bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of surgical complications on the operating surgeon
Authors: Biggs S. , Waggett H. B. , Shabbir J.
Published: February 2020

Aim

The involvement of surgeons in major adverse outcomes can have a negative impact on their personal and professional lives, as well as on patient outcomes. Healthcare professionals involved in such incidents have been referred to as ‘second victims’. We designed an online survey to study the impact of operative complications on surgeons’ professional and personal lives.

Method

An online survey of general, gastrointestinal, hepato‐pancreato‐biliary and vascular surgeons was conducted using the Twitter feed of the Association of Coloproctology of Great Britain and Ireland, the Association of Surgeons of Great Britain and Ireland and the European Society of Coloproctology over an 8‐week period.

Results

Questionnaires were completed by 82 participants. Ninety‐one per cent of respondents were consultant surgeons, 37% with more than 15 years’ experience. Eighty‐three per cent were colorectal surgeons. The majority of surgeons (95%) reported that their practice had been affected as a result of serious complications and 54% suggested that it had had a negative impact on their family life. Fifty‐five per cent of respondents mentioned lack of support in their institution for healthcare professionals involved in adverse outcomes and an existing blame culture. Suggestions for improvement included mentoring (41%), counselling (38%), openness (66%), peer support groups (52%) and human factors training (32%).

Conclusion

This survey highlights that the majority of surgeons involved in serious complications are adversely affected. Those involved in the running of surgical services need to improve support for surgeons in the aftermath of such events.
The Role of Reasoning and Pragmatics in the Modifier Effect
Authors: Strößner Corina , Schurz Gerhard
Published: February 2020

The modifier effect refers to the fact that the perceived likelihood of a property in a noun category is diminished if the noun is modified. For example, “Pigs live on farms” is rated as more likely than “Dirty pigs live on farms.” The modifier effect has been demonstrated in many studies, but the underlying cognitive mechanisms are still unclear. This paper reports two series of experiments that jointly point to the conclusion that the modifier effect is the result of a superposition of three cognitive mechanisms: (a) probabilistically softened default inheritance, (b) pragmatic implicatures due to Gricean relevance assumptions, and (c) inference based on world knowledge. We present evidence that the pragmatic effects operate largely on an unconscious level and that their influence can be reduced by changing the presentation format of the cognitive task.
Accelerating the monitoring of global biodiversity: Revisiting the sampled approach to generating Red List Indices
Authors: Henriques Sérgio , Böhm Monika , Collen Ben , Luedtke Jennifer , Hoffmann Michael , Hilton‐Taylor Craig , Cardoso Pedro , Butchart Stuart H. M. , Freeman Robin
Published: February 2020

Given the current biodiversity crisis, pragmatic approaches to detect global conservation trends across a broad range of taxa are critical. A sampled approach to the Red List Index (RLI) was proposed, as many groups are highly speciose. However, a decade after its conception, the recommended 900 species sample has only been implemented in six groups and trend data are available for none, potentially because this sample is unfeasibly high.

Using a broader set of all available data we show that when re‐assessments are conducted every 10 years, 200 species (400 in some cases) should be sufficient to detect a RLI trend. Correctly detecting changes in slope still requires samples of 900 species (11,000 in some cases).

Sampled assessments can accelerate biodiversity monitoring and complement current metrics, but the time‐period between assessments and the approaches’ purpose should be carefully considered, as there is a trade‐off between sample size and the resulting indices.
The Trickle‐down Effect of Fintech Development: From the Perspective of Urbanization
Authors: Zhang Xun , Tan Ying , Hu Zonghui , Wang Chen , Wan Guanghua
Published: February 2020

The emergence of a digital divide or a lack of internet access may hinder urbanization and adversely affect growth. However, fintech development can help to improve the accessibility and affordability of financial services, particularly for sections of the population formerly excluded from such services. Improved access is expected to stimulate the growth essential for promoting urbanization, possibly alleviating the negative impacts of a digital divide and creating a trickle‐down effect. This paper is among the first to investigate the effect of fintech development on urbanization, as indicated by labor transfer from agricultural to non‐agricultural sectors in China. It is found that: (i) the digital divide hindered, while fintech development contributed to urbanization; (ii) the positive effect of fintech development on urbanization affects individuals both with and without access to the internet, yielding the so‐called trickle‐down effect and thus helping to alleviate the negative consequences of a digital divide; and (iii) regarding transmission mechanisms, fintech development helps to generate additional jobs and raise income in non‐agricultural sectors, stimulating urbanization even for those without access to the internet.
Coaching approaches in early intervention and paediatric rehabilitation
Authors: Akhbari Ziegler Schirin , Hadders‐Algra Mijna
Published: February 2020

Currently, coaching is increasingly applied to foster the involvement of families with an infant or young child with special needs in early intervention and paediatric rehabilitation. Coaching practices are included in many forms of intervention and are regarded as essential to reach beneficial outcomes for the child and family. There are, however, many ambiguities that blur the concept of coaching and hamper its understanding and integration as an evidence‐based approach in early intervention and paediatric rehabilitation: lack of differentiation between coaching and training of families, for example. Challenges to incorporate coaching into professional practice relate to adult learning processes and knowledge acquisition, and transformation of attitudes, beliefs, and treatment habits. In this paper, we review the barriers encountered and the possibilities available to promote successful implementation of coaching in early childhood interventions.

What this paper adds

Literature defines coaching ambiguously, which hampers its implementation in early intervention.

The term ‘coaching’ should be reserved for relationship‐directed, family‐centred intervention.
Exploring the form‐ And time‐dependent effect of low‐frequency electromagnetic fields on maintenance of hippocampal long‐term potentiation
Authors: Dong Lei , Li Gang , Gao Yang , Lin Ling , Zheng Yu , Cao Xue‐bin
Published: February 2020

Low‐frequency electromagnetic field (LF‐EMF) stimulation is an emerging neuromodulation tool that is attracting more attention because of its non‐invasive and well‐controlled characteristics. However, the effect of different LF‐EMF features including the forms and the time of addition on neuronal activity has not been completely understood. In this study, we used multi‐electrode array (MEA) systems to develop a flexible in vitro magnetic stimulation device with plug‐and‐play features that allows for real‐time delivery of LF‐EMFs to biological tissues. Crucially, the method enables different forms of LF‐EMF to be added at any time to a long‐term potentiation (LTP) experiment without interrupting the process of LTP induction. We demonstrated that the slope of field excitatory postsynaptic potentials (fEPSPs) decreased significantly under post or priming uninterrupted sine LF‐EMFs. The fEPSPs slope would continue to decline significantly when LF‐EMFs were added two times with a 20‐min interval. Paired‐pulse ratio (PPR) was analyzed and the results reflected that LF‐EMFs induced LTP was expressed postsynaptically. The results of pharmacological experiments indicated that AMPA receptor activity was involved in the process of LTP loss caused by post‐LF‐EMFs. Moreover, the effect of priming sine or Quadripulse stimulation (QPS)‐patterned LF‐EMFs depended on the time interval between the end of LF‐EMF and the beginning of baseline recording. Interestingly, the effect of sine LF‐EMFs on LTP would not disappear within 120 min, while the impact of QPS‐patterned LF‐EMFs on LTP might disappear after 90 min. These results indicated that LF‐EMF might have a form‐ and time‐dependent effect on LTP.
Reversible expansion of pancreatic islet progenitors derived from human induced pluripotent stem cells
Authors: Tanaka Anna , Watanabe Ami , Nakano Yasuhiro , Matsumoto Masahito , Okazaki Yasushi , Miyajima Atsushi
Published: February 2020

Transplantation of pancreatic islets is an effective therapy for severe type 1 diabetes. As donor shortage is a major problem for this therapy, attempts have been made to produce a large number of pancreatic islets from human pluripotent stem cells (hPSCs). However, as the differentiation of hPSCs to pancreatic islets requires multiple and lengthy processes using various expensive cytokines, the process is variable, low efficiency and costly. Therefore, it would be beneficial if islet progenitors could be expanded. Neurogenin3 (NGN3)‐expressing pancreatic endocrine progenitor (EP) cells derived from hPSCs exhibited the ability to differentiate into pancreatic islets while their cell cycle was arrested. By using a lentivirus vector, we introduced several growth‐promoting genes into NGN3‐expressing EP cells. We found that SV40LT expression induced proliferation of the EP cells but reduced the expression of endocrine lineage‐commitment factors, NGN3, NEUROD1 and NKX2.2, resulting in the suppression of islet differentiation. By using the Cre‐loxP system, we removed SV40LT after the expansion, leading to re‐expression of endocrine‐lineage commitment genes and differentiation into functional pancreatic islets. Thus, our findings will pave a way to generate a large quantity of functional pancreatic islets through the expansion of EP cells from hPSCs.
Mating‐based regulation and ligand binding of an odorant‐binding protein support the inverse sexual communication of the greater wax moth, Galleria mellonella (Lepidoptera: Pyralidae)
Authors: Lizana P. , Machuca J. , Larama G. , Quiroz A. , Mutis A. , Venthur H.
Published: February 2020

In moths, sex pheromones play a key role in mate finding. These chemicals are transported in the antennae by odorant‐binding proteins (OBPs). Commonly, males encounter conspecific females; therefore, several OBPs are male‐biased. Less is known, however, about how the olfactory system of moths has evolved toward inverse sexual communication, ie where females seek males. Therefore, the objective of this study was to identify the profile of OBPs and their expression patterns in the bee hive pest, Galleria mellonella, a moth that uses inverse sexual communication. Here, OBP‐related transcripts were identified by an RNA Sequencing (RNA‐Seq) approach and analysed through both Reverse Transcription Polymerase Chain Reaction (RT‐PCR) in different tissues and quantitative real‐time PCR for two states, virgin and postmating. Our results indicate that G. mellonella has 20 OBPs distributed amongst different tissues. Interestingly, 17 of the 20 OBPs were significantly down‐regulated after mating in females, whereas only OBP7 was up‐regulated. By contrast, 18 OBP transcripts were up‐regulated in males after mating. Additionally, binding assays and structural simulations showed general odorant‐binding protein 2 (GOBP2) was able to bind sex pheromone components and analogues. These findings suggest a possible role of OBPs, especially GOBPs, in the inverse sexual communication of G. mellonella, with gene expression regulated as a response to mating.
Thermodynamic, lattice dynamical, and elastic properties of iron‐vanadium oxides from experiments and first principles
Authors: Xie Wei , Xing Xianran , Cao Zhanmin
Published: February 2020

The thermodynamic, lattice dynamical, and elastic properties of iron‐vanadium oxides are studied from experiments and first‐principles calculations. The high‐temperature heat capacities of FeVO4, Fe2V4O13, FeV2O4, and FeV3O8 are accurately measured using a three‐dimensional (3D) sensor. The phase diagram of Fe‐V‐O system at 873 K is reasonably predicted combining the calculated enthalpy of formation and entropy. The phonon dispersions of FeVO4 and Fe2V4O13 indicate that they are dynamically stable. The high‐frequency vibrations are dominated only by V and O atoms mainly due to the stronger V‐O bonding. All Raman and infrared (IR) frequencies at zone‐center are assigned unambiguously and different types of vibration are established. The physical properties such as elastic constant, bulk modulus, shear modulus, Young's modulus, Poisson's ratio, Debye temperature, elastic wave velocity, and minimum thermal conductivity of FeVO4 and Fe2V4O13 are calculated.
Healthcare services utilization among people with intellectual disability and comparison with the general population
Authors: Maltais Julie , Morin Diane , Tassé Marc J.
Published: February 2020

Background

Studies have reported unmet health needs in individuals with intellectual disability (ID). This study illustrated and analysed patterns of healthcare services utilization among people with intellectual disability and compared their use to that of the general population.

Method

Participants (N = 791, aged 15–82) were mainly recruited through government‐financed agencies specializing in services for people with intellectual disabilities in Québec, Canada. Comparisons were possible by using health administrative data.

Results

Some services were more used by people with intellectual disability than the general population (general medicine, psychiatry, PSA blood tests), and others were accessed at significantly lower frequencies (optometry, physiotherapy, Pap tests). Similar rates were found for mammography, dentistry and psychology. Inequities were more salient for individuals who had more severe levels of intellectual disability.

Conclusions

Our findings support that the population with intellectual disability would benefit from policies and practices aimed at enhancing the access to healthcare services.
A risk signature with four autophagy‐related genes for predicting survival of glioblastoma multiforme
Authors: Wang Yulin , Zhao Weijiang , Xiao Zhe , Guan Gefei , Liu Xin , Zhuang Minghua
Published: February 2020

Glioblastoma multiforme (GBM) is a devastating brain tumour without effective treatment. Recent studies have shown that autophagy is a promising therapeutic strategy for GBM. Therefore, it is necessary to identify novel biomarkers associated with autophagy in GBM. In this study, we downloaded autophagy‐related genes from Human Autophagy Database (HADb) and Gene Set Enrichment Analysis (GSEA) website. Least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox regression analysis were performed to identify genes for constructing a risk signature. A nomogram was developed by integrating the risk signature with clinicopathological factors. Time‐dependent receiver operating characteristic (ROC) curve and calibration plot were used to evaluate the efficiency of the prognostic model. Finally, four autophagy‐related genes (DIRAS3, LGALS8, MAPK8 and STAM) were identified and were used for constructing a risk signature, which proved to be an independent risk factor for GBM patients. Furthermore, a nomogram was developed based on the risk signature and clinicopathological factors (IDH1 status, age and history of radiotherapy or chemotherapy). ROC curve and calibration plot suggested the nomogram could accurately predict 1‐, 3‐ and 5‐year survival rate of GBM patients. For function analysis, the risk signature was associated with apoptosis, necrosis, immunity, inflammation response and MAPK signalling pathway. In conclusion, the risk signature with 4 autophagy‐related genes could serve as an independent prognostic factor for GBM patients. Moreover, we developed a nomogram based on the risk signature and clinical traits which was validated to perform better for predicting 1‐, 3‐ and 5‐year survival rate of GBM.
Dual role of RACK1 in airway epithelial mesenchymal transition and apoptosis
Authors: Pu Yue , Liu Yuan‐qi , Zhou Yan , Qi Yi‐fan , Liao Shi‐ping , Miao Shi‐kun , Zhou Li‐ming , Wan Li‐hong
Published: February 2020

Airway epithelial apoptosis and epithelial mesenchymal transition (EMT) are two crucial components of asthma pathogenesis, concomitantly mediated by TGF‐β1. RACK1 is the downstream target gene of TGF‐β1 shown to enhancement in asthma mice in our previous study. Balb/c mice were sensitized twice and challenged with OVA every day for 7 days. Transformed human bronchial epithelial cells, BEAS‐2B cells were cultured and exposed to recombinant soluble human TGF‐β1 to induced apoptosis (30 ng/mL, 72 hours) and EMT (10 ng/mL, 48 hours) in vitro, respectively. siRNA and pharmacological inhibitors were used to evaluate the regulation of RACK1 protein in apoptosis and EMT. Western blotting analysis and immunostaining were used to detect the protein expressions in vivo and in vitro. Our data showed that RACK1 protein levels were significantly increased in OVA‐challenged mice, as well as TGF‐β1‐induced apoptosis and EMT of BEAS‐2B cells. Knockdown of RACK1 (siRACK1) significantly inhibited apoptosis and decreased TGF‐β1 up‐regulated EMT related protein levels (N‐cadherin and Snail) in vitro via suppression of JNK and Smad3 activation. Moreover, siSmad3 or siJNK impaired TGF‐β1‐induced N‐cadherin and Snail up‐regulation in vitro. Importantly, JNK gene silencing (siERK) also impaired the regulatory effect of TGF‐β1 on Smad3 activation. Our present data demonstrate that RACK1 is a concomitant regulator of TGF‐β1 induces airway apoptosis and EMT via JNK/Smad/Snail signalling axis. Our findings may provide a new insight into understanding the regulation mechanism of RACK1 in asthma pathogenesis.
The Cost of Legal Restrictions on Experience Rating
Authors: Barseghyan Levon , Molinari Francesca , Morris Darcy Steeg , Teitelbaum Joshua C.
Published: February 2020

We investigate the cost of legal restrictions on experience rating in auto and home insurance. The cost is an opportunity cost as experience rating can mitigate the problems associated with unobserved heterogeneity in claim risk, including mispriced coverage and resulting demand distortions. We assess this cost through a counterfactual analysis in which we explore how risk predictions, premiums, and demand in home insurance and two lines of auto insurance would respond to unrestricted multiline experience rating. Using claims data from a large sample of households, we first estimate the variance‐covariance matrix of unobserved heterogeneity in claim risk. We then show that conditioning on claims experience leads to material refinements of predicted claim rates. Last, we assess how households’ demand for coverage would respond to multiline experience rating. We find that the demand response would be large.
Does Capital Bear the U.S. Corporate Tax After All? New Evidence from Corporate Tax Returns
Authors: Fox Edward
Published: February 2020

This article uses U.S. corporate tax return data to assess how government revenue would have changed if, over the period 1957–2013, corporations had been subject to a hypothetical corporate cash flow tax—that is, a tax allowing for the immediate deduction of investments in long‐lived assets like equipment and structures—rather than the corporate tax regime actually in effect. Holding taxpayer behavior fixed, the data indicate actual corporate tax revenue over the most recent period (1995–2013) differed little from that under the hypothetical cash flow tax. This result has three important implications. First, capital owners appear to bear a large fraction of the corporate tax today. This is because economic theory holds that corporate cash flow taxes are largely borne by capital owners and my result implies that the actual tax behaves in practice much like a cash flow tax. This theory is embodied in the Treasury's most recent model of corporate tax incidence. Applying the model to my results implies that only a small portion (2–10 percent) of the U.S. corporate tax was borne by labor in the years before the 2017 Act and thus capital providers are the primary beneficiaries of the Act's large corporate rate cut. Second, the results suggest that the United States could switch fully over to a cash flow tax, which is likely to be administratively simpler for both the government and corporations, at relatively low revenue cost. Third, the impact of fully switching to a cash flow tax on the operations of the real economy and its efficiency are likely to be fairly small. This is precisely because the corporate tax has already evolved to largely mimic a cash flow tax, and the article explores the reasons underlying this evolution using a novel dataset.
Delirium point prevalence studies in inpatient settings: A systematic review and meta‐analysis
Authors: Koirala Binu , Hansen Bryan R. , Hosie Annmarie , Budhathoki Chakra , Seal Stella , Beaman Adam , Davidson Patricia M.
Published: February 2020

Aims

To examine the delirium point prevalence studies conducted in different inpatient settings and to discuss the implication of the findings for delirium screening, assessment, prevention and management.

Background

Delirium—a common and distressing condition manifesting as an acute decline of attention and cognition—is frequently overlooked, misdiagnosed or treated inappropriately. This neuropsychiatric syndrome manifests as changes in attention, cognition and awareness, with resultant impact on behaviour, function and emotions. Delirium is recognised as a patient management challenge in the inpatient setting, and there is a need to understand the current point prevalence and assessment practices of delirium.

Design

A systematic review and meta‐analysis.

Methods

A systematic review of published delirium prevalence studies in inpatient settings was conducted and the implications of findings for delirium screening, assessment, prevention and management identified. The random‐effects meta‐analysis was conducted among studies measuring delirium point prevalence. The PRISMA statement was used to report systematic review and meta‐analysis.

Results

Nine studies were included in the review, with sample sizes ranging from 47–1867. Delirium point prevalence ranged from 9%–32%. Hypoactive delirium was the most common subtype, ranging from 23%–78%. Fifteen delirium screening tools or assessment or diagnostic methods were used. Comorbid dementia was present in up to 50% of inpatients.

Conclusions

Gaining a consensus on effective delirium instruments, the time windows for assessment and measurement will be crucial in driving benchmarking and quality improvement studies.

Relevance to clinical practice

Consistent identification of high‐risk patients and treatment settings with elevated risk, accompanied by the implementation of effective preventive and management strategies, are critical to addressing delirium—a frequent and burdensome condition, that adversely affects patient outcomes.
Development and randomised controlled trial of a Continence Product Patient Decision Aid for men postradical prostatectomy
Authors: Murphy Catherine , de Laine Christine , Macaulay Margaret , Fader Mandy
Published: February 2020

Aims and Objectives

To develop and evaluate an evidence‐based Continence Product Patient Decision Aid (CP‐PDA) to reduce decisional conflict and support continence product choice for men postradical prostatectomy.

Background

In 2018, 1.3 million men globally were diagnosed with prostate cancer. A common treatment is radical prostatectomy, usually leading to sudden onset of urinary incontinence. For people experiencing incontinence, products to contain leakage are fundamental to health‐related quality of life, but many product users and healthcare professionals are unaware of available options. No evidence‐based guidance on choosing products exists despite known physical and psychological burdens of poorly managed leakage (e.g. isolation, anxiety, depression, skin damage).

Design and Methods

4 phases, underpinned by international decision aid guidance.

Evidence/expert opinion: Literature review; consultation with specialist continence clinicians (n = 7) to establish evidence base.

Prototype: CP‐PDA developed with continence specialist (n = 7) feedback.

Alpha testing (stakeholders): CP‐PDA materials were provided to expert patients (n = 10) and clinicians (n = 11) to assess content/presentation.

Beta testing (field) following CONSORT guidelines, registered NIHR CPMS 31077: Men (n = 50) postradical prostatectomy randomised to evaluate usability and decision‐making using the Decisional Conflict Scale compared with usual care.

Results

An algorithm differentiating patients by mobility, dependency, cognitive impairment and type/level of leakage, leading to 12 user groups, was developed. For each group, an option table and associated product information sheets guide product choice. Total Decisional Conflict Score for men using the CP‐PDA was significantly better than for men without. CP‐PDA users reported greater confidence in product knowledge and choice.

Conclusion

This is the first evidence‐based CP‐PDA, developed using an internationally recognised method. Compared to usual care, it significantly reduced decisional conflict for men choosing continence products postprostatectomy.

Relevance to clinical Practice

The CP‐PDA provides nurses with the first comprehensive, evidence‐based intervention to help postprostatectomy men in complex continence product choices. An online version is available: www.continenceproductadvisor.org.
Proposal for rational antibacterial use in the diagnosis and treatment of dogs with chronic diarrhoea
Authors: Cerquetella M. , Rossi G. , Suchodolski J. S. , Schmitz S. Salavati , Allenspach K. , Rodríguez‐Franco F. , Furlanello T. , Gavazza A. , Marchegiani A. , Unterer S. , Burgener I. A. , Pengo G. , Jergens A. E.
Published: February 2020

Chronic diarrhoea is a frequent complaint in canine practice and the diagnostic path is often characterised by numerous diagnostic tests and stepwise empirical treatments, often applied before gastrointestinal endoscopy/mucosal biopsies. These include dietary interventions (novel protein, hydrolysed protein diet), parasiticides and still, in many cases, antibacterials. Indiscriminate use of antibacterial drugs risks detrimental consequences for both the individual patient (antimicrobial resistance, long‐term disruption of intestinal bacterial populations, potential worsening of gastrointestinal signs) and the general public. For that reason, in this Perspective essay we advocate use of antibacterials only after histopathologic evaluation of gastrointestinal biopsies or, for those cases in which endoscopy is not possible, after other therapeutic trials, such as diet/pre‐probiotics or anti‐inflammatory drugs have proven unsuccessful. They should be reserved, after appropriate dietary trials, for those canine chronic diarrhoeic patients with signs of true primary infection (i.e. signs of systemic inflammatory response syndrome or evidence of adherent‐invasive bacteria) that justify antibacterial use.
Regulatory pathways of CYC‐like genes in patterning floral zygomorphy exemplified in Chirita pumila
Authors: Liu Jing , Wu Jie , Yang Xia , Wang Yin‐Zheng
Published: February 2020

Floral zygomorphy is thought of as an essential adaptation to specific pollinators. The CYCLOIDEA (CYC)‐like genes belonging to the plant‐specific TCP transcription factor family are the key regulators of floral zygomorphy. Their expression differentiations bring about diverse forms of floral zygomorphy. However, the regulatory mechanism underlying their expression differentiation remains unknown. In this study, we selected Chirita pumila D. Don, a zygomorphic member of Gesneriaceae, as a model to address this question. Mutant analysis shows that the CYC gene in C. pumila (CpCYC) plays an important role in controlling floral zygomorphy. Further functional investigation of CpCYC intron and 5′ regulatory regions indicates that an 899 bp promoter region is a key determinant of the dorsal‐specific expression of CpCYC. In this region, using electrophoretic mobility shift assay and transient expression system, we identified three kinds of cis‐regulatory elements with putative binding factors, that is, auxin responsive element, WRKY binding site, LEAFY binding site, and an element with an unknown binding factor. We undertook functional analyses of the two putative LEAFY binding sites, and found that LEAFY could directly activate and regulate CpCYC for its dorsal‐specific expression in patterning floral zygomorphy. This research would shed significant light on the regulatory and evolutionary pathways underlying the spatial‐specific expression of CYC‐like genes for the development of zygomorphic flowers.
Abnormal weight gain with fatigue and stress in early survivorship after childhood brain tumor diagnosis
Authors: Johnson Ann H. , Rodgers Phillips Shameka , Rice Marti
Published: February 2020

Background

Diagnosis and treatment for individuals with brain tumors during childhood involves sequelae, including abnormal weight gain. This symptom is commonly clustered with fatigue and increased risk for cardiovascular disease. Children's Oncology Group recommendations include annual surveillance of body mass index (BMI) and cardiometabolic comorbidities; however, there has been little emphasis on individualized screening early in survivorship.

Purpose

The primary purpose of this paper is to describe the findings of abnormal weight gain and its correlates in a sample of young childhood brain tumor survivors during early survivorship.

Design and Methods

This cross‐sectional multi‐site study included brain tumor survivors of ages 8–12 years who were less than 6 years posttreatment. Convenience sampling from two pediatric cancer centers in the southern United States was utilized. Data collected included BMI, parent report of sleep, and child report of fatigue and stress.

Results

The sample (N = 21) consisted of children who had received chemotherapy, radiation treatment, and surgery for childhood brain tumor. BMI in overweight and obese categories exceeded normative samples with 38% at or above the 85th percentile. There were clinically significant relationships with fatigue, stress about weight, tumor location, cranial radiation, chemotherapy, and recurrence

Practice Implications

Screening for abnormal weight gain and related factors, such as fatigue should begin early in survivorship after childhood brain tumor treatment completion with the aim of health promotion and disease prevention. Adiposity measurement techniques should be utilized in future clinical and research settings to improve assessment of cardiometabolic risk.
ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs
Authors: Reinero Carol , Visser Lance C. , Kellihan Heidi B. , Masseau Isabelle , Rozanski Elizabeth , Clercx Cécile , Williams Kurt , Abbott Jonathan , Borgarelli Michele , Scansen Brian A.
Published: February 2020

Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (DirofilariaandAngiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.
Nutrition and physical activity recommendations for cancer survivors in Scotland: Feasibility of a short course to promote behaviour change
Authors: Masson L. F. , Douglas F. , MacLure K.
Published: February 2020

More people are living for longer following a cancer diagnosis; however, long‐term survivors are more likely to experience chronic illnesses. Improving their diet and physical activity behaviours may increase survival and reduce the risk of cancer recurrence and other non‐communicable diseases. The World Cancer Research Fund and American Institute for Cancer Research recommend that cancer survivors aim to be a healthy weight and physically active; eat a diet rich in wholegrains, vegetables, fruits and beans; limit consumption of ‘fast foods’, red and processed meat, sugar‐sweetened drinks and alcohol; and meet nutritional needs through diet alone rather than relying on supplements. Evidence suggests that cancer survivors are receptive to receiving advice and making dietary and physical activity changes, but barriers to improving the diet and being physically active need to be explored and addressed. We collaborated with CLAN Cancer Support (an independent charity) to assess the feasibility of a 2‐day course designed to improve diet and physical activity in cancer survivors in Scotland. Further, it explored the barriers and facilitators that cancer survivors identify in relation to eating a healthy diet and being physically active. The course included presentations, practical activities and group discussions. Initial analysis indicates that factors specific to this population need to be designed into the delivery of the course to enhance recruitment and promote behaviour change. Research then needs to be translated into sustainable support programmes accessible by all cancer survivors. This article describes the rationale behind the study, its design and expected outcomes.
Removing plastic packaging from fresh produce – what’s the impact?
Authors: White A. , Lockyer S.
Published: February 2020

There has been a rise in public awareness and scrutiny of the negative environmental impact of plastic pollution in recent years. Plastic packaging of food causes a significant proportion of the UK’s plastic waste, and manufacturers and retailers are exploring alternatives to single‐use plastics, particularly in relation to fresh produce, including increasing the availability of loose items in supermarkets. However, there is an important trade‐off to consider when removing plastic packaging from fruit and vegetables, which is the resultant reduction in shelf life and therefore potential increase in food waste. Fresh produce is estimated to be the most highly wasted type of food in the UK and it is likely that food waste has an even greater environmental impact than the production and disposal of plastic. Full life cycle analysis is currently unavailable for some alternative types of packaging (such as edible films and coatings), which means the relative effect of these on the environment compared to plastic is unclear, and may in fact be worse. More research is required to fully ascertain the best solution for this complex issue. However, communicating strategies to the general public to minimise household wastage of fresh produce, including optimal storage conditions for different varieties of fruit and vegetables, is likely to be of benefit.
Proceedings of a roundtable event ‘Is communicating the concept of nutrient density important?’
Authors: Lockyer S. , Cade J. , Darmon N. , Flynn M. , Gatenby S. , Govindji A. , Quick B. , Raats M. , Rayner M. , Sokolović M. , Spiro A. , Sritharan N. , Stanner S. , Buttriss J. L.
Published: February 2020

The British Nutrition Foundation held a 1‐day roundtable event to gather views from a wide range of stakeholders on the relevance and importance of the concept of nutrient density in supporting and motivating people to make healthier dietary choices. The opportunities and barriers associated with the use of this concept were also explored. The roundtable involved experts from research, public health nutrition, dietetics, retail and nutrition science communication, and this report describes the main themes emerging from the discussions. High obesity prevalence rates indicate that, on average, we are consuming too many calories relative to energy requirements; yet, the quality of our diets, with respect to certain vitamins and minerals and fibre, seems to be falling somewhat short of recommendations. Addressing this issue may require a more holistic approach than the current focus on restricting single nutrients prevalent in public health messaging internationally. Most members of the roundtable felt that communicating the concept of nutrient density may help in encouraging healthier food choices and dietary patterns that are higher in nutritional quality. However, while nutrient profiling has been used to guide front‐of‐pack labelling and in restricting the advertising of less healthy foods to children, there is a lack of consensus on the precise definition of a ‘nutrient dense’ food or which nutrients should be used as markers of the ‘healthiness’ of foods/drinks, and the term seems to be poorly understood by consumers and health professionals alike. Therefore, further work is required if tools around this concept are to be developed to try and successfully promote behaviour change.
Nurses’ engagement with power, voice and politics amidst restructuring efforts
Authors: McMillan Kim , Perron Amélie
Published: February 2020

Change is inevitable, and increasingly rapid and continuous in healthcare as organizations strive to adapt, improve and innovate. Organizational change challenges healthcare providers because it restructures how and when patient care delivery is provided, changing ways in which nurses must carry out their work. The aim of this doctoral study was to explore frontline nurses’ experiences of living with rapid and continuous organizational change. A critical hermeneutic approach was utilized. Participants described feeling voiceless, powerless and apolitical amidst rapid and continuous organizational changes which fuelled apathy, cynicism and disengagement from the organization. However, critical analysis of the data showed that nurses actively engaged with power, voice and politics through resistant and transgressive behaviours in micro‐ethical moments of practice. There is a need to reconceptualize the concepts of voice, power and politics in nursing as there is dissonance between nurses’ beliefs about these concepts and what they are enacting in practice. Recognizing their enactment of power, voice and political agency at the micro‐level may empower nurses. Empowerment would mitigate the high levels of reports of powerlessness experienced in practice during organizational changes.
Which behaviour change techniques within interventions to prevent weight gain and/or initiate weight loss improve adiposity outcomes in young adults? A systematic review and meta‐analysis of randomized controlled trials
Authors: Ashton Lee M. , Sharkey Thomas , Whatnall Megan C. , Haslam Rebecca L. , Bezzina Aaron , Aguiar Elroy J. , Collins Clare E. , Hutchesson Melinda J.
Published: February 2020

Young adulthood is associated with the highest rate of weight gain compared with any other adult age group. This review evaluates the effectiveness of interventions with adiposity outcomes among young adults and identifies which behaviour change techniques (BCTs) are most effective. BCT utilization was assessed using Michie's 93‐item BCT Taxonomy v1. Six electronic databases were searched for randomized controlled trials assessing change in adiposity in young adults (17‐35 years) until December 2019; identifying 21,582 articles. Fifty‐one studies were included. Meta‐analyses for weight (n=19 studies), body mass index (BMI) (n=20 studies), and waist circumference (n=10 studies) demonstrated no significant between‐group differences at ≤3 or >3 months. There were no differences between interventions focusing on weight loss or weight‐gain prevention. Narrative synthesis showed significant between‐group differences in weight change, favouring the intervention in 14/43 (33%) studies. In studies assessing BMI and waist circumference, this was 31% (11/36) and 25% (4/16). Two BCTs had a percentage effectiveness ratio >50% in weight loss interventions; social support (unspecified) and self‐monitoring behaviour, and one in weight‐gain prevention interventions; and goal‐setting (outcome). Findings demonstrate initial potential for these types of BCTs and can help build cumulative evidence towards delivering effective, cost‐efficient, and replicable interventions.
Homology of posterior interray plates in crinoids: a review and new perspectives from phylogenetics, the fossil record and development
Authors: Ausich William I. , Wright David F. , Cole Selina R. , Sevastopulo George D.
Published: February 2020

Despite their importance for understanding phylogeny, character evolution and classification, well‐constrained homology relationships for posterior plating in crinoids have only recently been attempted. Here, we re‐evaluate posterior plate homologies in all major crinoid lineages using development, fossil ontogenies and phylogenetic evidence. Based on these lines of evidence, we change terminology for some posterior plates to correct misnomers and make recommendations for updated terminology of others to better reflect homology. Among pentacrinoids (disparids, hybocrinids, eucladids, flexibles and articulates) the relative position of posterior interray plates, not their topology, reflects homology. From proximal to distal, pentacrinoid posterior plates are the radianal, anal X and right sac plate, regardless of the total number of plates in the adult calyx. Camerate posterior plating contrasts with pentacrinoids, but insufficient data are available to resolve homology relationships between these two clades. More examples of early post‐larval ontogeny are needed in camerates and other Palaeozoic crinoids.
Desmopressin response in nocturnal enuresis showing concentrated urine
Authors: Akagawa Shohei , Tsuji Shoji , Akagawa Yuko , Yamanouchi Sohsaku , Kimata Takahisa , Kaneko Kazunari
Published: February 2020

Background

In Japan, the use of desmopressin (1‐desamino‐8‐D‐arginine vasopressin) is only recommended for nocturnal enuresis with unconcentrated first morning urine, which suggests a relative deficiency of antidiuretic hormone secretion during sleep. However, no such limitations have been described in a standardization document of the International Children’s Continence Society. We aimed to determine whether desmopressin treatment induces any response in nocturnal enuresis with concentrated first morning urine.

Methods

Outpatients aged 6–15 years who exhibited monosymptomatic nocturnal enuresis were examined. Data were obtained from 41 treatment‐naive patients (median age 9.7 years) with nocturnal enuresis, who received desmopressin as their first line of treatment. The patients were divided into two groups demonstrating unconcentrated (osmolality < 800 mOsm/L, Low‐Osm group) and concentrated (osmolality ≥ 800 mOsm/L, High‐Osm group) first morning urine, respectively; we compared the response to desmopressin treatment between the groups at 1 month after the administration or updosing of desmopressin; responses were defined as partial or complete according to the International Children’s Continence Society standards. Mann–Whitney U‐tests or Fisher’s exact tests were used for analysis.

Results

The Low‐Osm (median age 9.6 years) and High‐Osm groups (median age 9.7 years) had 14 and 27 patients, respectively; the response rates to desmopressin treatment were 64.3% and 59.2%, respectively, indicating no significant differences (P = 0.99).

Conclusion

Desmopressin treatment may be a feasible option for treating nocturnal enuresis with concentrated first morning urine.
Holding space and transitional space: stroke survivors’ lived experience of being on an acute stroke unit. A hermeneutic phenomenological study
Authors: Suddick Kitty M. , Cross Vinette , Vuoskoski Pirjo , Stew Graham , Galvin Kathleen T.
Published: February 2020

Despite substantial reorganisation of stroke unit provision in the United Kingdom, limited qualitative research has explored how stroke survivors experience the acute stroke unit. This hermeneutic phenomenological study used accounts from four stroke survivors who experienced one of two acute stroke units. Through detailed analysis, the acute stroke unit emerged as a meaningful space, in two distinct but interconnected forms. As holding space, the unit was understood to offer protection and safe haven, as the stroke survivors looked to cope and respond to the temporal, bodily, biographical disruption and significant vulnerability brought about by stroke and by being in hospital. Holding was fulfilled by different people (including their fellow stroke survivors) and reflected a human response to human need and existential vulnerability. This space, and the practices within it, functioned to hold them intimately but also at a distance from their prestroke lifeworld. As such, the acute stroke unit holding space was intertwined with how it supported, encouraged or provoked transition. In the transitional space of the acute stroke unit, stroke survivors described how they survived the hospital‐healthcare space, stroke unit and poststroke space. This paper articulates how transition was meaningfully signified through its absence or presence, as they transformed, relinquished or re‐asserted their ‘self’, and in one case, recovered whilst ‘in there’. The findings of this study provide phenomenological insight into stroke survivors’ lived experience, the meaningful holding and transitional contribution of the unit, and how these spatial forms were intertwined. These insights are discussed in relation to the existing evidence base and stroke unit provision.
The sociology of intellectuals in the 20th and 21st century
Authors: Želinský Dominik
Published: February 2020

Sociologists have treated intellectuals and their ideas for a long time as mere products of external social structures. Recently, however, researchers shifted their focus to cultural explanations, appreciating more fully the role cultural structures play in shaping their biographical trajectories and success. At the same time, I argue that these theories do not fully integrate the insight of performance theories and focus usually on textual self‐presentation of intellectuals. Although such an approach is valuable, I propose that sociologists should pay attention also to the processes of meaning‐making that make up intellectual appeal on stage. In the second part of the paper, I argue that the sociology of intellectuals has been for too long obsessed with questions of success and prestige, and I propose that sociologists should shift their attention to the underappreciated and marginalised among intellectuals.