Authors: Fontes-Sousa Mário , Lobo João , Lobo Silvana , Salta Sofia , Amorim Maria , Lopes Paula , Antunes Luís , de Sousa Susana Palma , Henrique Rui , Jerónimo Carmen
Published: February 2020

Background

Breast cancer (BC) is a major health concern and better understanding of its biology might improve treatment decisions and patient outcomes. Histone3 Lysine27 tri-methylation (H3K27me3) is a post-translational histone modification frequently associated with altered gene expression. In BC patients, lower H3K27me3 expression has been associated with worse prognosis. We assessed H3K27me3 immunoexpression with digital imaging software assistance, in a cohort of luminal-like BC patients with long-term follow-up time and evaluated its association with clinically relevant endpoints and its clinical usefulness.

Methods

H3K27me3 immunoexpression was assessed, by means of digital-imaging system, in archival tissue samples of 160 luminal A/B-like HER2-negative invasive BC, stages I-III. Survival analysis was performed using Kaplan-Meier and Cox regression. Cases were categorized as ‘low’ or ‘high’ expression based on cut-off defined by receiver operating characteristic (ROC) curve analysis.

Results

The patient cohort showed a median age of 61-years, with a median follow-up time of 11.7 years. Low H3K27me3 expression (below 85% cut-off) was significantly associated with recurrence, both in univariable (HR = 1.99, 95%CI 1.066–3.724) and multivariable analysis when adjusting for grade and age (HR = 1.89, 95%CI 1.004–3.559). A trend for higher risk of death in low H3K27me3 expression BC was observed (p = 0.069), reaching statistical significance in younger patients (p = 0.021).

Conclusions

H3K27me3 immunoexpression assessed by digital imaging scoring software is an independent prognosis biomarker in luminal-like BC patients and may assist in more individualized adjuvant treatment decisions, thus potentially reducing recurrences after curative-intent treatment, while sparing unnecessary toxicity.
Accuracy of Broselow tape in estimating the weight of the child for management of pediatric emergencies in Nepalese population
Authors: K.C. Pukar , Jha Akhilendra , Ghimire Kamal , Shrestha Roshana , Shrestha Anmol Purna
Published: February 2020

Background

Children with emergency conditions require immediate life-saving intervention and resuscitation. Unlike adults, the pediatric emergency drug dose, equipment sizes, and defibrillation energy doses are calculated based on the weight of the individual child. Broselow tape is a color-coded length-based tape that utilizes height/weight correlations for children. However, in low-income countries like Nepal, due to factors like undernutrition, the Broselow tape may not accurately estimate weight in all ranges of pediatric age group.

Methods

This study was conducted in the Department of Pediatrics of Dhulikhel Hospital, Kathmandu University Teaching Hospital, in children less than 15 years of age. Our study aims to prospectively compare the actual weights of urban and rural Nepalese children with the estimated weights using the Broselow tape (2017 edition) and the updated APLS formula. The errors in the selection of endotracheal tube size and adrenaline dose using the Broselow tape were also explored.

Results

This study included 315 children with male to female ratio of 0.63:1. They were divided into 3 groups according to their estimated weight by the Broselow tape into < 10 kg, 10–18, and > 18 kg. There was a total agreement of the estimated color zone according to the Broselow tape with the actual weight in the gray zone (p = 0.01). There was a positive relationship between the actual body weight and the estimated body weight (correlation (r = 0.970, p = 0.01) and accuracy (r2 = 0.941)). Our analysis showed that the accuracy of estimated weight with the Broselow tape decreases with increasing weight of children. The precision of the tape was relatively high in the lower length zones as compared to the higher length zones. The estimated size of the endotracheal tube (p = 0.01) and adrenaline dose (p = 0.08) by the Broselow tape was in agreement with that estimated using PALS formula in weight group of less than 18 kg, but decreases as the estimated weight increases further.

Conclusions

The accuracy of the Broselow tape in estimating the weight of a child, endotracheal tube size, and dose of adrenaline is higher in weight group of less than 18 kg, and accuracy decreases as the weight of child increases. The Broselow tape should be avoided in children weighing more than 18 kg. Hence, PALS age-based formula for ET tube size estimation and weight-based formula for adrenaline dose calculation are recommended for children weighing more than 18 kg.
Beyond large-effect loci: large-scale GWAS reveals a mixed large-effect and polygenic architecture for age at maturity of Atlantic salmon
Authors: Sinclair-Waters Marion , Ødegård Jørgen , Korsvoll Sven Arild , Moen Thomas , Lien Sigbjørn , Primmer Craig R. , Barson Nicola J.
Published: February 2020

Background

Understanding genetic architecture is essential for determining how traits will change in response to evolutionary processes such as selection, genetic drift and/or gene flow. In Atlantic salmon, age at maturity is an important life history trait that affects factors such as survival, reproductive success, and growth. Furthermore, age at maturity can seriously impact aquaculture production. Therefore, characterizing the genetic architecture that underlies variation in age at maturity is of key interest.

Results

Here, we refine our understanding of the genetic architecture for age at maturity of male Atlantic salmon using a genome-wide association study of 11,166 males from a single aquaculture strain, using imputed genotypes at 512,397 single nucleotide polymorphisms (SNPs). All individuals were genotyped with a 50K SNP array and imputed to higher density using parents genotyped with a 930K SNP array and pedigree information. We found significant association signals on 28 of 29 chromosomes (P-values: 8.7 × 10−133–9.8 × 10−8), including two very strong signals spanning the six6 and vgll3 gene regions on chromosomes 9 and 25, respectively. Furthermore, we identified 116 independent signals that tagged 120 candidate genes with varying effect sizes. Five of the candidate genes found here were previously associated with age at maturity in other vertebrates, including humans.

Discussion

These results reveal a mixed architecture of large-effect loci and a polygenic component that consists of multiple smaller-effect loci, suggesting a more complex genetic architecture of Atlantic salmon age at maturity than previously thought. This more complex architecture will have implications for selection on this key trait in aquaculture and for management of wild salmon populations.