bluuebunny/crossref_metadata_2025 huggingface dataset:
Postoperative hormonal treatment for prevention of endometrioma recurrence after ovarian cystectomy: a systematic review and network meta‐analysis
Authors: Wattanayingcharoenchai R , Rattanasiri S , Charakorn C , Attia J , Thakkinstian A
Published: June 2020

Background

The efficacy of hormonal regimens for the prevention of endometrioma recurrence in women who have undergone conservative surgery is still controversial.

Objective

To compare the efficacy of different hormonal regimens in this context and to rank them.

Search strategy

MEDLINE and Scopus databases were searched through January 2020.

Selection criteria

Randomised controlled trials (RCTs) or cohorts, comparing the effect of any pair of interventions (i.e. cyclic oral contraceptives [OC], continuous OC, gonadotropin‐releasing hormone agonist [GnRHa], dienogest [DNG], levonorgestrel‐releasing intrauterine system [LNG‐IUS] and expectant management) on endometrioma recurrence were selected.

Data collection and analysis

Data were independently extracted by two reviewers. Relative treatment effects were estimated using network meta‐analysis (NMA) and ranked in descending order.

Main results

Six RCTs (675 patients) and 16 cohorts (3089 patients) were included. NMA of the RCTs involving expectant management, cyclic OC, continuous OC, GnRHa and GnRHa + LNG‐IUS, showed that all hormonal regimens had a nonsignificant lower risk of endometrioma recurrence compared with expectant management. NMA of the cohorts involving expectant, cyclic OC, continuous OC, GnRHa, DNG, LNG‐IUS, GnRHa + OC, and GnRHa + LNG‐IUS indicated that LNG‐IUS, DNG, continuous OC, GnRHa + OC and cyclic OC had a significantly lower risk of endometrioma recurrence than expectant management. LNG‐IUS was ranked highest, followed by DNG and GnRHa + LNG‐IUS. Long‐term use of hormonal treatment either OC or progestin had a significantly lower risk of endometrioma recurrence than expectant treatment.

Conclusion

In the NMA of RCTs, there was no evidence supporting hormonal treatment for postoperative prevention of endometrioma recurrence. This was at odds with the cohort evidence, which found the protective effect of OC and progestin regimens, especially long‐term treatment. Large‐scale RCTs of these agents are still required.

Tweetable abstract

Hormonal regimens given as long‐term treatment tend to reduce risk of endometrioma recurrence after conservative surgery.
Foreign Exchange Risk, Hedging, and Tax‐Motivated Outbound Income Shifting
Authors: DENG ZERO
Published: June 2020

Although outbound income shifting to low‐tax jurisdictions provides tax savings, it is often accompanied by nontax costs. In this study, I examine whether foreign exchange (FX) risk constrains tax‐motivated outbound income shifting by U.S. multinational corporations. My findings indicate that exposure to greater currency volatility is associated with less outbound income shifting, and this effect is stronger for firms with foreign affiliates using foreign functional currencies. I also investigate whether hedging facilitates outbound income shifting. Consistent with hedging lowering costs associated with exchange rate volatility, I find that U.S. firms that use more currency derivatives tend to shift more income to low‐tax foreign jurisdictions. Overall, these findings suggest that FX risk is an important cost of outbound income shifting.
Tobacco extracts promote PD‐L1 expression and enhance malignant biological differences via mTOR in gefitinib‐resistant cell lines
Authors: Xiao Fengqi , Liu Yanguo , Zhang Zhihui , Wang Luojia , Wang Ting , Wang Xiuwen
Published: June 2020

Background

The aim of this study was to investigate whether tobacco extracts could regulate PD‐L1 expression and enhance malignant biological differences in gefitinib‐resistant cell lines.

Methods

We constructed gefitinib‐resistant cells and observed the biological differences in gefitinib‐resistant cells. The cells were stimulated with medium containing 5% volume of tobacco extract, and the change in PD‐L1 expression and the mammalian target of rapamycin (mTOR) and p‐mTOR expression in gefitinib‐resistant cells treated with tobacco extracts was observed. We discussed the relationship between PD‐L1 and mTOR.

Results

Tobacco extracts could promote PD‐L1 expression in the cell line. Western blot analysis showed that mTOR and p‐mTOR were significantly enhanced in gefitinib‐resistant cell lines cultured in the tobacco extracts. The mTOR signaling pathway was involved in PD‐L1 expression and in regulating the expression of cytokines IL‐6 and IL‐23. In addition, the tobacco extracts could promote macrophage migration via mTOR/IL‐6.

Conclusions

PD‐L1 can transmit inhibitory signals and reduce the proliferation of CD8 + T cells in lymph nodes. Tobacco extracts upregulate PD‐L1 expression via mTOR/IL‐6. These results imply that lung cancer patients should not smoke and stay away from a smoke environment.
Predictors of transport to hospital after emergency ambulance call‐out for older people living in residential aged care
Authors: Dwyer Rosamond A. , Gabbe Belinda J. , Tran Thach , Smith Karen , Lowthian Judy A.
Published: June 2020

Objectives

People living in residential aged care (RAC) frequently experience ambulance call‐out. These episodes may have unintended consequences, yet remain under‐investigated. Our aim was to examine clinical and sociodemographic features associated with transfer to hospital for this population.

Methods

Retrospective cohort study using 6 years of clinical data from Ambulance Victoria (AV). Data analysis included multilevel multivariable logistic regression analysis of factors associated with transport to hospital.

Results

Odds of transfer were greater for people in rural areas, those with a history of depression, cardiovascular disease and osteoporosis, and residents prescribed antipsychotic and antidepressant medication. Ambulance call‐out for trauma (commonly low‐level fall) was less frequently transferred to hospital than that for a medical complaint.

Conclusion

These results will improve prediction of call‐outs likely to require transfer. Findings include identification of clinical features to be targeted by community and preventative health programs to reduce risk of acute health deterioration and requirement for emergency hospital transfer.
Planned delivery route and outcomes of cephalic singletons born spontaneously at 24‐31 weeks’ gestation: The EPIPAGE‐2 cohort study
Authors: Gaudineau Adrien , Lorthe Elsa , Quere Mathilde , Goffinet François , Langer Bruno , Le Ray Isabelle , Subtil Damien
Published: June 2020

Introduction

The objective of this study was to investigate the association between planned mode of delivery and neonatal outcomes with spontaneous very preterm birth among singletons in cephalic presentation.

Material and methods

Etude Epidémiologique sur les Petits Ages Gestationnels 2 is a French national, prospective, population‐based cohort study of preterm infants. For this study, we included women with a singleton cephalic pregnancy and spontaneous preterm labor or preterm premature rupture of membranes at 24‐31 weeks’ gestation. The main exposure was the planned mode of delivery (ie planned vaginal delivery or planned cesarean delivery at the initiation of labor). The primary outcome was survival at discharge and secondary outcome survival at discharge without severe morbidity. Propensity scores were used to minimize indication bias in estimating the association.

Results

The study population consisted of 1008 women: 206 (20.4%) had planned cesarean delivery and 802 (79.6%) planned vaginal delivery. In all, 723 (90.2%) finally had a vaginal delivery. Overall, 187 (92.0%) and 681 (87.0%) neonates in the planned cesarean delivery and planned vaginal delivery groups were discharged alive, and 156 (77.6%) and 590 (76.3%) were discharged alive without severe morbidity. After matching on propensity score, planned cesarean delivery was not associated with survival (adjusted odds ratio [aOR] 1.05, 95% confidence interval [CI] 0.48‐2.28) or survival without severe morbidity (aOR 0.64, 95% CI 0.36‐1.16).

Conclusions

Planned cesarean delivery for cephalic presentation at 24‐31 weeks’ gestation after preterm labor or preterm premature rupture of membranes does not improve neonatal outcomes.
Impact of minimal invasive extracorporeal circulation on atrial fibrillation after coronary artery bypass surgery
Authors: Ellam Sten , Hartikainen Juha , Korvenoja Pekka , Pitkänen Otto , Tyrväinen Esko , Valtola Antti , Halonen Jari
Published: June 2020

Postoperative atrial fibrillation (POAF) is the most common arrhythmia after cardiac surgery with an incidence between 15% and 50% and pathophysiology not fully known. By choosing the method of extracorporeal circulation with focus on the reduction of systemic inflammatory response, one can potentially decrease the risk of POAF. In this prospective, randomized trial, we compared minimal invasive extracorporeal circulation (MiECC) with conventional extracorporeal circulation (CECC) in the prevention of POAF after coronary artery bypass surgery (CABG). A total of 240 patients who were scheduled for their first on‐pump CABG, were randomized to MiECC or CECC. The primary outcome measure was the incidence of first POAF during the first 84 hours after surgery. POAF occurred in 42/120 (35.0%) MiECC patients and 43/120 (35.8%) CECC patients with nonsignificant difference between the groups (OR 1.043, 95% CI 0.591‐1.843, P = .884). The first postoperative creatine kinase‐MB mass (CK‐MBm) value was lower in the MiECC group, 13.95 [10.5‐16.7] (median [IQR]) than in the CECC group, 15.30 [11.4‐18.9] (P = .036), whereas the use of perioperative dobutamine was higher in the MiECC group, 18/120 (15.0%), than in the CECC group 8/120 (6.7%) (P = .038). The incidence of a stroke, perioperative myocardial infarction, and resternotomy caused by bleeding did not differ in the MiECC and CECC groups. Age (OR 1.08, 95% CI 1.04‐1.13, P = .000) and peak postoperative CK‐MBm (OR 1.57, 95% CI 1.06‐2.37, P = .026) were independent predictors of POAF. MiECC compared to CECC was not effective in reducing the incidence of POAF in patients undergoing CABG.
Pharmacokinetic and pharmacodynamic evidence of adrenaline administered via auto‐injector for anaphylactic reactions: A review of literature
Authors: Moss James , Jani Yogini , Edwards Brian , Tomlin Stephen , Rashed Asia N.
Published: June 2020

Anaphylaxis is a severe allergic reaction that can lead to death if not treated quickly. Adrenaline (epinephrine) is the first‐line treatment for anaphylaxis and its prompt administration is vital to reduce mortality. Following a number of high‐profile cases, serious concerns have been raised, both about the optimal dose of intramuscular adrenaline via an auto‐injector and the correct needle length to ensure maximal penetration every time.

To date, the public data are sparse on the pharmacokinetics–pharmacodynamics of adrenaline administered via an auto‐injector. The limited available literature showed a huge variation in the plasma concentrations of adrenaline administered through an auto‐injector, as well as variations in the auto‐injector needle length. Hence, delivering an effective dose during an anaphylaxis remains a challenge for both patients and healthcare professionals. Collaborative work between pharmacokinetics–pharmacodynamics experts, clinical triallists and licence holders is imperative to address this gap in evidence so that we can improve outcomes of anaphylaxis. In addition, we advise inclusion of expertise of human factors in usability studies given the necessity of carer or self‐administration in the uniquely stressful nature of anaphylaxis.
Patterns of use and safety of ibrutinib in real‐life practice
Authors: Allouchery Marion , Tomowiak Cécile , Guidez Stéphanie , Delwail Vincent , Delaunay Paul , Lafay‐Chebassier Claire , Salvo Francesco , Pérault‐Pochat Marie‐Christine
Published: June 2020

Aims

To provide real‐life data on patterns of use and safety of ibrutinib.

Methods

A cohort study including all patients initiating ibrutinib between 21 November 2014 and 21 November 2018, and followed for 1 year was conducted. Patient characteristics, ibrutinib use and adverse drug reactions (ADRs) were collected from medical records. Kaplan–Meier analysis estimated the probability of developing ibrutinib‐associated serious ADRs (SADRs) with a 95% confidence interval (CI). A Cox proportional hazards model was used to investigate factors associated with SADR occurrence.

Results

In total, 102 patients were included in the study. The median age was 70.3 years (interquartile range 64.7–75.6), the male/female gender ratio was 2.9. Almost half the patients (47.1%) were prescribed ibrutinib for chronic lymphocytic leukaemia (CLL). Forty‐three patients (42.1%) permanently discontinued ibrutinib in the first year, mostly for progression (51.2%) or ADRs (32.6%). Forty‐eight patients (47.1%) experienced at least one ibrutinib‐associated SADR. Haematological, infectious and vascular disorders were the most frequent SADRs. The probability of developing ibrutinib‐associated SADR was 35.1% (95% CI 26.3–45.7%) at 3 months, 44.8% (35.2%; 55.8%) at 6 months and 54.3% (44.0%; 65.2%) at 12 months. Age ≥80 years (hazard ratio [HR] 2.03; 95% CI 1.02–4.05) and CLL (HR 1.81; 95% CI 1.01–3.25) were significantly associated with a higher risk of SADR occurrence.

Conclusion

This study found a high cumulative incidence of ibrutinib‐associated SADRs within the first year of treatment. In view of the risk of SADR, patients aged ≥80 years or treated for CLL deserve special attention.
Public CFO competencies – A National Defence case study examining the balance between financial and strategic priorities
Authors: Schobel Kurt , Pond Geoffrey
Published: June 2020

The role of the Chief Financial Officer (CFO) in the public sector is relatively new. Prior research on private sector CFOs identified that CFOs tend to focus on either financial or strategic issues. In this study, we examined if these same tendencies exist within the public sector. Using the Department of National Defence as a case study, we asked Comptrollers to compare a set of 8 roles to determine if a bias towards financial or strategic roles exists. We found that some bias exists within National Defence; however, we also found most recognize that you cannot focus exclusively on either role.
Immigration policy in Québec‐Canada as a case study of incrementalism
Authors: Couture Gagnon Alexandre
Published: June 2020

Québec has more powers in immigration policy than other provinces. Since the 1991Canada–Québec Accord relating to Immigration and Temporary Admission of Aliens(the 1991Agreement), it selects almost all categories of immigrants and manages a relatively important monetary contribution from Ottawa for their integration. How did Québec and Canada arrive at the favorable‐for‐Québec 1991Agreement? Surveying the main actions that have comprised immigration policy in Québec and Canada from the 1960s until 1991, this article shows that the method for change was incrementalism and contributes to developing incrementalism as an applied theory of policymaking including proposing the conditions under which it is most likely to be relied on in immigration policy.
NEVA: Visual Analytics to Identify Fraudulent Networks
Authors: A. Leite Roger , Gschwandtner Theresia , Miksch Silvia , Gstrein Erich , Kuntner Johannes
Published: June 2020

Trust‐ability, reputation, security and quality are the main concerns for public and private financial institutions. To detect fraudulent behaviour, several techniques are applied pursuing different goals. For well‐defined problems, analytical methods are applicable to examine the history of customer transactions. However, fraudulent behaviour is constantly changing, which results in ill‐defined problems. Furthermore, analysing the behaviour of individual customers is not sufficient to detect more complex structures such as networks of fraudulent actors. We propose NEVA (Network dEtection with Visual Analytics), a Visual Analytics exploration environment to support the analysis of customer networks in order to reduce false‐negative and false‐positive alarms of frauds. Multiple coordinated views allow for exploring complex relations and dependencies of the data. A guidance‐enriched component for network pattern generation, detection and filtering support exploring and analysing the relationships of nodes on different levels of complexity. In six expert interviews, we illustrate the applicability and usability of NEVA.
Depressive and anxiety symptoms and suicidality in adolescent and young adult females with moderate to severe obesity before and after weight loss surgery
Authors: Baskaran Charumathi , Bose Amita , Plessow Franziska , Torre Flores Landy , Toth Alexander T. , Eddy Kamryn T. , Bredella Miriam A. , Misra Madhusmita
Published: June 2020

Data are conflicting regarding the impact of weight loss on mood and anxiety in adolescent and young adult females with moderate to severe obesity (OB), who are at increased risk for mood dysfunction compared with normal‐weight females (NW). We examined depressive and anxiety symptoms in 94 females 13‐21 years old: 39 in the NW group (body mass index [BMI]: 5th‐85th percentiles) and 55 in the OB group (BMI >40 kg/m2 or >35 kg/m2 with comorbidities). Fifteen participants in the OB group who underwent bariatric surgery (gastric bypass or sleeve gastrectomy) and 15 getting routine care were re‐assessed after 6 months. The Beck Depression Inventory‐II (BDI‐II) and State‐Trait Anxiety Inventory (STAI) assessed depressive and anxiety symptoms, respectively. The OB group had higher BDI‐II and STAI T‐scores (P < .0001), a higher prevalence of clinical depression and anxiety (P < .001), and reported greater suicidal ideation (P = .02) vs the NW group. The bariatric surgery and non‐surgical groups did not differ for changes in BDI‐II and STAI T‐Scores and suicidality over 6‐month follow‐up, despite greater weight loss in the former. Depressive and anxiety symptoms and suicidality were more frequently observed in the OB vs NW group. These symptoms did not improve following bariatric surgery despite significant weight loss, underscoring the need to investigate determinants of emergence and resolution of these symptoms in the OB group.
Using decision science to evaluate global biodiversity indices
Authors: Watermeyer Kate E. , Guillera‐Arroita Gurutzeta , Bal Payal , Burgass Michael J. , Bland Lucie M. , Collen Ben , Hallam Chris , Kelly Luke T. , McCarthy Michael A. , Regan Tracey J. , Stevenson Simone , Wintle Brendan A. , Nicholson Emily
Published: June 2020

Global biodiversity indices are used to measure environmental change and progress toward conservation goals, yet few indices have been evaluated comprehensively for their capacity to detect trends of interest, such as declines in threatened species or ecosystem function. Using a structured approach based on decision science, we qualitatively evaluated 9 indices commonly used to track biodiversity at global and regional scales against 5 criteria relating to objectives, design, behavior, incorporation of uncertainty, and constraints (e.g., costs and data availability). Evaluation was based on reference literature for indices available at the time of assessment. We identified 4 key gaps in indices assessed: pathways to achieving goals (means objectives) were not always clear or relevant to desired outcomes (fundamental objectives); index testing and understanding of expected behavior was often lacking; uncertainty was seldom acknowledged or accounted for; and costs of implementation were seldom considered. These gaps may render indices inadequate in certain decision‐making contexts and are problematic for indices linked with biodiversity targets and sustainability goals. Ensuring that index objectives are clear and their design is underpinned by a model of relevant processes are crucial in addressing the gaps identified by our assessment. Uptake and productive use of indices will be improved if index performance is tested rigorously and assumptions and uncertainties are clearly communicated to end users. This will increase index accuracy and value in tracking biodiversity change and supporting national and global policy decisions, such as the post‐2020 global biodiversity framework of the Convention on Biological Diversity.
Barriers to accessing psychosocial support for humanitarian aid workers: a mixed methods inquiry
Authors: Cockcroft‐McKay Caitlin , Eiroa‐Orosa Francisco José
Published: June 2020

International and national humanitarian aid workers were recruited for this study via purposive sampling techniques using social media. Eight interviews and one focus group discussion were carried out (n=13), and a survey disseminated (n=62), to garner a broad range of perspectives on barriers to aid workers seeking out and accessing psychosocial support. A thematic analysis was performed on the transcriptions of the interviews and focus group discussion. The hypothesis was that participants would describe a variety of personal, professional, and environmental obstacles, with ‘tough‐guy macho culture’ and/or ‘martyr culture’ being the strongest deterrents. Fourteen barriers in total were identified: accessibility; appropriateness; attitude; availability; confidentiality and trust; duty of care; guidance; normalisation; experience; repercussions; self‐awareness; self‐reliance; stigma; and time. It is recommended that organisations improve the provision of quality, appropriate psychosocial support for staff, and that it is communicated regularly, and they train staff in pinpointing when others are in need of assistance.
Remission of type 2 diabetes following long‐term treatment with injectable testosterone undecanoate in patients with hypogonadism and type 2 diabetes: 11‐year data from a real‐world registry study
Authors: Haider Karim Sultan , Haider Ahmad , Saad Farid , Doros Gheorghe , Hanefeld Markolf , Dhindsa Sandeep , Dandona Paresh , Traish Abdulmaged
Published: June 2020

Aims

To investigate whether testosterone therapy (TTh) in men with hypogonadism and type 2 diabetes mellitus (T2DM) improves glycaemic control and insulin sensitivity, and results in remission of T2DM.

Material and Methods

A total of 356 men who had total testosterone levels ≤12.1 nmol/L (350 ng/dL) and symptoms of hypogonadism were included in the study and followed up for 11 years. All patients received standard diabetes treatment and 178 patients additionally received parenteral testosterone undecanoate 1000 mg every 12 weeks following an initial 6‐week interval. A control group comprised 178 hypogonadal patients who opted not to receive TTh.

Results

Patients with hypogonadism and T2DM treated with testosterone had significant progressive and sustained reductions in fasting glucose, glycated haemoglobin (HbA1c) and fasting insulin over the treatment period. In the control group, fasting glucose, HbA1c and fasting insulin increased. Among the patients treated with testosterone 34.3% achieved remission of their diabetes and 46.6% of patients achieved normal glucose regulation. Of the testosterone‐treated group, 83.1% reached the HbA1c target of 47.5 mmol/mol (6.5%) and 90% achieved the HbA1c target of 53.0 mmol/mol (7%). In contrast, no remission of diabetes or reductions in glucose or HbA1c levels were noted in the control group. There were fewer deaths, myocardial infarctions, strokes and diabetic complications in the testosterone‐treated group.

Conclusions

Long‐term TTh in men with T2DM and hypogonadism improves glycaemic control and insulin resistance. Remission of diabetes occurred in one‐third of the patients. TTh is potentially a novel additional therapy for men with T2DM and hypogonadism.
Increased TG/HDL‐C in female G allele carriers of rs1061622 at gene of tumour necrosis factor receptor 2 with suicidal ideation
Authors: Si Yan Jun , Guo Qi Wei , Chen Xu , Yang Mei , Lin Jia , Fang Ding Zhi
Published: June 2020

Background

Relationships between tumour necrosis factor receptor 2 (TNF‐RII), suicidal ideation and levels of serum lipids have not been reported yet. The present study was to explore lipids profiles in Chinese adolescents with different genotypes of TNF‐RII rs1061622 and with or without suicidal ideation.

Methods

Dietary intakes were surveyed by questionnaires. TNF‐RII rs1061622 genotypes were examined by polymerase chain reaction restriction‐fragment length polymorphism and verified by DNA sequencing. Lipids levels were examined by routine methods.

Results

Higher TC/HDL‐C levels were observed in the subjects with suicidal ideation than those without suicidal ideation in the male students, but no significant differences were found in the female counterparts. When both TNF‐RII rs1061622 and suicidal ideation were considered, although there was no significant difference of suicidal ideation prevalence between the TT homozygotes and the G allele carriers, the G allele carriers had elevated levels of TG and TG/HDL‐C compared with the TT homozygotes only in the female subjects with suicidal ideation. The subjects with suicidal ideation had higher TG/HDL‐C levels than those without suicidal ideation only in the female G allele carriers. Both suicidal ideation and TNF‐RII rs1061622, together with BMI, gender and fat intakes, were found the predictors of TG/HDL‐C levels. Different relationship patterns of lipids levels were discovered between male and female subjects with different genotypes and with or without suicidal ideation.

Conclusions

Different changes of lipids profiles between the subjects with or without suicidal ideation may result from not only the genders, but also their interactions with TNF‐RII rs1061622.
Effect of host plant on the fitness of the spittlebug Notozulia entreriana: alternative method for rearing
Authors: Foieri Alvaro , Virla Eduardo Gabriel , Maciá Arnaldo , Marino de Remes Lenicov Ana Maria
Published: June 2020

Among the species belonging to 11 genera of Neotropical spittlebugs attacking graminaceous plants, Notozulia entreriana (Berg) (Hemiptera: Cercopidae) is one of the most important pests of grasses in several countries of South America. In this study, we evaluate the influence of three economically relevant species of host plants (Poaceae) on life‐cycle traits of N. entreriana. We tested for differences in fitness responses (survival and fecundity) of insects on forage species which are frequent hosts for wild populations of spittlebugs. Comparison of life cycles on three host plants showed that only 2.5% of nymphs completed their development on Zea mays L., 22.5% on Chloris gayana Kunth, and 95% on Brachiaria decumbens Stapf. All the above suggests that C. gayana and B. decumbens are able to sustain complete development, behaving like natural hosts; the latter species is superior for artificial colonies because a shorter developmental period, higher survivorship in nymphs, and longer lifespan of adults were observed. Zea mays did not allow proper development, causing high mortality instead. We also developed a new approach for small‐scale breeding of N. entreriana, which will enable subsequent biological and behavioral studies on this important pest species.
Gait‐phase‐dependent and gait‐phase‐independent cortical activity across multiple regions involved in voluntary gait modifications in humans
Authors: Yokoyama Hikaru , Kaneko Naotsugu , Masugi Yohei , Ogawa Tetsuya , Watanabe Katsumi , Nakazawa Kimitaka
Published: June 2020

Modification of ongoing walking movement to fit changes in external environments requires accurate voluntary control. In cats, the motor and posterior parietal cortices have crucial roles for precisely adjusting limb trajectory during walking. In human walking, however, it remains unclear which cortical information contributes to voluntary gait modification. In this study, we investigated cortical activity changes associated with visually guided precision stepping using electroencephalography source analysis. Our results demonstrated frequency‐ and gait‐event‐dependent changes in the cortical power spectrum elicited by voluntary gait modification. The main differences between normal walking and precision stepping were as follows: (a) the alpha, beta or gamma power decrease during the swing phases in the sensorimotor, anterior cingulate and parieto‐occipital cortices, and (b) a power decrease in the theta, alpha and beta bands and increase in the gamma band throughout the gait cycle in the parieto‐occipital cortex. Based on the previous knowledge of brain functions, the former change was considered to be related to execution and planning of leg movement, while the latter change was considered to be related to multisensory integration and motor awareness. Therefore, our results suggest that the gait modification is achieved by higher cortical involvements associated with different sensorimotor‐related functions across multiple cortical regions including the sensorimotor, anterior cingulate and parieto‐occipital cortices. The results imply the critical importance of the cortical contribution to voluntary modification in human locomotion. Further, the observed cortical information related to voluntary gait modification would contribute to developing volitional control systems of brain–machine interfaces for walking rehabilitation.
Circadian misalignment: A biological basis for mood vulnerability in shift work
Authors: Chellappa Sarah L.
Published: June 2020

Background

Approximately one in five workers perform night shift work. Epidemiological studies suggest that night shift workers are at a 25–30% higher risk for mental illnesses, including depression and anxiety, which is an increasingly important socioeconomic burden for the workforce. Thus, it is important to determine how shift work negatively affects mood, as it will help identify mechanisms that underlie a night shift worker's higher risk for developing mood disturbances.

Methods

This opinion discusses recently identified, potential biological mechanisms—including the role of the circadian system and circadian misalignment—underlying mood vulnerability in shift workers. Studies included are recent epidemiological, human laboratory studies and animal preclinical work on night shift work or circadian misalignment. Target biological mechanisms of interest discussed here include circadian misalignment effects on brain activity and brain–gut axis, essential for mood regulation.

Results

Circadian misalignment, which corresponds to the misalignment between biological (circadian) system and daily sleep‐wake behaviours, can adversely affect mood levels and cortical activity underlying mood regulation. Furthermore, animal preclinical work shows that the brain–gut axis function is not only implicated in mood regulation but can disrupt specific metabolites essential for mood regulation when animals are exposed to circadian disruption.

Conclusions

Circadian misalignment is a key mechanism underlying mood in e.g. shift workers. Therefore, understanding its role and applying sleep/circadian behavioural interventions to mitigate the adverse consequences of circadian misalignment on mood have the potential to improve quality of life, which is tightly associated with mood and sleep quality, in shift workers.
When Thinking inside the Box Is Good: The Nuanced Relationship between Conformity and Creativity
Authors: Magni Federico , Manzoni Beatrice
Published: June 2020

Creativity is one of the most valued employee skills, but there exists a tension in organizations, as managers want workers who are creative and, at the same time, who conform to existing norms in the organization. In the current paper we propose and study a nuanced relationship between conformity and creativity in the workplace, looking for conditions in which conformity is not detrimental for creativity. We test how the interaction of conformity with the personality dimensions of openness to experience and conscientiousness predicts creativity. Our results suggest that, while openness does not interact with conformity to predict creativity, conscientiousness does. In particular, when individuals are highly conscientious, conformity has a positive impact on creativity, while the conformity‐creativity relationship is negative for individuals that are not very conscientious.
A qualitative exploration of oral health care among stroke survivors living in the community
Authors: O'Malley Lucy , Powell Rachael , Hulme Sharon , Lievesley Matthew , Westoby Wendy , Zadik Jess , Bowen Audrey , Brocklehurst Paul , Smith Craig J.
Published: June 2020

Background

Dental disease is highly prevalent in people with stroke. Stroke survivors regard oral hygiene as an important, yet neglected, area. The aim was to explore experiences of and barriers to oral care, particularly in relation to oral hygiene practice and dental attendance, among stroke survivors in the community.

Methods

This was a qualitative study incorporating a critical realist approach. Interviews were conducted with community‐dwelling stroke survivors requiring assistance with activities of daily living, and focus groups were held with health and care professionals. Interviews and focus groups were recorded and transcribed verbatim. Thematic analysis was conducted.

Results

Twenty‐three stroke survivors were interviewed, and 19 professionals took part in 3 focus groups. Professionals included nurses, speech and language therapists, occupational therapists, dieticians, professional carers and dental staff. Interviews revealed difficulties in carrying out oral hygiene self‐care due to fatigue, forgetfulness and limb function and dexterity problems. Routine was considered important for oral hygiene self‐care and was disrupted by hospitalization resulting from stroke. Professionals highlighted gaps in staff training and confidence in supporting patients with oral care. Access to dental services appeared particularly problematic for those who were not registered with a dentist pre‐stroke.

Conclusion

Oral hygiene routines may be disrupted by stroke, and resulting disabilities may make regular oral self‐care more difficult. This study has identified specific barriers to oral hygiene self‐care and dental service access. Findings from this study are feeding into the development of an intervention to support stroke survivors with oral care.
When used together SS18–SSX fusion‐specific and SSX C‐terminus immunohistochemistry are highly specific and sensitive for the diagnosis of synovial sarcoma and can replace FISH or molecular testing in most cases
Authors: Zaborowski Matthew , Vargas Ana C , Pulvers Jeremy , Clarkson Adele , de Guzman Danica , Sioson Loretta , Maclean Fiona , Chou Angela , Gill Anthony J
Published: June 2020

Aims

Synovial sarcoma is defined by recurrent t(X;18)(p11;q11) translocations creating SS18–SSX1, SS18–SSX2 or SS18–SSX4 fusions. Recently, a novel rabbit monoclonal antibody designed to identify these fusions (SS18–SSX, clone E9X9V) was proposed to be highly specific (100%), but not completely sensitive (95%) for this diagnosis. Another antibody designed to identify the C‐terminal end of SSX (SSX_CT, clone E5A2C) was proposed to be highly sensitive (100%), but not completely specific (96%). We sought to validate these antibodies in an independent cohort.

Methods and results

We performed immunohistochemistry for SS18–SSX and SSX_CT on 39 synovial sarcoma samples from 25 patients with confirmed gene rearrangements. Thirty‐four (87%) and 36 (92%) were positive for SS18–SSX and SSX_CT, respectively. False‐negative staining was associated with suboptimally handled small biopsies and decalcified specimens, even when staining was diffuse and strong in subsequent optimally processed excisions and non‐decalcified areas. None of 580 non‐synovial sarcoma tumours (76 whole sections, 504 TMA samples) were positive for SS18–SSX (100% specificity), whereas 39 (93% specificity) were positive for SSX_CT.

Conclusions

SS18–SSX fusion‐specific IHC is 87–95% sensitive for the diagnosis of synovial sarcoma and highly (perhaps perfectly) specific. Therefore, positive SS18–SSX staining definitively confirms the diagnosis of synovial sarcoma. SSX_CT is less specific (93–96%) but highly sensitive (92%, but approaching 100% when suboptimally processed biopsies and decalcified specimens are excluded). Negative SSX_CT staining may therefore have an ancillary role as a rule‐out test for synovial sarcoma. We caution that both antibodies are prone to false‐negative staining in decalcified specimens.
Review on calcium silicate‐based bioceramics in bone tissue engineering
Authors: Srinath Palakurthy , Abdul Azeem P. , Venugopal Reddy K.
Published: June 2020

Calcium (Ca) and silica (Si) ions have attracted intense interest in biomedical applications. The two ions are directly involved in many biological processes; for instance, Ca plays a key role in regulating cellular responses to bioceramics, promoting cell growth, and differentiation into osteoblasts. Si plays a significant role in bone calcification and is helpful for bone density improvement and inhibiting osteoporosis. Calcium silicate ceramics including a large group of trace metal containing calcium silicate‐based compounds are involved in biomedical applications such as repairing hard tissue texture, bone scaffolds, bone cements, or implant coatings. The aim of the study is to provide a comprehensive overview of developments in research on calcium silicate‐based ceramics, such as wollastonite (CaSiO3), diopside (CaMgSi2O6), akermanite (Ca2MgSi2O7), bredigite (Ca7Mg(SiO4)4), merwinite (Ca3MgSi2O8), monticellite (CaMgSiO4), hardystonite (Ca2Zn(Si2O7), and baghdadite (Ca3ZrSi2O9), including degradation, apatite mineralization, and mechanical properties. Finally, the biological in vitro and in vivo presentation for bone tissue repair are summarized, which show promise with regard to application of calcium silicate‐based ceramics as bone repair and replacement materials.
Two homozygous missense mutations in ITGB3 gene as a cause of Glanzmann Thrombasthenia in four consanguineous Pakistani pedigrees
Authors: Ali Tooba , Gul Saira , Amar Ali , Shakoor Madiha , Farhan Saima , Mohsin Shahida , Khaliq Shagufta
Published: June 2020

Introduction

Glanzmann thrombasthenia (GT) is most common of inherited platelet disorders, resulting from quantitative/qualitative defects in platelet surface integrin αIIbβ3, encoded by ITGA2B and ITGB3 genes. Little is known about clinical and molecular characteristics of GT patients from highly consanguineous Pakistani population.

Methods

This study analyzed the clinical and molecular spectrum of six GT patients from four unrelated but consanguineous families. Platelet surface expression of αIIbβ3 integrin was determined using flow cytometry analysis. ITGA2B and ITGB3 genes were screened for causative mutations by DNA sequencing. Detected mutations were characterized for their pathogenicity using a variety of in silico tools.

Results

Glanzmann thrombasthenia patients in this study generally presented early in life, had a severe course of clinical disease with transfusion dependency for management of bleeding episodes. Molecular analysis revealed 2 homozygous missense mutations in ITGB3 gene, c.422 A˃G (p.Y141C) in three GT patients from a single pedigree with familial segregation and c.1641 C>G (p.C547W) in three unrelated GT patients from three families manifesting type I GT with severe reduction in platelet αIIbβ3 levels. In silico pathogenicity predictions, multiple sequence alignment and 3D protein modeling unanimously suggested deleterious nature of the detected mutations, possibly due to aberrant disulfide bonding. Of note, clinical diversity was observed even among GT patients with same mutation in GT1 family.

Conclusion

This study provides an initial yet important account of clinical and genetic characterization of GT in local patients which may spark further studies to help molecular diagnosis, optimal disease management, and genetic counseling based prevention efforts.
Gender differences in the manifestation of burden among family caregivers of people with mental disorders
Authors: Treichel Carlos Alberto dos Santos , Jardim Vanda Maria da Rosa , Kantorski Luciane Prado , Alves Poliana Farias
Published: June 2020

This is a cross‐sectional study conducted with 537 family caregivers of people with mental disorders. The objective was to quantify the degree of burden experienced by men and women, and identify the most affected dimensions of their lives and the factors associated with burden manifestation by gender. The Zarit Burden Interview (ZBI) scale was used to assess burden. Mean burden was 22.8 points (SD = 6.3) for men and 27.8 points (SD = 17.8) for women. The most affected dimensions among the two groups were the same; however, among the 22 items on the scale, 11 presented significantly higher means among women. The factors associated with the manifestation of burden in both groups were as follows: low income; use of psychotropic drugs; greater degree of dependence of the service user; not receiving family support; and dissatisfaction with family relationships. For men, manifestation of burden was also associated with age. For women, there were further associations of the outcome with the presence of health problems, not having someone to share care with, and caring for the assisted person for >10 years. Our findings suggest that the degree of burden of family members caring for those with mental disorders is associated with gender, and this should be considered by services responsible for planning care shared by professionals and relatives. Guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE Statement) were adhered to in this study.
A qualitative analysis of caregiver perceptions of pediatric dental surgery under general anesthesia
Authors: Lee Helen H. , LeHew Charles W. , Avenetti David , Cory Molly , Buscemi Joanna , Koerber Anne
Published: June 2020

Background

Dental surgery under general anesthesia (GA) is a common treatment for severe childhood caries and thus may serve as an event to motivate behavior change. The frequency of recurrent caries, however, indicates opportunities within current practice to change a child's oral health behaviors.

Aim

To assess caregiver experiences related to their child's dental surgery to inform development of a behavioral intervention.

Design

Semi‐structured interviews with caregivers of children receiving GA for dental surgery. Transcripts (n = 19) were analyzed using qualitative thematic methods.

Results

Children were 2–5 years of age, mean 3.8 years. Limited access to GA services was a source of caregiver frustration and a barrier to caries treatment. Surgical events elicited emotional reactions including guilt, anxiety, and a sense of caregiver accountability for development of severe caries. There was variation in caregiver awareness and/or motivation to change oral health behaviors.

Conclusions

A child's dental surgery under GA is an emotionally challenging event yet may inspire hope and expectations for improvement. Surgery offers an opportunity to implement interventions at a time when caregivers may be open to assistance with behavior change, though stress and anxiety may create barriers. Behavioral interventions should be tailored to individual caregiver needs/barriers and stage of developmental readiness.
Pre‐symptomatic transmission of novel coronavirus in community settings
Authors: Kong Dechuan , Zheng Yang , Wu Huanyu , Pan Hao , Wagner Abram L. , Zheng Yaxu , Gong Xiaohuan , Zhu Yiyi , Jin Bihong , Xiao Wenjia , Mao Shenghua , Lin Sheng , Han Ruobing , Yu Xiao , Cui Peng , Jiang Chenyan , Fang Qiwen , Lu Yihan , Fu Chen
Published: June 2020

We used contact tracing to document how COVID‐19 was transmitted across 5 generations involving 10 cases, starting with an individual who became ill on January 27. We calculated the incubation period of the cases as the interval between infection and development of symptoms. The median incubation period was 6.0 days (interquartile range, 3.5‐9.5 days). The last two generations were infected in public places, 3 and 4 days prior to the onset of illness in their infectors. Both had certain underlying conditions and comorbidity. Further identification of how individuals transmit prior to being symptomatic will have important consequences.
Exploring pre‐service teachers' use of technology: The technology acceptance model and expectancy–value theory
Authors: Ranellucci John , Rosenberg Joshua M. , Poitras Eric G.
Published: June 2020

Understanding how prepared teachers are to use technology to enhance their teaching can assist researchers to support them better, yet the theoretical basis for understanding teachers' self‐beliefs is in need of stronger empirical support. The first objective of this study was to replicate and extend prior research that empirically tested portions of the technology acceptance model (TAM) amongst pre‐service teachers. The second objective was to empirically test an alternative set of antecedents of behavioural intentions to use technology based on the expectancy–value theory (EVT). Four theoretical models were tested using structural equation modelling with a sample of pre‐service teachers (N = 249). Results provide support for the TAM and the extended TAM models, however, no support was found for the combined EVT and TAM models. We discuss the implications to promote teacher integration of technology in the classroom by creating facilitating conditions.
Gingival inflammation influences oral health‐related quality of life in individuals living in a rural area of southern Brazil
Authors: Oliveira Leandro M. , de David Silvia C. , Ardenghi Thiago M. , Moreira Carlos H. Cunha , Zanatta Fabrício B.
Published: June 2020

Aim

The aim of the present cross‐sectional study was to evaluate whether the extent levels of gingival inflammation (GI) in whole mouth or restricted to the anterior region are independently associated with oral health‐related quality of life (OHRQoL) in individuals living in a rural area of southern Brazil.

Materials and methods

A probability sample of 688 individuals was submitted to a full‐mouth periodontal examination at six sites on each tooth. Extent levels of GI in whole mouth and restricted to anterior region were dichotomously considered when bleeding on probing (BoP) occurred at 20% or more of whole‐mouth sites and at 10% or more of anterior region sites, respectively, in individuals with probing depths ≤3 mm, totalling 121 individuals analysed, aged 15–82 years. OHRQoL was assessed using the simplified version of the Oral Health Impact Profile (OHIP14) questionnaire. Adjusted multilevel Poisson regression analysis was used with a conceptual hierarchical approach to calculate the rate ratio (RR) of OHIP14 scores.

Results

In the adjusted model, higher extent levels of full‐mouth GI (RR = 1.23; 95% confidence interval [CI]: 1.06–1.44; p = .004) and GI restricted to the anterior region (RR = 1.29; 95% CI: 1.11–1.51; p ≤ .001) were significantly associated with poorer OHRQoL.

Conclusions

The extent of GI in whole mouth (≥20% of sites with BoP) and in the anterior region (≥10% of sites with BoP) was independently associated with OHRQoL in individuals living in a rural area.