bluuebunny/crossref_metadata_2025 huggingface dataset:
Rate of positive autoimmune markers in Human T lymphotropic virus type 1 carriers: a case‐control study from Iran
Authors: Ahmadi Ghezeldasht Sanaz , Hedayati‐Moghaddam Mohammad Reza , Habibi Meysam , Mollahosseini Farzad , Rafatpanah Houshang , Miri Rahele , Hatef Fard MohammadReza , Sahebari Maryam
Published: March 2017

Aim

Human T lymphotropic virus type 1 (HTLV‐1) infection with high prevalence in the north‐east of Iran, particularly in Mashhad, can lead to adult T‐cell leukemia (ATL) and HTLV‐1‐associated myelopathy/tropical spastic paraparesis (HAM/TSP) and a variety of autoimmune diseases. The aim of the study was to examine the presence of autoimmune markers in HTLV carries.

Methods

Serum samples were obtained from blood donors in Mashhad, northeastern Iran. One hundred and five HTLV‐1 positive (cases) and 104 age‐ and sex‐matched HTLV‐1 negative donors (controls) were assessed for presence of serum autoimmune markers by enzyme‐linked immunosorbent assay.

Results

The mean ages of cases and controls were 40.8 ± 9.4 and 41.5 ± 9.3 years, respectively (P = 0.5). In the case group, 81.9% and in the control group 83.7% were male (P = 0.74). The frequency of positive antinuclear antibodies and anticyclic citrullinated peptide antibodies in the serum of the two groups were not significantly different (P = 0.68 and P = 0.62, respectively). Only one antineutrophil cytoplasmic antibody‐positive case (1%) was observed in the group and no anti‐phospholipid immunoglobulin G positivity was observed. The frequency of rheumatoid factor (RF) was greater in case group than in the control group, although the difference was not significant (P = 0.08). The amount of RF in all 12 RF positive sera were higher than normal levels (33–37 IU/mL).

Conclusion

Because we failed to detect any significant relation between serum autoimmune markers and HTLV‐1 infection, and because of the relatively low prevalence of autoimmune diseases, it could be concluded that healthy HTLV‐1 carriers do not produce rheumatologic‐related auto‐antibodies more than the healthy population.
Association between genetic variants in the human leukocyte antigen‐B/MICA and Takayasu arteritis in Chinese Han population
Authors: Wen Xiaoting , Chen Si , Li Jing , Li Yuan , Li Liubing , Wu Ziyan , Yuan Hui , Tian Xinping , Zhang Fengchun , Li Yongzhe
Published: March 2017

Aim

Takayasu arteritis (TA) is a rare autoimmune disease with ethnic differences. Genome‐wide association studies (GWAS) showed novel genetic variants in the human leukocyte antigen (HLA) region were associated with TA. The present study aimed to investigate the linkage between these single nucleotide polymorphisms (SNP) and TA in a Chinese Han population.

Methods

Four hundred and twelve patients from multiple centers and 597 healthy controls were genotyped using the Sequenom MassArray iPLEX platform. The association between these SNPs and various clinical symptom of TA was also investigated.

Results

Our study showed a higher risk allele frequency of rs12524487 in TA patients compared to healthy controls (26.6% vs. 21.7%, odds ratio [OR] 1.31, 95% CI 1.06–1.61). The other SNP rs9366782 in HLA‐B/MICA (major histocompatibility complex class I polypeptide‐related sequence A) showed association with TA ischemic brain disease (OR: 1.78, 95% CI: 1.16–2.73, Pc = 0.03). However, rs3763288 and rs114202986 in MICA were negatively related to TA either as a whole or in any clinical features. Meanwhile, ATGT(rs9366782, rs12524487, rs3763288 and rs114202986) were the risk haplotypes (Pc = 2.48 × 10−10).

Conclusions

Our findings indicated that rs12524487 in HLA‐B/MICA was a genetic risk factor for TA in a Chinese Han population and rs9366782 in this region was associated with ischemic brain disease in TA but not TA susceptibility.
Comparing the adverse effects of platinum in combination with etoposide or irinotecan in previously untreated small‐cell lung cancer patients with extensive disease: A network meta‐analyses
Authors: Chen Yujie , Chen Lingxiao , Zhong Diansheng
Published: March 2017

Background

The safety of front‐line chemotherapies for the treatment of extensive stage small‐cell lung cancer (ED‐SCLC) is uncertain. We carried out a network meta‐analysis to compare the toxicity of different therapies for ED‐SCLC.

Methods

We searched EMBASE, PubMed, CENTRAL and clinicaltrials.gov. We performed network meta‐analysis on hematological (anemia, leukopenia, neutropenia, and thrombocytopenia) and non‐hematological toxicities (diarrhea, infection, and nausea and vomiting).

Results

Nine studies with 2317 patients were included. Etoposide with carboplatin (EC) was associated with a higher incidence of anemia (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.13–3.63), leukopenia (OR 2.67, 95% CI 1.25–5.72), neutropenia (OR 12.08, 95% CI 2.13–68.66), and thrombocytopenia (OR 2.73, 95% CI 1.27–5.85) compared with irinotecan with carboplatin (IC). Similarly, etoposide with cisplatin (EP) was associated with a higher incidence of anemia (OR 1.70, 95% CI 1.13–2.56), leukopenia (OR 2.65, 95% CI 1.34–5.28), neutropenia (OR 5.70, 95% CI 2.93–11.10), and thrombocytopenia (OR 3.26, 95% CI 1.66–6.38) compared with irinotecan with cisplatin (IP). EC was associated with a lower incidence of diarrhea (OR 0.26, 95% CI 0.10–0.68) compared with IC, and EP was associated with a lower incidence of diarrhea (OR 0.09, 95% CI 0.03–0.25) and nausea and vomiting (OR 0.53, 95% CI 0.33–0.84) than IP.

Conclusions

Hematological toxicities were most common in EC‐treated patients, while the lowest incidence occurred with IP treatment. The IP regimen was associated with the highest incidence of toxicities of the digestive tract, while the lowest incidence occurred with EC treatment.
Identifying Low‐risk Patients for Early Discharge From Emergency Department Without Using Subjective Descriptions of Chest Pain: Insights From Providing Rapid Out of Hospital Acute Cardiovascular Treatment (PROACT) 3 and 4 Trials
Authors: Sepehrvand Nariman , Zheng Yinggan , Armstrong Paul W. , Welsh Robert C. , Ezekowitz Justin A.
Published: March 2017

Background

Several accelerated diagnostic protocols (ADPs) have been developed to allow emergency department (ED) physicians to identify appropriate patients for safe early discharge after presentation with symptom of chest pain. Most ADPs require chest pain to be described and modify the algorithm based on the subjective chest pain characteristics. We investigated the performance of three established major ADPs simplified by eliminating the need for chest pain as a descriptor.

Methods

We pooled patients from PROACT‐3 and ‐4 trials, in which patients presenting to emergency medical services with chest pain or dyspnea were enrolled. The simplified Vancouver Chest Pain Rule (sVCPR), the simplified Emergency Department Assessment of Chest Pain Score (sEDACS) ADP and the Accelerated Diagnostic protocol to Assess Patients with chest pain using contemporary troponins as the only biomarker (ADAPT‐ADP) were compared using the sensitivity, specificity, and positive and negative predictive values (NPV). The primary outcome of interest was 30‐day major adverse cardiac events (MACE); the diagnosis of acute coronary syndrome (ACS) occurring within 30 days after ED presentation was also explored.

Results

A total of 1,081 patients were included (median age = 67 years, 53% male, median GRACE score = 113) of which 222 ACS diagnoses and 150 cardiac events occurred within 30 days after index ED presentation. The sVCPR, sEDACS ≥ 3, and ADAPT‐ADP, respectively, identified 9.7, 13.3, and 4.1% of patients as low risk with a sensitivity and NPV of 100% for the primary outcome of 30‐day MACE. The sEDACS‐ADP identified 24.2% of patients as low risk with a cut‐point score of 4 (sensitivity of 98.0% and NPV of 98.8%). The sVCPR, sEDACS ≥ 3, and ADAPT‐ADP, respectively, had NPVs of 98.1, 95.8, and 93.3% in identifying patients at higher risk of ACS diagnosis within 30 days after index ED visit.

Conclusion

The diagnostic protocols performed well without their chest pain characteristics component. Further studies are suggested to explore the performance of ADPs when these simplified ADPs are combined with high‐sensitive troponin assays.
Sublingual tacrolimus administration provides similar drug exposure to per‐oral route employing lower doses in liver transplantation: a pilot study
Authors: Solari S. , Cancino A. , Wolff R. , Norero B. , Vargas J. I. , Barrera F. , Guerra J. F. , Martínez J. , Jarufe N. , Soza A. , Arrese M. , Benitez C.
Published: March 2017

Background

Per‐oral tacrolimus administration is not always practicable. Sublingual administration is a potential alternative, but its feasibility and effectiveness compared with oral route has not been established.

Aim

To compare tacrolimus drug exposure after sublingual and oral administration in liver transplant recipients.

Methods

Experimental, open‐label, non‐randomised, cross‐over study. Tacrolimus exposure was evaluated in 32 liver transplant recipients receiving oral administration. 12 h tacrolimus area‐under‐the‐curve (AUC0–12 h) was calculated using tacrolimus blood concentrations at 0‐0.5‐1‐2‐4‐6‐8‐12 hrs post‐dose. Recipients were switched to sublingual administration, and dose was adjusted to reach similar trough levels, new AUC0‐12 h was calculated. Correlation between AUC0‐12 h and trough levels was determined for both oral and sublingual phases.

Results

Similar trough levels were accomplished with oral and sublingual administration (6.68 ± 2 ng/mL vs. 6.62 ± 1.9 ng/mL (P = 0.8)). Although concentration 2 h post dose was higher in oral phase (15.36 ± 7.14 vs. 13.18 ± 5.64, P = 0.015), AUC0‐12 h was similar in both phases (116.6 ± 34.6 vs. 111.5 ± 36.93 ng/mL*h, P = 0.19). Daily dose of tacrolimus required in sublingual phase was 37% lower than that used in oral phase (P < 0.0001), suggesting significantly increased bioavailability of tacrolimus when employing sublingual route. Good correlation between AUC0‐12 h and trough levels was observed in sublingual phase (r2 = 0.74). Twenty‐two recipients were maintained on sublingual administration after the end of study (mean follow‐up: 18.7 ± 5.8 months). No difference in liver function tests or rejection rates was found during follow‐up period.

Conclusions

Sublingual administration of tacrolimus is feasible and provides similar drug exposure compared with oral administration. In our study, at long‐term follow‐up, sublingual administration was not associated with liver transplant rejection.
Overcoming barriers between volunteer professionals advising project‐based learning teams with regulation tools
Authors: Rees Lewis Daniel G. , Easterday Matthew W. , Harburg Emily , Gerber Elizabeth M. , Riesbeck Christopher K.
Published: March 2017

To provide the substantial support required for project‐based learning (PBL), educators can incorporate professional experts as design coaches. However, previous work shows barriers incorporating design coaches who can rarely meet face‐to‐face: (1) communication online is time‐consuming, (2) updating coaches online is not perceived as valuable, (3) students do not seek help, (4) coaches are not proactive online and (5) coaches struggle to gain the awareness from student online communications. How might we design socio‐technical systems that can incorporate professionals coaching? In a 6‐week university PBL product design program with three teams (four members per team) and five coaches, teams met with coaches on campus for 2‐hours a week, but otherwise communicated with teams online. We created and tested StandUp, a system designed to overcome coaching barriers online that: prompts team planning, goal setting and monitoring of progress and displays this information online to coaches. We collected and analyzed interview, observation and log data. We found StandUp helped participants overcome coaching barriers by providing students a way to regulate group learning which in turn automatically emailed reports to coaches thereby supporting coach awareness; coach awareness in turn prompted both online coaching and face‐to‐face coaching. This work provides evidence from one context. Future work should measure learning and explore different regulation scripts.
The pro‐cognitive mechanisms of physical exercise in people with schizophrenia
Authors: Firth Joseph , Cotter Jack , Carney Rebekah , Yung Alison R
Published: March 2017

Schizophrenia is associated with pervasive cognitive deficits which are unresponsive to antipsychotic medications. Physical exercise has been shown to improve cognitive functioning in people with schizophrenia, although the mechanisms for this are unclear. We conducted a systematic review of all exercise intervention studies which reported changes in brain structure, connectivity or peripheral biomarkers which could underlie cognitive improvements from exercise in schizophrenia. An electronic database search was conducted on 22 September 2016 using keywords relevant to exercise and neurocognition in schizophrenia. The search returned 2342 articles. Sixteen were eligible for inclusion, reporting data from 14 independent trials of 423 patients with schizophrenia. Seven studies used neuroimaging to examine the impact of exercise on brain structure and connectivity in schizophrenia, whereas seven other studies examined peripheral biomarkers to assess the effects of exercise. Imaging studies collectively indicated that exercise can increase brain volume in people with schizophrenia, although the regions which responded to exercise varied across studies. Most biomarker studies assessed the effects of exercise on serum levels of BDNF. Several studies found significant increases from exercise along with positive correlations between BDNF and cognitive enhancements (indicating a mechanistic link), although other studies did not observe this relationship. In conclusion, the cognitive benefits of exercise in schizophrenia may be due to exercise stimulating neurogenesis, perhaps by up‐regulating BDNF, although current evidence is insufficient to draw definitive conclusions. Further exploration of the pro‐cognitive mechanisms of exercise in schizophrenia would inform the development of optimal interventions for reducing cognitive impairments in this population.

Linked Articles

This article is part of a themed section on Pharmacology of Cognition: a Panacea for Neuropsychiatric Disease? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.19/issuetoc
Children's Judgments and Reasoning About Same‐Sex Romantic Relationships
Authors: Spence Sarah , Helwig Charles C. , Cosentino Nicole
Published: March 2017

Children's (5‐, 7‐ to 8‐, and 10‐ to 11‐year‐olds), and adolescents’ (13‐ to 14‐year‐olds) judgments and reasoning about same‐sex romantic relationships were examined (N = 128). Participants’ beliefs about the acceptability and legal regulation of these relationships were assessed, along with their judgments and beliefs about excluding someone because of his or her sexual orientation and the origins of same‐sex attraction. Older participants evaluated same‐sex romantic relationships more positively and used more references to personal choice and justice/discrimination reasoning to support their judgments. Younger participants were less critical of a law prohibiting same‐sex relationships and were more likely to believe it was not acceptable to violate this law. Beliefs about origins of same‐sex attraction showed age‐specific patterns in their associations with evaluations.
Randomized controlled clinical trial comparing two dental implants with different neck configurations
Authors: Sanz‐Martín Ignacio , Sanz‐Sánchez Ignacio , Noguerol Fernando , Cok Susy , Ortiz‐Vigón Alberto , Sanz Mariano
Published: March 2017

Background

Peri‐implant bone levels can vary according to the implant neck macro‐design and the implant‐abutment interface.

Purpose

To compare the changes in soft and hard tissues when using a one‐piece implant with a machined collar (TG) versus a two‐piece implant with a progressive platform widening and a platform switching connection (SP).

Material and methods

Partially edentulous patients willing to receive one or two implants in the posterior maxilla or mandible were randomized to the control (TG) or to the test group (SP). Final prostheses were delivered after 12 months. Radiographic measurements of interproximal bone levels (primary outcome) were assessed at implant loading and 1‐year postloading. Clinical, patient related outcomes and adverse events were assessed at loading and after 6 and 12 months.

Results

Sixty‐one implants were placed in 47 patients, 37 patients (18 in the TG group and 19 in the SP group), and 47 implants (23 TG and 24 SP) completed the 24‐months follow up. At the patient level, a significantly greater bone resorption from baseline to implant loading was observed in the SP group (−0.42 ± 0.45 vs −0.07 ± 0.45; P = .001*), while from loading to the final visit, the TG group had significantly greater bone loss than the SP group (−0.26 ± 0.22 vs −0.11 ± 0.2; P = .020*). At 24 months after surgery, there were no significant differences between both groups (control: 0.33 ± 0.49 vs test: 0.53 ± 0.53; P = .230). Similarly, no significant differences were observed for the secondary outcomes.

Conclusions

Both types of implant reported high survival rates and similar bone level changes, clinical parameters, and patient related outcomes after 12 months of loading.
Trends in Industrial and Artisanal Catch Per Effort in West African Fisheries
Authors: Belhabib Dyhia , Greer Krista , Pauly Daniel
Published: March 2017

Artisanal fisheries are generally assumed to generate a lower fishing effort in comparison to the industrial sector. This study aims to comparing catch, fishing effort, and catch‐per‐unit‐of‐effort (CPUE) for each sector, using kWdays as a metric for fishing effort, and kg/kWdays for CPUE. The study, which covers West Africa (1950–2010), finds that the artisanal sector spends 4.7•109 kWdays/year versus 1.3•109kWdays/year by the industrial sector, due to increasing numbers and size of artisanal boats, which in Senegal and Ghana can exceed that of (smaller) industrial vessels. The artisanal total fishing effort increased by 10‐fold between 1950 and 2010, in contrast to a decrease in the industrial effort since the 1990s, which points to the occurrence of Malthusian overfishing, a form of fishing that favors excess labor instead of capital. This analysis finds that the CPUE declined by 1/3 since 1950 driven by a strong decline in the artisanal CPUE, which is 11 times lower than industrial CPUE. This confirms other indicators of decline of fish populations. This study calls for the prioritization of artisanal fisheries, with regard to management and data availability, but also as an important but unregulated sector, which contributes to overexploitation of fish stocks that are vital for communities in West Africa.
Cultural competence skills in a dental curriculum: A review
Authors: Mariño R. J. , Ghanim A. , Barrow S. L. , Morgan M. V.
Published: March 2017

This study aimed to analyse and evaluate the extent of transcultural content in the current curricula of the Doctor of Dental Surgery (DDS), Bachelor of Oral Health (BOH) and Master of Nursing Science (MNSc) courses at the University of Melbourne. Methods: The study was conducted in two phases: a quantitative review and assessment of the current DDS, BOH and MNSc curricula at the University of Melbourne, and interviews with various staff from the University of Melbourne who were responsible for curriculum development for these courses. Results: Staff from the DDS, BOH and MNSc courses concurred on the importance of transcultural skills, the necessity of covering cultural issues relevant to the main ethnic groups in Australia, obstacles faced and the lack of evaluation methods for cultural competency. The nursing curriculum had the most extensive coverage of transcultural content throughout both years of the course (total 71 formal contact hours; mean 36 formal contact hours per year). In contrast, modules on transcultural skills were limited to the first two of the 3‐year BOH course (54 hours; 18 hours) and only the first of the 4‐year dental curriculum (40 hours; 10 hours). Conclusion: The DDS course showed less time devoted to formal teaching of these concepts compared to the nursing and BOH courses despite showing a noticeable improvement from a previous assessment conducted in 2006. It is hoped that the DDS course continues to further increase the transcultural content and find ways to incorporate more transcultural education.
Species‐specific diversity in the anatomical and physiological organisation of the BNST‐VTA pathway
Authors: Kaufling Jennifer , Girard Delphine , Maitre Marlène , Leste‐Lasserre Thierry , Georges François
Published: March 2017

The anteromedial part of the bed nucleus of the stria terminalis (amBNST) is a limbic structure innervating the ventral tegmental area (VTA) that is remarkably constant across species. The amBNST modulates fear and anxiety, and activation of VTA dopamine (DA) neurons by amBNST afferents seems to be the way by which stress controls motivational states associated with reward or aversion. Because fear learning and anxiety states can be expressed differently between rats and mice, we compared the functional connectivity between amBNST and the VTA‐DA neurons in both species using consistent methodological approaches. Using a combination of in vivo electrophysiological, neuroanatomical tracing and laser capture approaches we explored the BNST influences on VTA‐DA neuron activity. First, we characterised in rats the molecular phenotype of the amBNST neurons projecting to the VTA. We found that this projection is complex, including both GABAergic and glutamatergic neurons. Then, VTA injections of a conventional retrograde tracer, the β‐sub‐unit of the cholera toxin (CTB), revealed a stronger BNST‐VTA projection in mice than in rats. Finally, electrical stimulations of the BNST during VTA‐DA neuron recording demonstrated a more potent excitatory influence of the amBNST on VTA‐DA neuron activity in rats than in mice. These data illustrate anatomically, but also functionally, a significant difference between rats and mice in the amBNST‐VTA pathway. More generally, together with previous findings, our research highlights the importance of species differences for the interpretation and the generalisation of research data.
The effect of reward expectation on the time course of perceptual decisions
Authors: Tosoni Annalisa , Committeri Giorgia , Calluso Cinzia , Galati Gaspare
Published: March 2017

Perceptual discriminations can be strongly biased by the expected reward for a correct decision but the neural mechanisms underlying this influence are still partially unclear. Using functional magnetic resonance imaging (fMRI) during a task requiring to arbitrarily associate a visual stimulus with a specific action, we have recently shown that perceptual decisions are encoded within the same sensory‐motor regions responsible for planning and executing specific motor actions. Here we examined whether these regions additionally encode the amount of expected reward for a perceptual decision. Using a task requiring to associate a gradually unmasked female vs. male picture with a spatially‐directed hand pointing or saccadic eye movement, we examined whether the fMRI time course of effector‐selective regions was modulated by the amount of expected reward. In both the pointing‐selective parietal reach region (PRR) and the saccade‐selective posterior intraparietal region (pIPS), reward‐related modulations were only observed after the onset of the stimulus, during decision formation. However, while in the PRR these modulations were specific for the preferred pointing response, the pIPS showed greater activity when either a saccadic or a pointing movement was associated with a greater reward relative to neutral conditions. Interestingly, the fusiform face area showed a similar reward‐related but response‐independent modulation, consistent with a general motivational signal rather than with a mechanism for biasing specific sensory or motor representations. Together, our results support an account of perception as a process of probabilistic inference in which top‐down and bottom‐up information are integrated at every level of the cortical hierarchy.
Sustained release of collagen VI potentiates sciatic nerve regeneration by modulating macrophage phenotype
Authors: Lv Dan , Zhou Lijuan , Zheng Xianyu , Hu Yongcheng
Published: March 2017

Although the peripheral nervous system has an intrinsic ability for repair and regeneration after injury, bridging long peripheral nerve defects remains a challenge. Functional nerve regeneration depends on interactions among axons, Schwann cells, fibroblasts and immune cells. Macrophages, as immune cells recruited early in this process, show polarization toward phenotypes that are detrimental or beneficial to tissue remodeling depending on the microenvironment of the scaffolds. In this study, we investigated the effects of macrophage phenotypes modulated by collagen VI on axonal regeneration and functional recovery by bridging a 15‐mm‐long sciatic nerve defect in rats. Our results showed that local delivery of collagen VI within a polycaprolactone (PCL) electrospun conduit increased the recruitment of macrophages and their polarization toward the pro‐healing (M2) phenotype. In addition, the axonal regeneration and neurologic functional recovery in the PCL/collagen VI conduit group are equivalent to that of an autograft. In conclusion, the present study confirmed that PCL/collagen VI conduits with sustained release of collagen VI in the local microenvironment may, through triggering macrophage M2 polarization to enhance the nerve regeneration, suggest that our combined biomaterial‐immunomodulatory system may be an attractive candidate for peripheral nerve regeneration.
Being Part of the Nação: Examining Costly Religious Rituals in a Brazilian Neo‐Pentecostal Church
Authors: Dengah H.J. François
Published: March 2017

Neo‐Pentecostalism is notable for its emphasis on “prosperity theology,” the belief that economic prosperity is available to the faithful. Members give monetary offerings in exchange for later blessings of financial prosperity. Despite the faith's rapid growth worldwide, the influence of prosperity theology on believers’ lives is still being understood. This mixed‐method study examines Brazilian neo‐Pentecostal rituals through the dual paradigms of religious signaling and cognitive dissonance theory. Signaling theory posits that costly behaviors, such as giving significant sums of money, are honest signs of an individual's intent toward group cooperation. Cognitive dissonance theory suggests that individuals will justify the costly signals required by overvaluing membership in the group. The integration of these two approaches provides a comprehensive model for costly ritual participation by addressing both social and individual motivating factors. This study furthers our understanding of neo‐Pentecostalism by examining how prosperity theology rituals influence behaviors, cognitions, and the psychological well‐being.

Neopentecostalismo é notável por sua ênfase na “teologia da prosperidade,” a crença de que a prosperidade econômica está disponível para os fiéis. Os membros dão ofertas monetárias em troca de bênçãos financeiras. Este estudo de método misto examina os rituais neopentecostais através de dois paradigmas: sinalização custosa e dissonância cognitiva. A teoria da sinalização custosa postula que os comportamentos caros, tais como dar somas significativas de dinheiro, são sinais honestos de intenções para a cooperação e participação dentro do grupo. A teoria da dissonância cognitiva sugere que as pessoas vão justificar os sinais caros exigidos pela supervalorização no grupo. A integração dessas duas abordagens oferece um modelo mais abrangente para a participação nos rituais, abordando ambos os fatores sociais e individuais de motivação. Este estudo possibilita a compreensão do evangelho da prosperidade, examinando como seu ritual influencia comportamentos, cognições e o bem‐estar psicológico dos neopentecostais brasileiros.
Acute leukaemia with a pure erythroid phenotype: under‐recognized morphological and cytogenetic signatures associated universally with primary refractory disease and a dismal clinical outcome
Authors: Park David C , Ozkaya Neval , Lovitch Scott B
Published: March 2017

Aims

Pure erythroid leukaemia (PEL) is an extremely rare and aggressive subtype of acute myeloid leukaemia defined by the World Health Organization (WHO) as a neoplastic proliferation of immature cells committed exclusively to the erythroid lineage, comprising >80% of bone marrow cells and not meeting the criteria of other well‐defined myeloid neoplasms. The aim of this study was to describe the clinicopathological features of acute leukaemias with a pure erythroid phenotype (ALPEP) irrespective of their WHO classification and to determine if ALPEP represents a distinct clinicopathological entity.

Methods and results

We identified seven cases of ALPEP, in which immature cells fulfilled WHO morphological and immunophenotypical criteria for PEL. All patients except one were male, with a median age of 60 years. Three cases represented de novo PEL, three were therapy‐related myeloid neoplasms and one was a blast phase of a myeloproliferative neoplasm. Extensive tumour necrosis was present in five cases (71%). Five cases with available modal karyotypes all demonstrated a complex karyotype involving the TP53 gene locus, with three cases (60%) also showing a monosomy 5 or deletion 5q and additional material on chromosome 19q13. All patients died of their disease, with a mean overall survival of 189 and 64.7 days in cases without and with necrosis on the initial biopsy, respectively.

Conclusions

We describe previously unreported but relatively common findings of extensive tumour necrosis and recurring cytogenetic abnormalities in ALPEP. Our findings suggest strongly that ALPEP represents a distinct clinicopathological entity regardless of its WHO classification.
Occupancy dynamics of the Wood Warbler Phylloscopus sibilatrix assessed with habitat and remote sensing data
Authors: Huber Nica , Kéry Marc , Pasinelli Gilberto
Published: March 2017

The study of population dynamics and species–habitat interactions is important for many ecological and conservation issues. We analysed the occupancy dynamics of the Wood Warbler Phylloscopus sibilatrix, a forest interior passerine that has suffered long‐term declines in many European countries. Considering a broad range of habitat descriptors, including LiDAR‐based variables characterizing forest structure, we identified environmental factors influencing the probabilities of occupancy, colonization, extinction and detection, and mapped these probabilities at a landscape scale. We used presence–absence data collected between 1999 and 2013 in a robust‐design protocol with replicated surveys within each primary sampling season (i.e. breeding season). To analyse occupancy dynamics, we fitted dynamic occupancy models with covariates describing topography, forest extent and structure, soil, seed masting (as a proxy for rodent abundance) and weather conditions during settlement. Initial occupancy was positively related to slope, forest cover and the proportion of broadleaf forest, and negatively related to forest edge length, canopy height variation and soil nutrients. Colonization probability was positively associated with slope and negatively with canopy height variation and soil nutrients. Extinction probability was negatively related to slope, positively related to forest edge length and was lowest at intermediate vegetation heights. Detection probability decreased during the season and was positively related to forest cover. This study provides insights into the settlement dynamics of a declining forest species by identifying potential drivers of the processes underlying occupancy dynamics, instead of simply modelling species abundance or occurrence. Forest‐related covariates were of overwhelming importance for the settlement dynamics of the Wood Warbler. Conservation measures should focus on providing and maintaining the species' preferred forest structure, specifically in extended forests. In Switzerland, forests located on slopes and on nutrient‐poor soils should be prioritized for conservation. Finally, comparing findings derived from the relatively coarse scale of this study with those from the small scale of individual territories suggests that conservation recommendations deduced from large‐scale monitoring schemes alone may be incomplete, and vice versa.
Medical student‐led patient education prior to hospital discharge improves 1‐month adherence rates
Authors: Leung Chun H. S. , Chong Carol , Lim Wen K.
Published: March 2017

Approximately 40% of patients are non‐adherent to their medications. A prospective study of 80 patients evaluated the effectiveness of medical student‐led pre‐discharge medication education sessions. A significantly greater proportion of patients in the intervention group were adherent to their regular medications at 1 month compared with the control group (76.3% compared to 60.3%,P = 0.037). Medical student‐led patient education significantly improved medication adherence rates.
Japanese experience of evolving nurses’ roles in changing social contexts
Authors: Kanbara S. , Yamamoto Y. , Sugishita T. , Nakasa T. , Moriguchi I.
Published: March 2017

Aim

To discuss the evolving roles of Japanese nurses in meeting the goals and concerns of ongoing global sustainable development.

Background

Japanese nurses’ roles have evolved as the needs of the country and the communities they served, changed over time. The comprehensive public healthcare services in Japan were provided by the cooperation of hospitals and public health nurses.

Introduction

The nursing profession is exploring ways to identify and systemize nursing skills and competencies that address global health initiatives for sustainable development goals.

Methods

This paper is based on the summary of a symposium, (part of the 2015 annual meeting of the Japan Association for International Health) with panel members including experts from Japan's Official Development Assistance.

Findings

The evolving role of nurses in response to national and international needs is illustrated by nursing practices from Japan. Japanese public health nurses have also assisted overseas healthcare plans. In recent catastrophes, Japanese nurses assumed the roles of community health coordinators for restoration and maintenance of public health.

Discussion

The Japanese experience shows that nursing professionals are best placed to work with community health issues, high‐risk situations and vulnerable communities. Their cooperation can address current social needs and help global communities to transform our world.

Conclusion

Nurses have tremendous potential to make transformative changes in health and bring about the necessary paradigm shift. They must be involved in global sustainable development goals, health policies and disaster risk management. A mutual understanding of global citizen and nurses will help to renew and strengthen their capacities.

Implications

Nursing professionals can contribute effectively to achieve national and global health goals and make transformative changes.
Comparison of fasciocutaneous V‐Y and rotational flaps for defect coverage of sacral pressure sores: a critical single‐centre appraisal
Authors: Djedovic Gabriel , Metzler Julia , Morandi Evi M , Wachter Tanja , Kühn Shafreena , Pierer Gerhard , Rieger Ulrich M
Published: March 2017

Pressure sore rates remain high in both nursing homes as well as in hospitals. Numerous surgical options are available for defect coverage in the sacral region. However, objective data is scarce as to whether a specific flap design is superior to another. Here, we aim to compare two fasciocutaneous flap designs for sacral defect coverage: the gluteal rotation flap and the gluteal V‐Y flap. All primary sacral pressure sores of grades III–IV that were being covered with gluteal fasciocutaneous rotational or V‐Y flaps between January 2008 and December 2014 at our institution were analysed. A total of 41 patients received a total of 52 flaps. Of these, 18 patients received 20 gluteal rotational flaps, and 23 patients received 32 V‐Y flaps. Both groups were comparable with regards to demographics, comorbidities and complications. Significantly more V‐Y flaps were needed to cover smaller defects. Mean length of hospital stay was significantly prolonged when surgical revision had to be carried out. Both flap designs have proven safe and reliable for defect coverage after sacral pressure sores. Gluteal rotational flaps appear to be more useful for larger defects. Both flap designs facilitate their reuse in case of pressure sore recurrence. Complication rates appear to be comparable in both designs and to the current literature.
From actinic keratosis to squamous cell carcinoma: pathophysiology revisited
Authors: Fernandez Figueras M.T.
Published: March 2017

The precursor of most cutaneous invasive squamous cell carcinomas (iSCCs) is intraepithelial UV‐induced damage, known as field cancerization, which can eventually transform into actinic keratosis (AK). Although AK is the most common precursor of iSCC, many AKs will either persist in the same stage or regress, while only a few will progress into iSCC. Nevertheless, because the progression of individual AKs cannot be predicted, it has been proposed that all AKs, regardless of the grade, should be carefully monitored and appropriately treated in clinical practice. Modern imaging techniques such as dermatoscopy, reflectance confocal microscopy (RCM) and high‐definition optical coherence tomography (HD‐OCT) may have potential to monitor the evolution of actinic field damage. Dermatoscopy can be used to differentiate between AK, intraepidermal carcinoma (IEC) and SCC which may help clinicians to diagnose in situ or invasive lesions at an earlier stage. HD‐OCT and RCM can be used to detect cellular and histological changes characteristic of subclinical lesions, allowing visualization of previously invisible lesions. As development of invasive AK directly from the cancer field cannot be ruled out, the ideal treatment should be able to eradicate AK lesions and reverse the underlying field cancerization.
Modeling Collaborative Interaction Patterns in a Simulation‐Based Task
Authors: Andrews Jessica J. , Kerr Deirdre , Mislevy Robert J. , von Davier Alina , Hao Jiangang , Liu Lei
Published: March 2017

Simulations and games offer interactive tasks that can elicit rich data, providing evidence of complex skills that are difficult to measure with more conventional items and tests. However, one notable challenge in using such technologies is making sense of the data generated in order to make claims about individuals or groups. This article presents a novel methodological approach that uses the process data and performance outcomes from a simulation‐based collaborative science assessment to explore the propensities of dyads to interact in accordance with certain interaction patterns. Further exploratory analyses examine how the approach can be used to answer important questions in collaboration research regarding gender and cultural differences in collaborative behavior and how interaction patterns relate to performance outcomes.
Measuring Student Engagement During Collaboration
Authors: Halpin Peter F. , von Davier Alina A. , Hao Jiangang , Liu Lei
Published: March 2017

This article addresses performance assessments that involve collaboration among students. We apply the Hawkes process to infer whether the actions of one student are associated with increased probability of further actions by his/her partner(s) in the near future. This leads to an intuitive notion of engagement among collaborators, and we consider a model‐based index that can be used to quantify this notion. The approach is illustrated using a simulation‐based task designed for science education, in which pairs of collaborators interact using online chat. We also consider the empirical relationship between chat engagement and task performance, finding that less engaged collaborators were less likely to revise their responses after being given an opportunity to share their work with their partner.
A Contextual Therapy Framework for MFT Educators: Facilitating Trustworthy Asymmetrical Training Relationships
Authors: Sude Michael E. , Eubanks Gambrel Laura
Published: March 2017

This article provides a conceptual framework for asymmetrical relationships between family therapy educators and trainees. Our framework is based on contextual family therapy, and we apply the concepts of trust, entitlement, self‐validation, and loyalty to training relationships. We highlight the value of educators modeling responsible uses of power in addition to teaching trainees clinical concepts and skills. We propose that training can be a process where trainers earn constructive entitlement through their interactions with trainees, who then give to future clients, supervisees, and trainees to continue the cycle of intergenerational trustworthiness. We also provide examples that illustrate the application of contextual therapy skills such as multidirected partiality, I‐Thou relating, acknowledgment, validation, and accountability to family therapy training.
Acute caloric restriction counteracts hepatic bile acid and cholesterol deficiency in morbid obesity
Authors: Straniero S. , Rosqvist F. , Edholm D. , Ahlström H. , Kullberg J. , Sundbom M. , Risérus U. , Rudling M.
Published: March 2017

Background

Bile acid (BA) synthesis is regulated by BA signalling in the liver and by fibroblast growth factor 19 (FGF19), synthesized and released from the intestine. In morbid obesity, faecal excretion and hepatic synthesis of BAs and cholesterol are strongly induced and caloric restriction reduces their faecal excretion considerably. We hypothesized that the high intestinal food mass in morbidly obese subjects promotes faecal excretion of BAs and cholesterol, thereby creating a shortage of both BAs and cholesterol in the liver.

Methods

Ten morbidly obese women (BMI 42 ± 2.6 kg m−2) were monitored on days 0, 3, 7, 14 and 28 after beginning a low‐calorie diet (800–1100 kcal day−1). Serum was collected and liver size and fat content determined. Synthesis of BAs and cholesterol was evaluated from serum markers, and the serum levels of lipoproteins, BAs, proprotein convertase subtilisin/kexin type 9 (PCSK9), insulin, glucose and FGF19 were monitored. Fifty‐four nonobese women (BMI <25 kg m−2) served as controls.

Results

At baseline, synthesis of both BAs and cholesterol and serum levels of BAs and PCSK9 were elevated in the obese group compared to controls. Already after 3 days on a low‐calorie diet, BA and cholesterol synthesis and serum BA and PCSK9 levels normalized, whereas LDL cholesterol increased. FGF19 and triglyceride levels were unchanged, and liver volume was reduced by 10%.

Conclusions

The results suggest that hepatic BAs and cholesterol are deficient in morbid obesity. Caloric restriction rapidly counteracts these deficiencies, normalizing BA and cholesterol synthesis and circulating PCSK9 levels, indicating that overproduction of cholesterol in enlarged peripheral tissues cannot explain this phenotype. We propose that excessive food intake promotes faecal loss of BAs and cholesterol contributing to their hepatic deficiencies.
Lessons Learned From the Implementation of Brighter Bites: A Food Co‐op to Increase Access to Fruits and Vegetables and Nutrition Education Among Low‐Income Children and Their Families
Authors: Sharma Shreela V. , Chow Joanne , Pomeroy Michael , Raber Margaret , Salako David , Markham Christine
Published: March 2017

BACKGROUND

Food co‐op models have gained popularity as a mechanism for offering affordable, quality produce. We describe the challenges, successes, and lessons learned from implementation of a school‐based program using a food co‐op model combined with nutrition education to improve access to and intake of fresh fruits and vegetables among low‐income children and their families.

METHODS

Brighter Bites is a 16‐week intervention comprising of fresh produce deliveries, recipe demonstrations, and nutrition education. A mixed‐methods approach was used comprising survey and focus group data collected from Brighter Bites staff, parents, and teachers. Descriptive statistics and frequencies were computed for the survey data collected.

RESULTS

Brighter Bites was implemented across 9 schools, serving a total of 1530 predominantly low‐income families in the 2013‐2014 school year. Brighter Bites distributed an average 60.2 servings of fresh fruits and vegetables per family per week. Lessons learned included the importance of leveraging existing infrastructure of food banks and schools to implement the program, early school and parent engagement, and incorporating strategies to track and optimize engagement.

CONCLUSIONS

Clear expectations and reliable partnerships are keys to the delivery of the Brighter Bites program.
On the discovery of cementum
Authors: Foster B. L.
Published: March 2017

Though cementum of the tooth root is critical for periodontal structure and tooth attachment and function, this tissue was not discovered and characterized on human teeth until a full century later than enamel and dentin. Early observations from the seventeenth to the nineteenth centuries by Marcello Malpighi, Antonie van Leeuwenhoek, Robert Blake, Jacques Tenon and Georges Cuvier founded a confusing and conflicting nomenclature that obscured the nature of cementum, often conflating it with bone. Advances in microscopy and histological procedures yielded the first detailed descriptions of human cementum in the 1830s by Jan Purkinje and Anders Retzius, who identified for the first time acellular and cellular types of cementum, and the resident cementocytes embedded in the latter. Comparative anatomy studies by Richard Owen and others over the latter half of the nineteenth century identified coronal and radicular cementum varieties across the Reptilia and Mammalia. The functional importance of cementum was not appreciated until detailed anatomical studies of the periodontium were performed by G.V. Black and others in the late nineteenth and early twentieth centuries. These early studies on cementum laid the foundation for more advanced understanding of cementum ultrastructure, composition, development, physiology, disease, genetics, repair and regeneration throughout the twentieth and into the twenty‐first century.
“You Can Learn Merely by Listening to the Way a Patient Walks through the Door”: The Transmission of Sensory Medical Knowledge
Authors: Hammer Gili
Published: March 2017

Examining the mechanisms of medical knowledge transfer, this article addresses the ways nonvisual senses are employed within medical training, asking about the role of sound, touch, and movement in transmitting knowledge of the body. Based on a 10‐month ethnography in a medical massage training course for blind students, the article examines the ways sensory medical knowledge is transferred in this setting. I discuss the multisensory characteristics of medical knowledge transfer, and the dual process inherent in this sensory pedagogy, in which senses such as touch and hearing undergo medicalization and scientification, while medicine enters the realm of the sensorial. Contributing to emerging research of nonvisual senses in medical training, this case study allows rethinking larger processes of medical knowing, challenging the dominancy of vision as the means of scientific knowledge transmission, and exposing the multisensorial elements of medical perception, and learning in general.