bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Can I tell?’ Children’s participation and positioning in a secretive atmosphere in family therapy
Authors: Helimäki Mira , Laitila Aarno , Kumpulainen Kirsti
Published: May 2020

As a multifaceted phenomenon, family secrets affect interaction in the therapeutic system. This qualitative study, applying the multi‐actor Dialogical Methods for Investigations of Happening of Change, explored how children participated and positioned themselves in family therapy in a climate of family secrets. The results showed that the children were active co‐participants in the complex dynamics of a secretive atmosphere, involving themselves in the paradoxical processes of reconstructing and deconstructing the secretive and unsafe climate. In family therapy, a child’s symptomatic behaviour can function as a visible ‘cover story’ for invisible constructions of secrets, preventing sensitive topics from becoming the focus of therapy. Family secrets therefore continue to present a challenge in family therapy practice and research.

Practitioner points

Family secrets should be asked about in pre‐therapy assessment and diagnostic interviews where all family members are present

The genogram enables the exploration of multigenerational family patterns and functions that might be influenced by family secrets

By normalising the phenomenon of family secrets, therapists could make room for joint discussions on these and encourage family members to talk about their good reasons for keeping secrets
Review article: A primer for clinical researchers in the emergency department: Part XI. Inertia before investigation: Pre‐test probability in emergency medicine
Authors: Pellatt Richard , Purdy Eve , Keijzers Gerben
Published: May 2020

In this series, we address research topics in emergency medicine. Rational clinical decision making is based on knowledge of the disease prevalence, clinical assessment features and test characteristics such as sensitivity and specificity. The concept of pre‐test probability is important as it will allow the clinician and patient decide together if a ‘test threshold’ or ‘treatment threshold’ has been reached, or if further investigations are required to make such a decision. This research primer uses three case scenarios to explore these concepts.
Socioeconomic characteristics of mothers and their relationship with dietary diversity and food group consumption of their children
Authors: Quezada‐Sánchez Amado D. , Shamah‐Levy Teresa , Mundo‐Rosas Verónica
Published: May 2020

Aim

The aim of this study was to analyse the relationship between socioeconomic characteristics of mothers and dietary diversity (DD) as well as food group (FG) consumption of their children in Mexico.

Methods

A sample of 1041 children aged 1 to 4 years from the 2012 Mexican National Health and Nutrition Survey was analysed. DD included nine FG: dairy, meat, egg, fish, fruits, vegetables, legumes, tubers and cereals. For DD as well as for each FG, relative means were estimated from Poisson regressions with covariates of mothers' socioeconomic characteristics such as attained educational level, occupation, Indigenous language spoken, household socioeconomic status and child's characteristics. Standard errors were adjusted to account for data dependencies within primary sampling units.

Results

Children whose mothers had college education were less likely to have low DD (−57%,P < .01) and more likely to consume meat (+27%,P < .05), fruits (+17%,P < .01) and vegetables (+43%,P < .01) compared to children whose mothers had elementary education or none. Children of mothers who speak an Indigenous language had considerably higher (58%,P < .001) probability of low DD than non‐Indigenous speaking mothers.

Conclusions

Specific mother characteristics may either limit or facilitate access to nutrient diverse diets. These characteristics should be taken into account for designing public policies geared towards improving diet and nutritional status during the first years of life.
Percutaneous endobiliary radiofrequency ablation and stents in management of hepatocellular carcinoma with bile duct tumor thrombus: Initial single‐institution experience
Authors: Cui Wei , Xu Rongde , Wang Yu , Shi Feng , Li Jiaping , Chen Xiaoming
Published: May 2020

Aim

Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is a rare condition, but it can lead to hepatic failure and is associated with poor prognosis. Treatment for HCC with BDTT remains a challenge. This study aimed to retrospectively evaluate the safety and feasibility of percutaneous endobiliary radiofrequency ablation (EB‐RFA) and biliary metal stent placement as an alternative treatment for patients with HCC with BDTT.

Methods

From October 2014 to December 2016, nine patients (all men, mean age 53.2 ± 12.0; range 40–70) who underwent percutaneous EB‐RFA and biliary metal stent placement for HCC with BDTT were included. Stent patency, overall survival, technical and clinical success rate and complications were investigated.

Results

Median stent patency from the time of the first EB‐RFA was 6.0 months (95% CI, 5.4–6.6 months) and survival from the time of diagnosis was 6.0 months (95% CI, 2.2–9.8 months). Two of 9 patients underwent bilateral EB‐RFA and stent placement, one underwent unilateral EB‐RFA and stent‐in‐stent procedure, and one EB‐RFA as treatment for biliary metal stent occlusion. One patient who presented with stent occlusion underwent repeat ablations 182 days after the first ablation procedure and 53 days after the re‐ablation procedure. Combination therapy was administered to five patients. The technical and clinical success rate were 100% and 89% per patient. After treatment, serum direct bilirubin levels were notably decreased in eight patients. No major complications were observed. Minor complications included one bile duct bleeding, three postoperative abdominal pain and two cholangitis.

Conclusion

Percutaneous EB‐RFA and biliary metal stent placement might be technically safe and feasible therapeutic options for patients with HCC with BDTT.
Globalising sustainable development: Decolonial disruptions and environmental justice in Bolivia
Authors: Hope Jessica
Published: May 2020

The 2015 United Nations Sustainable Development Goals (SDGs) are the new global development goals guiding the work of mainstream development actors until 2030. The shift to “sustainable development” marks a response to climate change and constitutes a rebranding of international development as global development, prominently by the UN, World Bank, and IMF. In this paper, I draw from recent fieldwork in Bolivia to question what is being globalised. In response to calls for northern geographers to better attend to new forms of coloniality and knowledge production, I take seriously indigenous agendas for development, land, and sovereignty to critique Agenda 2030 with decolonial territorial agendas and theories of environmental justice. I argue that the implementation of Agenda 2030 has reconfigured the borderlands between international development and indigenous territorial agendas. In a drastic reworking of the “boomerang effect,” development infrastructure is being disconnected from anti‐extractive indigenous territorial politics, as the modes of engagement between states, the private sector, and NGOs are reconfigured by the unifying agenda of sustainable development – weakening both indigenous struggles for territorial sovereignty and the environmental remit of the SDGs. An environmental justice perspective locates the case of the Territorio Indígena y Parque Nacional Isiboro (TIPNIS) Secure case within a bigger struggle between local claims to land and global extractive capital, foregrounding that decolonial agendas for territory are entangled with contemporary extractive capitalism. In seeking consensus between states, the private sector, and civil society, the SDGs minimise the sites of conflict that instruct “sustainable development,” revealing both a critical weakness of the SDGs and a pathway towards their greater effectiveness.
Scared of compassion: Fear of compassion in anxiety, mood, and non‐clinical groups
Authors: Merritt Olivia A. , Purdon Christine L.
Published: May 2020

Objectives

Fear of receiving compassion from others, expressing compassion to others, and being compassionate towards oneself have been identified as potentially important factors in the persistence of depression, stress disorders, and eating disorders. There is good reason to expect that these fears may play a role in anxiety and related difficulties, but there is little available information on the extent to which they are present and associated with symptom severity.

Methods

This study compared the severity of the three fears of compassion (receiving, expressing to others, and showing to oneself) in those with a principal diagnosis of depression (n = 34), obsessive–compulsive disorder (OCD; n = 27), social anxiety disorder (SAD; n = 91), generalized anxiety disorder (GAD, n = 43), and a control sample with no mental health difficulties (n = 212).

Results

Those with depression, OCD, SAD, and GAD exhibited greater fear of receiving compassion and fear of self‐compassion than controls, and the differences between anxious and control groups remained significant even when controlling for depressed mood. Whereas fears of compassion did not predict symptom severity over and above depressed mood in people with GAD, fear of receiving compassion uniquely predicted SAD symptom severity, and fear of expressing compassion for others uniquely predicted OCD symptom severity in those high on fear of self‐compassion.

Conclusions

Fear of compassion is higher in those with anxiety and related disorders than non‐anxious controls. Although further research is needed, clinicians may benefit from assessing fear of compassion and addressing it in treatment.

Practitioner points

Those with anxiety and related disorders may fear receiving compassion from others or expressing compassion for themselves, even when controlling for depression.

It may be informative to assess for fear of compassion and incorporate discussions about these fears into treatment, as these fears may interfere with treatment progress.
Caught between the users and the firm: How does identity conflict affect employees' innovative behavior
Authors: Schweisfurth Tim G. , Raasch Christina
Published: May 2020

Absorbing external knowledge is crucial for innovation within the organization. One way of tapping external knowledge sources is to rely on employees who reach out across the firm's boundary to external stakeholders and address knowledge sets located beyond the organizational boundary. However, such employees are likely to identify with the stakeholders they reach out to which exposes them to potentially conflicting demands—with positive or negative effects for their employing organization. We investigate whether and how their dual identification with the organization and with users, and the potential identity conflicts this engenders, affects their job satisfaction and innovativeness. We study a sample of 243 employees in two industries, revealing that perceived conflict between organizational identification and user identification detracts from job satisfaction if and only if employees are strongly identified with both targets. We find also that identity conflict is indirectly and negatively related to innovative work behavior through job satisfaction. Our paper contributes to the literature on the benefits and risks of employee ties to external stakeholders. We contribute also to research on embedded users by elucidating under what conditions they are most valuable to their employing organizations.
Comparing Associations Between Puberty, Ethnic–Racial Identity, Self‐Concept, and Depressive Symptoms Among African American and Caribbean Black Boys
Authors: Carter Rona , Seaton Eleanor K. , Blazek Janelle L.
Published: May 2020

Research on pubertal development among Black boys is limited. Addressing this gap, we examined associations between three pubertal domains (e.g., voice change, hair growth, and perceived relative timing), depressive symptoms, self‐esteem, and self‐efficacy, among a nationally representative sample of 395 African American and 164 Caribbean Black boys (Mage = 15 years). Moderation by ethnic–racial identity (e.g., racial centrality, racial regard) was also explored. Results indicated that for both ethnic subgroups early voice change increased self‐esteem; whereas early voice change increased depressive symptoms among boys who felt society views Blacks more negatively. Buffering effects of ethnic–racial identity also varied significantly between the two groups. Findings suggest that the meaning Black boys ascribe to their ethnic–racial group may explain puberty‐linked outcomes.
Prevalence of non‐thyroidal illness syndrome in COPD exacerbation and effect of hypoxaemia and hypercapnia on thyroid functions
Authors: Gumus Aziz , Ozyurt Songul , Ozcelik Neslihan , Kara Bilge Yılmaz
Published: May 2020

Introduction

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease showing acute exacerbations during its course. Comorbidities often accompany. Non‐thyroidal illness syndrome (NTIS) occurs because of the functional impairment in the hypothalamic‐pituitary‐thyroid axis in severe critical cases. The objective of the current study is to determine the prevalence of NTIS among hospitalised patients due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to reveal the factors affecting thyroid functions.

Materials and methods

A total of 132 patients hospitalised for AECOPD were enroled. Arterial blood gas samples at room air and venous blood samples for thyroid function tests were obtained within 24 hours following hospitalisation.

Results

The mean age was 69.3 ± 9.6 years with male predominance (M/F:130/2). The prevalence of NTIS was 55%. Subgroups of NTIS cases were analysed. Low TSH levels were the most common pathology (55%). Patients with NTIS had significantly lower PaO2 and SaO2 levels compared with those without NTIS (P = 0.045 and P = 0.022, respectively). In addition, a positive correlation was found between PaO2 and free thyroxine (fT4) (P < 0.001, r = 0.313). A statistically significant negative correlation between PaCO2 and fT4 was found (P < 0.001, r = −0.393). And a statistically significant negative correlation between PaCO2 and free triiodothyronine (fT3) values were found (P = 0.040, r = −0.183).

Conclusion

NTIS is a very common condition during AECOPD. We believe that hypoxemia causing functional impairment in the hypothalamic‐pituitary‐thyroid axis is the main mechanism in NTIS development and hypercapnia disrupts freeT3 and freeT4 production and secretion.
Establishment of an in‐vivo porcine delayed perforation model after duodenal endoscopic submucosal dissection
Authors: Hashiguchi Keiichi , Maruya Yasuhiro , Matsumoto Ryo , Yamaguchi Shun , Ogihara Kumi , Ohnita Ken , Kobayashi Shinichiro , Kanetaka Kengo , Nakao Kazuhiko , Eguchi Susumu
Published: May 2020

Objectives

Duodenal endoscopic submucosal dissection (ESD) for superficial non‐ampullary duodenal epithelial tumors has a significant incidence rate of delayed perforation. Although several methods have been proposed to prevent delayed perforation, the most appropriate methods remain unclear. Currently, there is no appropriate animal model to validate methods for preventing duodenal delayed perforation. This study aimed to establish an in‐vivo porcine delayed perforation model after duodenal submucosal dissection.

Methods

Two porcine models underwent either ESD or surgical submucosal dissection. In the surgical dissection model, an inverted duodenal mucosa was resected with electrosurgical energy. In the ESD model, a gauze was placed behind the duodenum with grasped transverse part to improve endoscopic maneuverability. The mucosal defects after dissection were treated with omental coverage without suture in both models. All models were euthanized 0–5 days after procedure. Body weight; resection size; procedure dissection time; presence of intraoperative perforation and delayed perforation; and adhesion score were assessed.

Results

There were no significant differences in body weight and adhesion score between the two models. Resection size was significantly larger in the surgical dissection models than in the ESD models (19 mm vs 14.3 mm, P < 0.01). Procedure time was significantly longer in the ESD models than in the surgical models (45.2 minutes vs 4.5 minutes, P < 0.01). Delayed perforation rates in the surgical dissection models and the ESD models were 0% (0/5) and 100% (5/5), respectively (P < 0.01).

Conclusions

This study indicated that our in‐vivo porcine duodenal ESD model is beneficial to evaluate a prevention strategy for delayed perforation.
Practical advice for management of inflammatory bowel diseases patients during the COVID‐19 pandemic: World Endoscopy Organization Statement
Authors: Neumann Helmut , Emura Fabian , Bokemeyer Bernd , Guda Nalini , Tajiri Hisao , Matsumoto Takayuki , Rubin David T.
Published: May 2020

COVID‐19 is rapidly spreading worldwide and specific literature how to deal with inflammatory bowel diseases (IBD) patients is limited so far. Here, the World Endoscopy Organisation is providing practical advice for the management of IBD patients during the pandemic covering the diagnostic and therapeutic spectrum.
‘You have textbooks; we have story books’. Disability as perceived by professionals and parents
Authors: Rosenbaum Peter
Published: May 2020

Video Podcast: https://www.youtube.com/watch?v=E9NyZAUIqfA
Is resting metabolic rate related to reproductive output in an orb‐web spider, Argiope radon?
Authors: Ameri Mohammad , Kemp Darrell J. , Barry Katherine L. , Herberstein Marie E.
Published: May 2020

1. Resting metabolic rate (RMR) is a fundamental feature of animal biology that reflects the baseline level of energy expenditure. There are two main strategies that can address energy demands; animals can reallocate energy from maintenance by reducing RMR to meet energy demands (compensation model) or they can increase intake rate by increasing metabolic activities (performance model).

2. Orb‐web spiders are sit‐and‐wait foragers that typically reside at the centre of their web waiting to intercept prey. Given their sedentary resource acquisition strategy, it is predicted that lower RMR is favoured to reduce self‐maintenance energetic costs and to allow greater allocation to oogenesis (i.e., egg sac development).

3. In this study, we tested temporal variation in RMR of female Argiope radon (Araneae: Araneidae) spiders in response to mating status. Then we tested the degree to which between‐individual variation in the parental RMR relates to reproductive output and spiderling early life‐history traits.

4. Despite the notable between‐individual variation, we found a temporal consistency of RMR in the female spiders at early adulthood. Mated females significantly reduced their RMR by around 35% compared to their unmated stage which supports compensation model. However, there was a significant correlation between female RMR and mass of the egg sac in these spiders which is an evidence for performance model.

5. Our findings suggest that energy management in this species is a complex phenomenon, both strategies are in effect simultaneously at within‐ and between‐individual level shaping the individuals' phenotype.
Arthroscopic debridement of short frontal plane proximal phalanx fractures preserves racing performance
Authors: Elzer Elizabeth J. , Bramlage Lawrence R.
Published: May 2020

Background

Outcomes have been reported for a limited number of short frontal plane fractures of the proximal phalanx following nonsurgical treatment and internal fixation.

Objectives

To describe a new approach, arthroscopic debridement, of short frontal plane fractures of the proximal phalanx in flat‐racing Thoroughbreds and post‐operative racing outcome.

Study design

Retrospective case‐control study.

Methods

Medical records of 81 Thoroughbred racehorses treated with arthroscopic debridement for frontal plane fractures of the proximal phalanx were reviewed. Diagnostic images and operative reports were used to characterise lesions and a technique for arthroscopic treatment was described. Post injury racing career length, starts, earnings and race quality are compared with matched controls.

Results

Of 81 treated horses, 74 (91%) raced post‐operatively. Treated horses had fewer post‐operative starts compared with controls (median 12, 95% CI 9‐16 vs median 19, 95% CI 15‐23; P < .001), but there was no difference in post‐operative earnings (median $51 465, 95% CI $39 868‐$85 423 vs median $68 017, 95% CI $54 247‐$87 870, P = .7) or career length (median 7 quarters, 95% CI 5‐8 vs median 9 quarters, 95% CI 8‐10, P = .1).

Main limitations

Retrospective studies prevent prospective control of sampling bias and limit selection of matched controls.

Conclusions

Treatment of frontal plane fractures of the proximal phalanx by arthroscopic debridement results in racing performance comparable to uninjured controls with respect to longevity and earnings.
Synergistic excitability plasticity in cerebellar functioning
Authors: Ohtsuki Gen , Shishikura Mari , Ozaki Akitoshi
Published: May 2020

The cerebellum, a universal processor for sensory acquisition and internal models, and its association with synaptic and nonsynaptic plasticity have been envisioned as the biological correlates of learning, perception, and even thought. Indeed, the cerebellum is no longer considered merely as the locus of motor coordination and its learning. Here, we introduce the mechanisms underlying the induction of multiple types of plasticity in cerebellar circuit and give an overview focusing on the plasticity of nonsynaptic intrinsic excitability. The discovery of long‐term potentiation of synaptic responsiveness in hippocampal neurons led investigations into changes of their intrinsic excitability. This activity‐dependent potentiation of neuronal excitability is distinct from that of synaptic efficacy. Systematic examination of excitability plasticity has indicated that the modulation of various types of Ca2+‐ and voltage‐dependent K+ channels underlies the phenomenon, which is also triggered by immune activity. Intrinsic plasticity is expressed specifically on dendrites and modifies the integrative processing and filtering effect. In Purkinje cells, modulation of the discordance of synaptic current on soma and dendrite suggested a novel type of cellular learning mechanism. This property enables a plausible synergy between synaptic efficacy and intrinsic excitability, by amplifying electrical conductivity and influencing the polarity of bidirectional synaptic plasticity. Furthermore, the induction of intrinsic plasticity in the cerebellum correlates with motor performance and cognitive processes, through functional connections from the cerebellar nuclei to neocortex and associated regions: for example, thalamus and midbrain. Taken together, recent advances in neuroscience have begun to shed light on the complex functioning of nonsynaptic excitability and the synergy.
The heparan sulfate proteoglycan syndecan‐1 regulates colon cancer stem cell function via a focal adhesion kinase—Wnt signaling axis
Authors: Kumar Katakam Sampath , Tria Valeria , Sim Wey‐Cheng , Yip George W. , Molgora Stefano , Karnavas Theodoros , Elghonaimy Eslam A. , Pelucchi Paride , Piscitelli Eleonora , Ibrahim Sherif Abdelaziz , Zucchi Ileana , Reinbold Rolland , Greve Burkhard , Götte Martin
Published: May 2020

In colon cancer, downregulation of the transmembrane heparan sulfate proteoglycan syndecan‐1 (Sdc‐1) is associated with increased invasiveness, metastasis, and dedifferentiation. As Sdc‐1 modulates signaling pathways relevant to stem cell function, we tested the hypothesis that it may regulate a tumor‐initiating cell phenotype. Sdc‐1 small‐interfering RNA knockdown in the human colon cancer cell lines Caco2 and HT‐29 resulted in an increased side population (SP), enhanced aldehyde dehydrogenase 1 activity, and higher expression of CD133, LGR5, EPCAM, NANOG, SRY (sex‐determining region Y)‐box 2, KLF2, and TCF4/TCF7L2. Sdc‐1 knockdown enhanced sphere formation, cell viability, Matrigel invasiveness, and epithelial‐to‐mesenchymal transition‐related gene expression. Sdc‐1‐depleted HT‐29 xenograft growth was increased compared to controls. Decreased Sdc‐1 expression was associated with an increased activation of β1‐integrins, focal adhesion kinase (FAK), and wingless‐type (Wnt) signaling. Pharmacological FAK and Wnt inhibition blocked the enhanced stem cell phenotype and invasive growth. Sequential flow cytometric SP enrichment substantially enhanced the stem cell phenotype of Sdc‐1‐depleted cells, which showed increased resistance to doxorubicin chemotherapy and irradiation. In conclusion, Sdc‐1 depletion cooperatively enhances activation of integrins and FAK, which then generates signals for increased invasiveness and cancer stem cell properties. Our findings may provide a novel concept to target a stemness‐associated signaling axis as a therapeutic strategy to reduce metastatic spread and cancer recurrence.

Databases

The GEO accession number of the Affymetrix transcriptomic screening is GSE58751.
A novel approach for haploid generation in Lolium
Authors: Kindiger Bryan
Published: May 2020

Development of haploid and/or dihaploid methodologies for Lolium sp. is important to future improvement efforts as the genus includes the majority of the world's cool‐season annual and perennial turf and forage grass species. Microspore or anther culture haploid induction systems can result in the generation of either maternal or paternal haploids that can be effectively used to advance genetic gains through a breeding or selection program. The successful and traditional approach for the production of haploids and eventually dihaploids in Lolium sp. is most successful when microspore culture approaches are applied. Unfortunately, this approach is labor‐intensive, expensive and often restrictive to amendable genotypes. Within the Lolium‐Festuca genome complex, there is a need for modern breeding approaches that can facilitate the rapid development of haploids or dihaploids for the development of improved germplasm or cultivars. It has been suggested that an in vivo approach could facilitate further advances in Lolium sp. genetic studies, molecular breeding and superior cultivar development. The recent development of a two novel annual ryegrass (Lolium perenne L. subsp. multiflorum (Lam.) Husnot [syn. L. multiflorum Lam.]) line that when hybridized to tall fescue (Schedonorus arundinaceus (Schreb.) Dumort., nom. cons.) has been previously demonstrated. This research investigates and reports on the potential generation of haploids and/or dihaploids through this novel ryegrass when hybridized with L. multiflorum or L. perenne and production of the first invivo haploid/dihaploid Lolium sp. approach.
Global Leaders in Development: a global leadership module across three international pharmacy schools
Authors: Steeb David R , Bruno-Tome Andreia , Pyzik Oksana , Dascanio Sarah A , Bates Ian
Published: May 2020

Objectives

The objective of this study was to assess the impact of the Global Leaders in Development (GLIDE) module to determine whether the concepts of global mindset, citizenship and leadership can be effectively taught within a short-term didactic module.

Methods

Faculty members of PharmAlliance, a partnership between three schools of pharmacy, created a three-week optional, non-credit-bearing distance-based global leadership development module. Material and assignments focused on the concepts of global mindset, global citizenship and global leadership as applied to the global health issues of non-communicable diseases, universal health coverage and primary care. Student self-rated growth was measured with an adapted fifteen question pre–post-survey that also included open-ended questions.

Key Findings

Most statements showed growth on the pre–post-survey with seven being statistically significant (P < 0.05). The largest growth involved students’ perceived potential to be a global leader in pharmacy (global leadership category), the students’ connectedness to the pharmacy profession worldwide (global citizenship category) and the students’ awareness of global challenges faced in the pharmacy profession (global mindset category). Qualitative analysis identified several themes for each of the open-ended questions. Student expectations focused on the desire to expand their global mindset, better understand global pharmacy practice, develop teamwork skills and understand global pharmacy challenges and strategies for engagement.

Conclusions

The concepts of global mindset, global citizenship and global leadership may help promote awareness of global health challenges, opportunities to make a global difference in a local context and connectivity to the profession on a global scale.
Effect of low‐thermal dissection device versus conventional electrocautery in mastectomy for female‐to‐male transgender patients
Authors: Schlosshauer Torsten , Kiehlmann Marcus , Riener Marc‐Oliver , Rothenberger Jens , Sader Robert , Rieger Ulrich M.
Published: May 2020

Subcutaneous mastectomy, the first step in sexual reassignment surgery of female‐to‐male transsexuals, is associated with high rates of complication and revision surgery. Also, conventional electrosurgery and the associated thermal tissue damage may compromise outcome. This retrospective randomised clinical study evaluated the effect of low‐thermal plasma dissection device (PEAK PlasmaBlade, Medtronic, Minneapolis, Minnesota) in comparison with conventional electrosurgery. A total of 17 female‐to‐male transsexuals undergoing mastectomy were randomised to PEAK PlasmaBlade on one breast side and to monopolar electrosurgery on the other side of the same patient. Wounds of 17 patients were examined histologically for acute thermal injury. Significantly less total volume of drain output (58.8 ± 37.4 mL vs 98.5 ± 76.4 mL; P = .012) was found on the PEAK PlasmaBlade side compared with the electrosurgery side. Duration of drain was significantly shorter on the PEAK PlasmaBlade side (2.5 ± 0.7 days vs 3.2 ± 0.6 days; P = .010). Furthermore, the PEAK PlasmaBlade side showed fewer thermal damages (41.2% vs 82.4%; P = .039) and thermal injury depth from PEAK PlasmaBlade side was less (3170 vs 4060 μm). PEAK PlasmaBlade appears to be superior to monopolar electrosurgery for mastectomy in female‐to‐male transsexuals, because it demonstrated less thermal tissue damage, less total volume of drain output, and shorter duration of drain, resulting in faster wound healing.
Pulmonary vein narrowing after visually guided laser balloon ablation: Occurrence and clinical correlates
Authors: Yamamoto Tasuku , Takahashi Yoshihide , Yamaguchi Junji , Sekigawa Masahiro , Shirai Yasuhiro , Tao Susumu , Hayashi Tatsuya , Takigawa Masateru , Goya Masahiko , Sasano Tetsuo
Published: May 2020

Introduction

There are limited data focusing on pulmonary vein (PV) narrowing following ablation using a visually guided laser balloon (VGLB). We sought to assess the frequency and predictors of PV narrowing after VGLB ablation.

Methods and Results

Patients with paroxysmal atrial fibrillation treated with VGLB were screened. Study participants underwent contrast‐enhanced computed tomography (CT) scanning before and 6 months after the procedure. We defined 25% to 49%, 50% to 74%, and 75% to 100% reduction in PV cross‐sectional area as mild, moderate, and severe narrowing, respectively. Of 146 PVs in 38 patients analyzed, severe narrowing developed in two right superior and one right inferior PV. Moderate or severe narrowing occurred in 40 veins (27% of all PVs, 50% of the right superior, 22% of the right inferior, 21% of the left superior, and 14% of the left inferior PV). In PVs with moderate‐severe narrowing, the baseline orifice area was significantly larger (4.1 [interquartile range, 3.2‐4.8] vs 2.5 [1.9‐3.3] cm2, P < .0001), the narrowest region of stenosis was significantly more distal into the vessel (1.9 [0.7‐2.9] vs 0 [0‐1.7] mm from the orifice, P = .0006) and the total amount of energy delivered per vein was significantly greater (5190 ± 970 vs 4626 ± 1573 J, P = .018) than in PVs with mild or no significant narrowing. The baseline orifice area independently predicted moderate‐severe narrowing in multivariate analysis (odds ratio, 1.8 [1.3‐2.5] per 1 cm2 increase, P = .0003). No patient exhibited any signs or symptoms of PV stenosis.

Conclusions

Baseline PV orifice area, ablating distally inside the veins, and total amount of laser energy are associated with PV narrowing after VGLB ablation.
Long‐term outcomes of rituximab therapy in pemphigus
Authors: Shimanovich I. , Baumann T. , Schmidt E. , Zillikens D. , Hammers C.M.
Published: May 2020

Background

Rituximab induces a rapid remission in most patients with pemphigus.

Objective

Our aim was to assess the long‐term efficacy of rituximab in this disease.

Method

We conducted a retrospective study of 59 patients with pemphigus treated with rituximab and observed over a median period of 104 months.

Results

The rate of complete remission off therapy (CRoff) after the first rituximab cycle was 39%, increasing to 61% with additional rituximab courses. Long‐term CRoff was achieved in 27% of patients. The recurrence rate after the first rituximab cycle was 63%, decreasing to approximately 40% with subsequent rituximab cycles. Median time to relapse after the first and subsequent rituximab cycles was 25 months. Renewed rituximab therapy reinduced complete remission in 94% of cases. Baseline anti‐desmoglein antibody levels of ≤250 U/mL were significantly associated with the outcome of CRoff. In paired serum samples obtained before the first and six months after the last rituximab therapy, significant reductions of desmoglein‐specific autoantibodies were observed. Patients relapsing after a complete remission induced by the first rituximab cycle were more likely to achieve CRoff than patients relapsing after a less favourable outcome and non‐responders. There was no significant difference in age, sex, pemphigus subtype, rituximab dosing and disease duration between patients achieving CRoff and those not meeting this end point.

Conclusions

Lower desmoglein‐specific antibody levels at baseline were predictive of CRoff. In patients receiving multiple rituximab cycles, complete remission after the first cycle was associated with a favourable long‐term outcome. Repeated rituximab courses were highly effective for relapsed disease and improved the overall outcome.
The impacts of tomato residuum extract with Arabic gum and dill essential oil on the shelf life improvement of trout fillets stored at chilly condition
Authors: Tavakkoli Elahe , Bazargani‐Gilani Behnaz , Pajohi‐Alamoti Mohammadreza
Published: May 2020

The objective of this study was to evaluate the effects of tomato residuum extract (TRE) dipping and Arabic gum (AG) coating enriched with dill essential oil (DEO) on the shelf life extension of refrigerated trout fillets. Gas chromatography/mass spectrometry analysis revealed that the main constituents of DEO were alpha‐phellandrene (30.17%), limonene (28.31%), and carvone (21.31%). Antioxidant activities of acetone, ethanol, methanol, cold, and hot water extracts of tomato residuum were examined using reducing power and 2,2‐azinobis‐3‐ethylbenzothiazoline‐6‐sulphonic acid assays in maceration, ultrasound, and combined ultrasound and maceration extraction methods. The strongest antioxidant activities were found in the ultrasound‐assisted extraction with ethanol 50%. Thiobarbituric acid, total volatile basic nitrogen, and peroxide values indicated that TRE 3%–AG–DEO 2% and TRE 6%–AG–DEO 2% treatments could significantly (p ≤ .05) extend the shelf life of the fillets. Also, sensory evaluation showed that TRE along with DEO had significant (p ≤ .05) pleasant effects on the sensory characteristics of the fillets. It was concluded that TRE dipping along with AG coating containing DEO could be a suitable alternative for the synthetic preservative in the refrigerated trout fillets.
Response to letter regarding Tobacco smoking
Authors: Petersen B. , Stenager E. , Mogensen C. B. , Erlangsen A.
Published: May 2020

Click here to view the Letter to the Editor by Aubin et al.
Concussion Experiences in New England Private Preparatory High School Students Who Played Sports or Recreational Activities
Authors: Daugherty Jill , Waltzman Dana , Snedaker Katherine P. , Bouton Jason , Zhang Xinjian , Wang David
Published: May 2020

BACKGROUND

Sports‐ and recreation‐related (SRR) activities are a major cause of adolescent concussions. Most adolescent SRR concussion research has been conducted among public school students. As private schools are qualitatively different from public schools (eg, location, socioeconomic status, sports played), this study explores the concussion experiences of a large group of private high school students.

METHODS

We surveyed 2047 New England private preparatory high school students who played sports or engaged in a recreational activity in 2018 about the sports they played, and their self‐reported concussion experiences (eg, age at first concussion, if concussions were sports‐ or recreation‐related). Descriptive, bivariate, and multivariate statistics are presented.

RESULTS

One‐third (33.0%) of students who reported engaging in sport‐ or recreation‐related activities self‐reported experiencing a concussion in their lifetime. A higher percentage of boys, students who played contact sports, and those who played multiple seasons of school sports reported a concussion. Sex, contact level of primary sport played, and age of first concussion were also significantly associated with reporting a sports‐ or recreation‐related concussion.

CONCLUSIONS

A sizeable proportion of private preparatory high school students reported experiencing a concussion, with some students at higher risk. Private preparatory high school‐specific concussion prevention strategies may be needed.
Upscaling and downscaling: Negotiating scale in the English‐only movement
Authors: Flowers Katherine S.
Published: May 2020

Recent work on scale has emphasized upscaling, or the ways people try to make their discourse seem more universal and authoritative. To explore how people engage in other kinds of scale jumping, I examine how scaling practices vary among policymakers and activists in the US English‐only movement. This ethnographic, discourse analytic study focuses on people who shape language policy in four counties in the state of Maryland as well as the organizations U.S. English and ProEnglish. Drawing on interviews, observations, and texts, I argue that upscaling and downscaling can both play a key role in successfully developing linguistic authority, legitimizing English‐only ideologies, and enacting new English‐only policies. At the same time, when people mix different scaling practices in interaction, the combination may occasionally come across as more dissonant to their interlocutors. Ultimately, the US English‐only movement's penchant for scale jumping has led to more restrictive local language policies but also to more opportunities for questioning and resisting those policies.
Changes in Religiosity Among Lesbian, Gay, and Bisexual Emerging Adults
Authors: Woodell Brandi , Schwadel Philip
Published: May 2020

Highly religious Americans are relatively likely to oppose lesbian, gay, and bisexual (LGB) rights and many churches are unwelcoming to sexual minorities, which may lead LGB Americans to retreat from religion. To assess this possibility, we investigate trajectories of religious change for sexual minorities and other emerging adults. We use two longitudinal data sources (National Longitudinal Study of Adolescent to Adult Health and the National Study of Youth and Religion) to explore how sexuality predicts the likelihood of decreasing religiosity in emerging adulthood. Results show that three different operationalizations of sexual minority status—attraction, behavior, and identity—are each strongly and consistently associated with disaffiliating from religion and declines in religious service attendance. On the other hand, sexual minority status has inconsistent and relatively small associations with changes in prayer. We conclude by discussing how these results further understanding of religion, sexual identity, and the current generation of emerging adults.
Regulation outside the box: New mechanisms for small RNAs
Authors: Fröhlich Kathrin S. , Papenfort Kai
Published: May 2020

Regulation at the post‐transcriptional level is an important mode of gene expression control in bacteria. Small RNA regulators (sRNAs) that act via intramolecular base‐pairing with target mRNAs are key players in this process and most often sequester the target's ribosome binding site (RBS) to down‐regulate translation initiation. Over the past few years, several exceptions from this mechanism have been reported, revealing that sRNAs are able to influence translation initiation from a distance. In this issue of Molecular Microbiology, Azam and Vanderpool show that repression of the manY mRNA by the sRNA SgrS relies on an unconventional mechanism involving a translational enhancer element and ribosomal protein S1. Binding of S1 to an AU‐rich sequence within the 5ʹ untranslated region of the manY transcript promotes translation of the mRNA, and base‐pairing of SgrS to the same site can interfere with this process. Therefore, instead of blocking translation initiation by occluding the manY RBS, SgrS reduces ManY synthesis by inhibiting S1‐dependent translation activation. These findings increase the base‐pairing window for sRNA‐mediated gene expression control in bacteria and highlight the role of ribosomal protein S1 for translation initiation.
Crassulacean acid metabolism guard cell anion channel activity follows transcript abundance and is suppressed by apoplastic malate
Authors: Lefoulon Cécile , Boxall Susanna F. , Hartwell James , Blatt Michael R.
Published: May 2020

Plants utilising crassulacean acid metabolism (CAM) concentrate CO2 around RuBisCO while reducing transpirational water loss associated with photosynthesis. Unlike stomata of C3 and C4 species, CAM stomata open at night for the mesophyll to fix CO2 into malate (Mal) and store it in the vacuole. CAM plants decarboxylate Mal in the light, generating high CO2 concentrations within the leaf behind closed stomata for refixation by RuBisCO.

CO2 may contribute to stomatal closure but additional mechanisms, plausibly including Mal activation of anion channels, ensure closure in the light.

In the CAM species Kalanchoë fedtschenkoi, we found that guard cell anion channel activity, recorded under voltage clamp, follows KfSLAC1 and KfALMT12 transcript abundance, declining to near zero by the end of the light period. Unexpectedly, however, we found that extracellular Mal inhibited the anion current of Kalanchoë guard cells, both in wild‐type and RNAi mutants with impaired Mal metabolism.

We conclude that the diurnal cycle of anion channel gene transcription, rather than the physiological signal of Mal release, is a key factor in the inverted CAM stomatal cycle.
The reduction in leaf area precedes that in photosynthesis under potassium deficiency: the importance of leaf anatomy
Authors: Hu Wenshi , Lu Zhifeng , Meng Fanjin , Li Xiaokun , Cong Rihuan , Ren Tao , Sharkey Thomas D. , Lu Jianwei
Published: May 2020

Synergistic improvement in leaf photosynthetic area and rate is essential for enhancing crop yield. However, reduction in leaf area occurs earlier than that in the photosynthetic rate under potassium (K) deficiency stress.

The photosynthetic capacity and anatomical characteristics of oilseed rape (Brassica napus) leaves in different growth stages under different K levels were observed to clarify the mechanism regulating this process.

Increased mesophyll cell size and palisade tissue thickness, in K‐deficient leaves triggered significant enlargement of mesophyll cell area per transverse section width (S/W), in turn inhibiting leaf expansion. However, there was only a minor difference in chloroplast morphology, likely because of K redistribution from vacuole to chloroplast. As K stress increased, decreased mesophyll surface exposed to intercellular space and chloroplast density induced longer distances between neighbouring chloroplasts (Dchl‐chl) and decreased the chloroplast surface area exposed to intercellular space (Sc/S); conversely this induced a greater limitation imposed by the cytosol on CO2 transport, further reducing the photosynthetic rate.

Changes in S/W associated with mesophyll cell morphology occurred earlier than changes in Sc/S and Dchl‐chl, inducing a decrease in leaf area before photosynthetic rate reduction. Adequate K nutrition simultaneously increases photosynthetic area and rate, thus enhancing crop yield.
Examining the support needs of older male spousal caregivers of people with a long‐term condition: A systematic review of the literature
Authors: Fee Anne , McIlfatrick Sonja , Ryan Assumpta
Published: May 2020

Aim

The aim of this review was to identify and synthesise literature reporting on support needs of older male caregivers, who are providing care for a chronically ill spouse/partner at home.

Background

Traditionally, informal caregiving has been perceived as a feminised activity. Consequently, caregiving research has been dominated by female samples, and male caregivers are grossly under‐represented. Given the growing recognition of caregiving as a gendered concept, and the rise in number of male caregivers, particularly in later life, the need for better understanding of the needs of male caregivers is important in order to plan effective support for this population.

Design

A systematic literature review.

Methods

Four electronic databases and grey literature were systematically searched.

Results

The systematic search resulted in 3,646 papers, eligibility criteria were applied to the full texts of 104 papers, and 11 papers met the inclusion criteria. Two core themes were identified: the need to maintain masculinity and the provision of social support.

Conclusion

Findings suggest that men may have a gendered approach to caregiving based on dominant masculine norms. This can be manifested in a reluctance to ask for or accept help and a desire to retain control over caregiving. Findings also revealed isolation and loneliness experienced by older male caregivers, along with a preference for support to address this within a male‐specific context. It is suggested that healthcare professionals should be cognisant of the male caregiver approach and should have an increased awareness of male caregivers support preferences, and of their own gendered assumptions, in order to provide effective support for this population.

Implications for practice

Nurses have a key role in providing family support. Findings from this review suggest that nurses should be aware of the specific needs of older male spousal caregivers if they are to provide effective care and support to this population group.