bluuebunny/crossref_metadata_2025 huggingface dataset:
Speech and language therapists’ reflections on developing and maintaining confidence in tracheoesophageal speech rehabilitation
Authors: Hancock Kelli L. , Ward Elizabeth C. , Hill Anne E.
Published: October 2019

Background

The management of tracheoesophageal speech (TES) rehabilitation is an area of speech and language therapists’ (SLTs) clinical practice where knowledge and skills are primarily developed through postgraduate workplace experience and training. Although recent research suggests clinicians in Australia perceive there is adequate access to workplace training, little is known about how clinicians develop and/or maintain clinical confidence when working in this specialist caseload.

Aims

To investigate factors that contribute to development of clinician confidence as well as the factors that impact on improving and maintaining confidence when working in the clinical area of TES rehabilitation.

Methods & Procedures

SLTs working in an Australian clinical service and in a current or recent caseload including patients using TES were eligible to participate. A total of 36 SLTs were recruited and then grouped by level of experience (novice n = 15, intermediate n = 7, experienced n = 14). Ten focus groups of 60‐min duration were conducted each with three to four participants from the same experience level. A semi‐structured interview guide was used to facilitate the discussion of issues relating to training and confidence; however, only the content pertaining to clinical confidence is reported. Thematic analysis was used to analyse the transcripts.

Outcomes & Results

Four themes were identified as contributing to the development of confidence: training, exposure, accessing support and mentorship, and leadership opportunities. Three themes were identified as critical for improving or maintaining clinical confidence: ongoing management of a caseload, ongoing support and further learning. An additional overarching theme was the desire for SLTs to classify or quantify their level of confidence, typically using a numeric scale or in years of clinical experience. The impact of varying contexts and caseloads on confidence levels was highlighted by all participants, but particularly those in the novice focus groups.

Conclusions & Implications

The findings highlight the fact that the acquisition and maintenance of confidence is an ongoing consideration for SLTs, both those starting out and those with years of clinical experience. With patient presentation increasing in complexity, the importance of understanding contributing factors for gaining and maintaining confidence should be considered alongside postgraduate training and the provision of ongoing support for SLTs working in this specialized clinical area, regardless of experience level.
Deep Structure and Metallogenic Processes of the Altai‐Junggar‐Tianshan Collage in Southern Altaids
Authors: XIAO Wenjiao , SONG Dongfang , HAN Chunming , WAN Bo , ZHANG Jien , AO Songjian , ZHANG Zhiyong
Published: October 2019

The Altai‐Junggar‐Tianshan collage in southern Altaids is an important metallogenic domain in Central Asia that contain world‐class copper‐iron‐nickel deposits. As an accretionary‐type metallogenic system, the metallogenic processes of the Altai‐Junggar‐Tianshan collage is essential in understanding the genetic mechanism of ore deposits in general. Here in this paper we present a brief introduction to the project on the western part of the Southern Altaids, entitled “The deep structure and metallegenic processes of the North China accretionary metallogenic systems”. This project mainly focuses on the deep structure and metallogenic background of the Altai‐Junggar‐Tianshan collage by integrated studies from field geology, structural mapping, geochemistry and geophysical exploration. Multiple new geological and geophysical methods will be applied to make transparency of the Kalatongke and Kalatage ore clusters. This will update our understanding of the geodynamic processes of metallogenesis and lead to the development and foundation of new metallogenic theories in accretionary orogens.
Hydroxychloroquine in dermatology: New perspectives on an old drug
Authors: Chew Christopher Y , Mar Adrian , Nikpour Mandana , Saracino Amanda M
Published: October 2019

Hydroxychloroquine is an age‐old drug whose use as an immunomodulatory agent with a low side‐effect profile continues to expand. We present a review of this drug including recently updated prescribing recommendations and a summary of its clinical application in dermatology. A maximum daily dose of 5.0 mg/kg based on actual body weight and no greater than 400 mg is advised in order to reduce the risk of retinopathy, which is potentially permanent and has an estimated prevalence of 7.5% at 5 years on standard dosing. Baseline ophthalmologic assessment followed by annual screening after 5 years is recommended; however, closer monitoring should be considered in the setting of existing retinopathy, a cumulative dose > 1000 g or renal dysfunction. Hydroxychloroquine is now considered to be safe in pregnancy, and routine glucose‐6‐phosphate dehydrogenase (G6PD) deficiency testing is not required. Smoking can significantly decrease its efficacy although the reason is still uncertain. Hydroxychloroquine appears to also demonstrate antineoplastic and cardioprotective benefits.
Patients aged less than 3 years with acute myeloid leukaemia characterize a molecularly and clinically distinct subgroup
Authors: Hara Yusuke , Shiba Norio , Yamato Genki , Ohki Kentaro , Tabuchi Ken , Sotomatsu Manabu , Tomizawa Daisuke , Kinoshita Akitoshi , Arakawa Hirokazu , Saito Akiko M. , Kiyokawa Nobutaka , Tawa Akio , Horibe Keizo , Taga Takashi , Adachi Souichi , Taki Tomohiko , Hayashi Yasuhide
Published: October 2019

Although infants (age <1 year) with acute myeloid leukaemia (AML) have unique characteristics and are vulnerable to chemotherapy, children aged 1–2 years with AML may have characteristics similar to that of infants. Thus, we analysed 723 paediatric AML patients treated on the Japanese AML99 and AML‐05 trials to identify characteristics of younger children. We identified patients aged <3 years (the younger group) as a distinct subgroup. KMT2A‐rearrangement (KMT2A‐R), CBFA2T3‐GLIS2, CBFB‐MYH11 and NUP98‐KDM5A were frequently found in the younger group. Prognostic analyses revealed poor 5‐year overall survival (OS), event‐free survival (EFS) and cumulative incidence of relapse (CIR) in patients with CBFA2T3‐GLIS2 (42%, 17% and 83%, respectively) and those with NUP98‐KDM5A (33%, 17% and 83%, respectively). Additionally, we identified KMT2A‐R and CBFB‐MYH11 as age‐specific prognostic markers. Regarding KMT2A‐R, the younger group had significantly better OS, EFS and CIR than the older group (aged 3 to <18 years) (P = 0·023, 0·011 and <0·001, respectively). Conversely, concerning CBFB‐MYH11, the younger group had significantly poor EFS and CIR than the older group (each P < 0·001), suggesting that certain molecular markers are linked to different prognoses according to age. Therefore, we characterized patients <3 years as a distinct subgroup of paediatric AML.
The effect of glucocorticoids on Thrombospondin‐1, Osteocalcin and the Thrombospondin‐1:Osteocalcin ratio in humans
Authors: Cesana‐Nigro Nicole , Keshvari Sahar , Barclay Johanna L. , Sorbello Jane , Upham John W. , Benham Helen , Anderson Stephen T. , Steiger Natasha , Prins Johannes B. , Inder Warrick J.
Published: October 2019

Objective

Thrombospondin‐1 (TSP1), a matricellular protein, and Osteocalcin (OCN), a noncollagenous protein secreted by osteoblasts, are known to be up‐ and down‐regulated, respectively, by glucocorticoids. The aim of this study was to determine whether a ratio between TSP1:OCN was altered by changes in glucocorticoid activity in humans.

Design

Prospective observational study.

Setting

Tertiary university hospital in Queensland, Australia.

Patients and Measurements

Patients with Cushing's syndrome (CS, n = 19), asthma or giant cell arteritis on chronic prednisolone treatment (PRED, n = 13), adrenal insufficiency (AI, n = 16) and healthy volunteers (HV, n = 20). Plasma TSP1 and serum total OCN were measured by immunoassay at 0800h, 1200h and 1600h in patients with CS, patients with AI taking replacement glucocorticoids, HV before and after 4 mg dexamethasone and PRED patients predose at 800 and 4 hours post‐dose at 1200 hours.

Results

Plasma TSP1 in CS was higher (P < .0001), and serum OCN was lower (P < .0001) than HV. The TSP1:OCN ratio in HV increased significantly after 4 mg dexamethasone (P < .0001) and in AI after taking their hydrocortisone replacement therapy (P < .001). PRED patients had a higher TSP1:OCN ratio compared with HV at both 800 and 1200 hours (both P < .001), but no significant change occurred from pre‐ to post‐dose. A TSP1:OCN ratio of >73 at 800 hours differentiated CS from HV with a sensitivity of 95% and a specificity of 100%.

Conclusions

The TSP1:OCN ratio is elevated in patients on prednisolone and in patients with CS compared with healthy volunteers. It may be a useful biomarker of total body glucocorticoid activity in humans.
Nicotine smoking concentrations modulate GABAergic synaptic transmission in murine medial prefrontal cortex by activation of α7* and β2* nicotinic receptors
Authors: Cuevas‐Olguin Roberto , Esquivel‐Rendon Eric , Vargas‐Mireles Jorge , Barajas‐Lόpez Carlos , Salgado‐Delgado Roberto , Saderi Nadia , Arias Hugo R. , Atzori Marco , Miranda‐Morales Marcela
Published: October 2019

Nicotine is the major addictive component of cigarettes, reaching a brain concentration of ~300 nM during smoking of a single cigarette. The prefrontal cortex (PFC) mechanisms underlying temporary changes of working memory during smoking are incompletely understood. Here, we investigated whether 300 nM nicotine modulates γ‐aminobutyric acid (GABA) ergic synaptic transmission from pyramidal neurons of the output layer (V) of the murine medial PFC. We used patch clamp in vitro recording from C57BL/6 mice in the whole‐cell configuration to investigate the effect of nicotine on pharmacologically isolated GABAergic postsynaptic currents (IPSCs) in the absence or presence of methyllycaconitine (MLA) or dihydro‐β‐erythroidine (DHβE), selective antagonists of α7‐ and β2‐containing (α7* and β2*) nicotinic acetylcholine receptors (AChRs), respectively. Our results indicated that nicotine, alone or in the presence of MLA, decreases electrically evoked IPSC (eIPSC) amplitude, whereas in the presence of DHβE, nicotine elicited either an eIPSCs amplitude increase or a decrease. In the presence of DHβE, nicotine increased membrane conductance leaving the paired pulse ratio unchanged in all conditions, suggesting a non‐β2* mediated effect. In the presence of MLA, nicotine decreased the mean spontaneous IPSC (sIPSC) frequency but increased their rise time, suggesting a non‐α7* AChR‐mediated synaptic modulation. Also, in the presence of DHβE, nicotine decreased both eIPSC rise and decay times. No receptors other than α7* and β2* appear to be involved in the nicotine effect. Our results indicate that nicotine smoking concentrations modulate GABAergic synaptic currents through mixed pre‐ and post‐synaptic mechanisms by activation of α7* and β2* AChRs.
Characterising extinction debt following habitat fragmentation using neutral theory
Authors: Thompson Samuel E. D. , Chisholm Ryan A. , Rosindell James
Published: October 2019

Habitat loss leads to species extinctions, both immediately and over the long term as ‘extinction debt’ is repaid. The same quantity of habitat can be lost in different spatial patterns with varying habitat fragmentation. How this translates to species loss remains an open problem requiring an understanding of the interplay between community dynamics and habitat structure across temporal and spatial scales. Here we develop formulas that characterise extinction debt in a spatial neutral model after habitat loss and fragmentation. Central to our formulas are two new metrics, which depend on properties of the taxa and landscape: ‘effective area’, measuring the remaining number of individuals and ‘effective connectivity’, measuring individuals’ ability to disperse through fragmented habitat. This formalises the conventional wisdom that habitat area and habitat connectivity are the two critical requirements for long‐term preservation of biodiversity. Our approach suggests that mechanistic fragmentation metrics help resolve debates about fragmentation and species loss.
Exploring Exceptions and Discovering Solutions: A Case Presentation of Autism and the Family
Authors: Parker Michele L. , Diamond Rachel M. , Auwood Lauren H.
Published: October 2019

As the prevalence of autism spectrum disorder (ASD) continues to rise, there is a rapidly increasing need for treatment services among individuals diagnosed with ASD and families. Currently, the majority of the evidence‐based treatments, such as Applied Behavior Analysis, overlook the notable systemic effects of ASD and maintain a problem‐focused lens. There is a growing body of research calling for strength‐based, relational interventions that build on existing resources to enhance coping, efficacy, and well‐being among families affected by ASD. Solution‐Focused Brief Therapy (SFBT) is a widely practiced clinical approach that is increasingly being used among clinicians to address the systemic effects of developmental disabilities in the family. However, particular modifications to specific interventions may better accommodate autism‐associated deficits in executive functioning (e.g., goal development and impulsivity), perspective taking, or restricted interests when using an SFBT approach. This article offers recommendations for adapting a solution‐focused approach by modifying commonly used SFBT interventions to address family‐driven treatment goals using a collaborative stance with families of children with ASD. A case presentation is included to demonstrate SFBT as informed by the unique challenges and inherent resources of families affected by ASD that have been identified in the extant literature.
Patient and public involvement in doctoral research: Impact, resources and recommendations
Authors: Coupe Nia , Mathieson Amy
Published: October 2019

Background and aim

Patient and public involvement (PPI) has potential to enhance health‐care research and is increasingly an expectation, particularly for many funding bodies. However, PPI can be tokenistic, which may limit this potential. Furthermore, few studies report PPI processes and impact, particularly in doctoral research studies, which are seldom reported in peer‐reviewed papers. The aim of this paper was to explore the impact of PPI on two health‐related doctoral research studies and identify how PPI could be used meaningfully at this level.

Method

The PPI processes included (a) involvement of two ‘Research Buddies’ who informed the research design and ensured implementation of a booklet intervention was feasible for family carers, (b) data analysis workshops with ‘Research Buddies’ to identify emerging themes from practitioner interviews, (c) public and stakeholder involvement who informed data collection tool design, and the design of an intervention to help people with obesity who attend weight loss groups.

Findings

The application of PPI enhanced both doctoral studies by assisting data analysis; problem solving and improving recruitment rates; improving the usability and appeal of data collection tools and interventions; and developing implementation strategies. Patient and public involvement was considered a rewarding experience for both researchers and PPI contributors.

Conclusion

This paper demonstrates the value of PPI in doctoral research in relation to its impact on research processes, researchers and contributors. We also present recommendations on how PPI could be incorporated into future doctoral research, including resources required, planning PPI processes and involving PPI contributors in all stages of research.
Multipotentiality of skin‐derived precursors: application to the regeneration of skin and other tissues
Authors: Bergeron L. , Busuttil V. , Botto J.‐M.
Published: October 2019

Skin‐derived precursors (SKPs) have been described as multipotent dermal precursors. Here, we provide a review of the breadth and depth of scientific literature and studies regarding SKPs, accounting for a large number of scientific publications. Interestingly, these progenitors can be isolated from embryonic and adult skin, as well as from a population of dermal cells cultured in vitro in monolayer. Gathering information from different authors, this review explores different aspects of the SKP theme, such as the potential distinct origins of SKPs in rodents and in humans, and also their ability to differentiate in vitro and in vivo into multiple lineages of different progeny. This remarkable capacity makes SKPs an interesting endogenous source of precursors to explore in the framework of experimental and therapeutic applications in different domains. SKPs are not only involved in the skin’s dermal maintenance and support as well as wound healing, but also in hair follicle morphogenesis. This review points out the interests of future researches on SKPs for innovative perspectives that may be helpful in many different types of scientific and medical domains.
Investigating consumers’ green values and food‐related behaviours in Turkey
Authors: Gunden Cihat , Atis Ela , Salali H. Ece
Published: October 2019

This study sets out to examine the influence of consumers’ green values on food‐related behaviours. Data were collected from a random sample of 385 consumers in Izmir, Turkey via face‐to‐face interviews. Factor analysis was conducted to identify the underlying dimensions that capture the meaning of green values, which affect shopping, cooking and eating behaviours of consumers. A composite variable that represents consumers’ perception of green values was created to classify consumers into two segments labelled: Negative perceivers (37.7%) and positive perceivers (62.3%). The results indicated that the positive perceivers tended to have healthier and environmentally friendly food consumption behaviours than the negative perceivers. Gender, age, education, marital status, body mass index, regular exercise and smoking were significant for differentiating between the segments. We intend to construct value‐based intervention programmes that are easy to implement, non‐mandatory and cost‐effective for the negative perceivers.
The immunoglobulin γ marker 17 allotype and KIR/HLA genes prevent the development of chronic hepatitis B in humans
Authors: Di Bona Danilo , Pandey Janardan P. , Aiello Anna , Bilancia Massimo , Candore Giuseppina , Caruso Calogero , Colomba Claudia , Duro Giovanni , Ligotti Mattia Emanuela , Macchia Luigi , Rizzo Sergio , Accardi Giulia
Published: October 2019

Hepatitis B virus (HBV) infection causes a self‐limiting disease in most individuals. However, < 10% of infected subjects develop a chronic disease. Genetic host variability of polymorphic genes at the interface of innate and acquired immunity, such as killer immunoglobulin‐like receptors (KIR), their human leucocyte antigen (HLA) and IgG allotypes (GM), could explain this different clinical picture. We previously showed a protective role of the KIR2DL3 gene for the development of chronic hepatitis B (CHB), and a detrimental role of the KIR ligand groups, HLA‐A‐Bw4 and HLA‐C2. We have expanded the previous analysis genotyping patients for GM23 and GM3/17 allotypes. The comparison of the patients with CHB with those who resolved HBV infection showed that the presence of GM17 allele virtually eliminated the risk of developing CHB (OR, 0·03; 95% CI, 0·004–0·16; P < 0·0001). In addition, the combination of GM17, KIR2DL3, HLA‐A‐Bw4 and HLA‐C2 was highly sensitive to predict the outcome of HBV infection.
Implications of the movement behaviour of African tigerfishHydrocynus vittatusfor the design of freshwater protected areas
Authors: Jacobs Francois J. , Næsje Tor F. , Ulvan Eva M. , Weyl Olaf L. F. , Tiyeho Deon , Hay Clinton J. , O'Brien Gordon C. , Downs Colleen T.
Published: October 2019

African tigerfishHydrocynus vittatus(n =35) were tagged with external radio‐transmitters in the Kavango River, Namibia, to determine whether freshwater protected areas could be an effective tool for the management and conservation of this species. They were manually tracked in the core study area of 33 km everyc. 12 days from July–October 2016 to May 2017 for between 123 to 246 days. In addition, 14 extended surveys were carried out for up to 680 km to determine the total area use of the tagged individuals. Tigerfish displayed at least two behavioural patterns either having high site fidelity with shorter movements or using larger areas with longer movements. Twenty‐three (66%) of the tigerfish had high site fidelity using an area of less than 33 km of river, whereas 12 tigerfish (34%) undertook long distance movements of up to 397 km upstream and 116 km downstream from their tagging locations. During the long‐distance movements tigerfish crossed the territorial boundaries of Angola, Namibia and Botswana. Of the 35 fish that were monitored, 14 (40%) spent more than 80% of the monitored time in the 33 km study area and 18 (51%) stayed within the study area for at least 50% of the monitored time. These findings suggest that freshwater protected areas may be a useful management tool and we predict that a protected river area of 2–5 km river length could protect 25.9–34.6% of the population for at least 75% of the time whereas protection of 10 km river length could protect at least 50% of tigerfish for at least 75% of the time.
A pilot study of the performance of captive‐reared delta smelt Hypomesus transpacificus in a semi‐natural environment
Authors: Hung Tien‐Chieh , Rosales Marlin , Kurobe Tomofumi , Stevenson Troy , Ellison Luke , Tigan Galen , Sandford Marade , Lam Chelsea , Schultz Andrew , Teh Swee
Published: October 2019

A captive breeding programme was developed in 2008 for delta smelt Hypomesus transpacificus in reaction to dramatic population decline over several decades. We took 526 sub‐adult captive‐reared delta smelt and cultured them for 200 days without providing artificial food or water quality management to assess their performance once released in the wild. The results indicated captive‐reared sub‐adult delta smelt could survive in a semi‐natural environment with uncontrolled water quality and naturally produced wild prey through spawning and into their post spawning phase.
Regional cluster of vanishing gastroschisis: A comparative study of antenatal and post‐natal outcomes
Authors: Granger Jeremy , Do‐Wyeld Montgommery , Cundy Thomas P , Galek Alison , Stark Michael J , Cord‐Udy Catherine L
Published: October 2019

Aim

Vanishing gastroschisis describes the in utero spontaneous closure of the periumbilical defect. It is usually associated with intestinal loss due to ischaemia, necrosis and atresia. This comparative study aims to investigate the spectrum of pathology, antenatal ultrasound characteristics and post‐natal outcomes.

Methods

Our tertiary centre provides antenatal and post‐natal care of major congenital anomalies for a population of 1.6 million. Medical records were retrospectively evaluated for all cases of vanishing gastroschisis from May 2014 to May 2015. Cases of normal variant gastroschisis born during the same period were used for comparison. Maximum antenatael bowel diameter measurements were compared using the Mann–Whitney U‐test.

Results

Six infants with vanishing gastroschisis were born during the study period, representing 50% of all live‐born gastroschisis. Antenatal ultrasound showed progressively increasing intra‐abdominal bowel dilatation, with antenatal intra‐abdominal bowel diameter significantly greater in vanishing, than normal, variant gastroschisis (23.2 vs. 4.1 mm, P < 0.01). The classification of vanishing gastroschisis severity comprised two type I, three type II and one type III cases. Complete midgut atresia affected three infants, leading to overall mortality of 50% for the vanishing gastroschisis group versus 0% in the normal variant group (P = 0.05).

Conclusion

Vanishing gastroschisis is a severe, often catastrophic variant of gastroschisis. Aetiological factors contributing to the recent high incidence of this rare complication in our population of newborns remain unknown, prompting secondary prevention strategies to salvage the midgut. We propose closer antenatal surveillance for fetuses with intra‐abdominal bowel dilatation >10 mm to prompt consideration of earlier delivery to improve morbidity and mortality.
Is an unfunded social security system good or bad for growth? A theoretical analysis of social security systems financed by VAT
Authors: Maebayashi Noritaka
Published: October 2019

This study investigates how unfunded public pensions financed by value added tax (VAT), as discussed in Japan, affect economic growth and whether payroll tax (PT) or VAT is the more growth‐friendly tax structure for financing public pensions. We examine these issues using overlapping generations models with parental altruism and find that a public pension system financed by VAT may increase economic growth when bequests are operative. By contrast, when bequests are inoperative, public pensions hinder growth unless agents are sufficiently patient. Finally, public pensions financed by VAT are more growth‐friendly than those financed by PT.
Extra‐pair mating in a passerine bird with highly duplicated major histocompatibility complex class II: Preference for the golden mean
Authors: Rekdal Silje L. , Anmarkrud Jarl Andreas , Lifjeld Jan T. , Johnsen Arild
Published: October 2019

Genes of the major histocompatibility complex (MHC) are essential in vertebrate adaptive immunity, and they are highly diverse and duplicated in many lineages. While it is widely established that pathogen‐mediated selection maintains MHC diversity through balancing selection, the role of mate choice in shaping MHC diversity is debated. Here, we investigate female mating preferences for MHC class II (MHCII) in the bluethroat (Luscinia svecica), a passerine bird with high levels of extra‐pair paternity and extremely duplicated MHCII. We genotyped family samples with mixed brood paternity and categorized their MHCII alleles according to their functional properties in peptide binding. Our results strongly indicate that females select extra‐pair males in a nonrandom, self‐matching manner that provides offspring with an allelic repertoire size closer to the population mean, as compared to offspring sired by the social male. This is consistent with a compatible genes model for extra‐pair mate choice where the optimal allelic diversity is intermediate, not maximal. This golden mean presumably reflects a trade‐off between maximizing pathogen recognition benefits and minimizing autoimmunity costs. Our study exemplifies how mate choice can reduce the population variance in individual MHC diversity and exert strong stabilizing selection on the trait. It also supports the hypothesis that extra‐pair mating is adaptive through altered genetic constitution in offspring.
Mediators’ and Disputing Parties’ Perceptions of Trust‐Building in Family Mediation
Authors: Riera Adrover Joan Albert , Cuartero Castañer María Elena , Montaño Moreno Juan José
Published: October 2019

Different studies have demonstrated that trust‐building between mediators and disputing parties is a basic factor in the success of mediation processes. The aim of this study was to conduct an integrated analysis of mediation by taking into account the perceptions of mediators working for the Mediation Service and those of the service users over a period of one year. The obtained results show statistically significant differences in the two groups’ analyzed response patterns associated with a series of factors that predict trust‐building (the mediator's legal expertise; suggesting an alternative; sincerity; focusing on settling the dispute; the appointment of a mediator by public authorities and/or by a recognized service; focusing on the parties’ common goals; highlighting the rules of mediation; and devoting some time to talking about informal matters). The identification of these factors contributes to improved training and professional practices in the field of mediation.
Effects of acotiamide on functional dyspepsia patients with heartburn who failed proton pump inhibitor treatment in Japanese patients: A randomized, double‐blind, placebo‐controlled crossover study
Authors: Funaki Yasushi , Ogasawara Naotaka , Kawamura Yurika , Yoshimine Takashi , Tamura Yasuhiro , Izawa Shinya , Ebi Masahide , Sasaki Makoto , Kasugai Kunio
Published: October 2019

Background

Functional dyspepsia (FD) and non‐erosive reflux disease (NERD) are gastrointestinal disorders that often overlap. In this randomized, double‐blind, placebo‐controlled crossover study, the effects of adding acotiamide to treatment with proton pump inhibitors (PPI) were investigated in FD patients with heartburn who failed PPI treatment, corresponding to PPI‐resistant NERD.

Methods

The subjects included 16 FD patients with heartburn who failed PPI treatment, and they were administered acotiamide or a placebo for 28 days. After suspending medication for 28 days, the trial drug and placebo were crossed over and administered for 28 days. Before the study began and after each administration period, high‐resolution impedance manometry (HRiM) was performed, and the modified frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire was administered.

Key Results

Postprandial fullness in the FD assessment and all modified FSSG items were significantly lower in the acotiamide group than in the placebo group. Esophagogastric junction pressure was significantly higher in the acotiamide group. The distal contractile integral (DCI) pressure and the highest DCI pressure both increased significantly in the acotiamide group. Moreover, in the acotiamide group, the frequency of abnormal primary peristalsis decreased to normal levels; complete bolus transit (CBT), an indicator of esophageal clearance, increased; and CBT time decreased.

Conclusions & Inferences

Acotiamide was considered to improve upper gastrointestinal functions not only in the stomach but also in the esophagus. Adding acotiamide to PPI therapy appears to improve upper abdominal symptoms in FD patients with heartburn who failed PPI treatment.
Brachiopod shell thickness links environment and evolution
Authors: Balthasar Uwe , Jin Jisuo , Hints Linda , Cusack Maggie
Published: October 2019

While it is well established that the shapes and sizes of shells are strongly phylogenetically controlled, little is known about the phylogenetic constraints on shell thickness. Yet, shell thickness is likely to be sensitive to environmental fluctuations and has the potential to illuminate environmental perturbations through deep time. Here we systematically quantify the thickness of the anterior brachiopod shell which protects the filtration chamber and is thus considered functionally homologous across higher taxa of brachiopods. Our data come from 66 genera and 10 different orders and shows well‐defined upper and lower boundaries of anterior shell thickness. For Ordovician and Silurian brachiopods we find significant order‐level differences and a trend of increasing shell thickness with water depth. Modern (Cenozoic) brachiopods, by comparison, fall into the lower half of observed shell thicknesses. Among Ordovician–Silurian brachiopods, older stocks commonly have thicker shells, and thick‐shelled taxa contributed more prominently to the Great Ordovician Biodiversification but suffered more severely during the Late Ordovician Mass Extinction. Our data highlight a significant reduction in maximum and minimum shell thickness following the Late Ordovician mass extinction. This points towards stronger selection pressure for energy‐efficient shell secretion during times of crisis.
Multiple functions of S100A10, an important cancer promoter
Authors: Saiki Yuriko , Horii Akira
Published: October 2019

The S100 group of calcium binding proteins is composed of 21 members that exhibit tissue/cell specific expressions. These S100 proteins bind a diverse range of targets and regulate multiple cellular processes, including proliferation, migration and differentiation. S100A10, also known as p11, binds mainly to annexin A2 and mediates the conversion of plasminogen to an active protease, plasmin. Higher S100A10 expression has been reported to link to worse outcome and/or chemoresistance in a number of cancer types in lung, breast, ovary, pancreas, gall bladder and colorectum and leukemia although some discrepancy was reported. In this review, we focused on the roles of the S100A10 in cancer. We summarized its biological functions, role in cancer progression, prognostic value and targeting of S100A10 for cancer therapy.
Assessing the Benefits and Costs of Homeland Security Research: A Risk‐Informed Methodology with Applications for the U.S. Coast Guard
Authors: von Winterfeldt Detlof , Farrow R. Scott , John Richard S. , Eyer Jonathan , Rose Adam Z. , Rosoff Heather
Published: October 2019

This article describes a methodology for risk‐informed benefit–cost analyses of homeland security research products. The methodology is field‐tested with 10 research products developed for the U.S. Coast Guard. Risk‐informed benefit–cost analysis is a tool for risk management that integrates elements of risk analysis, decision analysis, and benefit–cost analysis. The cost analysis methodology includes a full‐cost accounting of research projects, starting with initial fundamental research costs and extending to the costs of implementation of the research products and, where applicable, training, maintenance, and upgrade costs. The benefits analysis methodology is driven by changes in costs and risks leading to five alternative models: cost savings at the same level of security, increased security at the same cost, signal detection improvements, risk reduction by deterrence, and value of information. The U.S. Coast Guard staff selected 10 research projects to test and generalize the methodology. Examples include tools to improve the detection of explosives, reduce the costs of harbor patrols, and provide better predictions of hurricane wind speeds and floods. Benefits models and estimates varied by research project and many input parameters of the benefit estimates were highly uncertain, so risk analysis for sensitivity testing and simulation was important. Aggregating across the 10 research products, we found an overall median net present value of about $385 million, with a range from $54 million (5th percentile) to $877 million (95th percentile). Lessons learned are provided for future applications.
Using sensor‐based technology for safety and independence – the experiences of people with dementia and their families
Authors: Malmgren Fänge Agneta , Carlsson Gunilla , Chiatti Carlos , Lethin Connie
Published: October 2019

Background

The majority of people with dementia prefer to live independently and safely in their own home cared for by their family members. Much effort has been invested in the development of technology, such as sensor‐based networks. Many challenges remain, in particular gaining more knowledge about their experiences and perceived benefits. This study aimed to explore experiences, needs and benefits with using sensor‐based technology for safety and independence in the homes of people with dementia and their family members.

Methods

This study is part of the TECH@HOME project, aiming to evaluate the effects of sensor‐based technology on independence among people with dementia and caregiver stress among their family members. This study applied an inductive, qualitative approach with semi‐structured interviews of people with dementia (n = 9) and family members (n = 21). The participants were interviewed between June and September 2018 after using the technology for at least 6 months. The interviews were analysed with manifest content analysis.

Results

Our findings highlighted that technology was considered as a precaution and a safety measure that could provide a sense of having control of the everyday life of the person with dementia. Understanding and acceptance of the technology were as important, together with the reliability of the technology. Ethical dilemmas related to the monitoring of the person with dementia in the home were also raised.

Conclusion

This study provides insights into how people with dementia and family members experience and benefit from using sensor‐based technology in their own homes. The knowledge generated is essential for healthcare professionals and policymakers developing and implementing care and service systems including technology, as well as for the industry.
Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment
Authors: Nord‐Ljungquist Helena , Engström Åsa , Fridlund Bengt , Elmqvist Carina
Published: October 2019

Background

In a rural environment where distances and access to ambulance resources in people’s immediate area are limited, other responders like firefighters dispatched to perform a first aid before ambulance arrives in areas where a longer response time exists; an assignment called ‘While Waiting for the Ambulance’ (WWFA). Knowledge is limited about the experience from a caller’s perspective when a person has a life‐threatening condition needing emergency help and both firefighters in a WWFA assignment and ambulance staff are involved.

Aim

The aim of the study is to describe the emergency situation involving a WWFA assignment in a rural environment from the caller's perspective.

Method

A descriptive design using qualitative methodology with a reflective lifeworld research (RLR) approach was used for this study, including in‐depth interviews with eight callers.

Results

An emergency situation involving WWFA assignment in a rural environment mean a sense of being lone and lonely with a vulnerability in while waiting to hand over responsibility for the affected person. Ambivalence in several dimensions arises with simultaneous and conflicting emotions. A tension between powerlessness and power of action where the throw between doubt and hope are abrupt with a simultaneous pendulum between being in a chaos and in a calm.

Conclusion

A double ambivalence emerges between, on one hand feeling alone in the situation and having full control, on the other hand, with trust handing over the responsibility, thereby losing control. Contact with the emergency medical dispatcher becomes a saving lifeline to hold onto, and access to emergency help in the immediate area of WWFA is valuable and important. Trust and confidence are experienced when callers are met with empathy, regardless of personal acquaintance with arriving responders.
Telenurses’ experiences of monitoring calls to parents of children with gastroenteritis
Authors: Sandelius Susanna , Wahlberg Anna Carin
Published: October 2019

Aims and objective

To describe telenurses’ experiences of monitoring calls in telephone advice nursing to parents of children with gastroenteritis.

Background

In previous studies, making monitoring calls is mentioned as a method used by telenurses to assess the need for care. MonitoringTHE terms ‘care‐seekers’, ‘care‐seeker’ and ‘careseekers’ are used inconsistently in the article. Please suggest which one to follow. We suggest Care‐seeker calls in telephone advice nursing have been described as when telenurses call care‐seekers back once or twice after an initial call. Calls from parents of children with gastroenteritis are common, and many of these calls result in telenurses providing self‐care advice.

Methods

Nineteen telenurses from two healthcare call centres in Sweden were interviewed. Data were analysed using inductive qualitative content analysis.

Results

One main category, four generic categories and eleven sub‐categories emerged. The telenurses described how working with monitoring calls aimed to provide self‐care at home in a patient‐safe way. Their focus on the parents aimed at increasing their feeling of security and focus on the child aimed at ensuring patient safety. Monitoring calls also provided a learning opportunity for parents and telenurses, and the possibility of relieving pressure on healthcare services. The findings indicate that the use of monitoring calls aims to provide a patient‐safe form of telephone advice nursing.

Conclusion

This study shows that many parents feel insecure when their child has gastroenteritis, and the use of monitoring calls may be an effective approach to help them feel more secure at home with their sick child.
Variability among four refractometers for the measurement of urine specific gravity and comparison with urine osmolality in dogs
Authors: Rudinsky Adam J. , Wellman Maxey , Tracy Gaemia , Stoltenberg Lisa , DiBartola Stephen P. , Chew Dennis J.
Published: October 2019

Background

Refractometry is often used in clinical veterinary medicine to estimate urine concentration. Variability among commonly‐used refractometers has not been critically evaluated.

Objective

This study aimed to evaluate the variability of urine specific gravity (USG) among four refractometers and compare results of USG measurements with those of urine osmolality (Uosm), the gold standard for determining urine concentrations.

Methods

USG was determined in 100 dogs using three optical refractometers, the American Optical Abbe refractometer 10450, Reichert TS 400 refractometer, and Heska Veterinary refractometer 2737‐E02, and one digital refractometer, the Misco Palm Abbe Digital refractometer #PA203. Results were compared between each pair of refractometers and between each refractometer and urine osmolality determined by freezing point depression using a Multi‐Osmette 2430E osmometer. Results were analyzed with Bland‐Altman plots and Passing‐Bablok regression analysis.

Results

The Reichert, Heska, and Misco refractometers provide USG measurements that can be used interchangeably based on small differences, consistently less than 0.002, between the USG measurements. The AO refractometer measured USG values with much larger differences, which were deemed clinically significant by the study parameters. None of the refractometers were able to accurately predict Uosm or vice versa within a clinically acceptable range.

Conclusions

Varying degrees of differences were seen in the USG measurements among the different refractometers. These differences were refractometer‐dependent, and the results from one instrument could affect clinical decisions.
Recent rapid changes in the spatio‐temporal distribution of West Nile Neuro‐invasive Disease in Italy
Authors: Moirano Giovenale , Richiardi Lorenzo , Calzolari Mattia , Merletti Franco , Maule Milena
Published: October 2019

In Italy, the first human case of West Nile Virus (WNV) infection was reported in 2008 and, since then, the number of cases has been steadily increasing. In this study, we describe the temporal and spatial pattern of WNV infection risk among humans in Italy, focusing on the human cases of West Nile Neuro‐invasive Disease (WNND) observed between 2008 and 2017. Incidence rates are estimated for each year and province under study. The incidence temporal trend is estimated using Poisson regression, and a spatio‐temporal cluster detection analysis is performed to detect high‐risk areas. In total, 231 WNND cases were notified in Italy between 2008 and 2017. The annual incidence rates increased during the study period (annual percentage change: 11.7%; 95%CI: −0.9%; 26.1%). A geographical spread of the disease was observed during the study period throughout Northern Italy, with an increasing number of affected provinces. Provinces close to the Po River (the main river in the north of Italy) and the Oristano province (in the Sardinia Island) experienced the highest incidence rates during the study period. Our study shows a gradual, but rapid spread of WNND across Northern Italy from east to west and suggests the hypothesis that provinces close to Po River might present ecological and climatic conditions favourable to the virus circulation.
English Language Needs of Industrial Trainees in Chemical Engineering Industry: A Case of UniKL MICET
Authors: Saharuddin Noorhayati , Hussin Sa’adiah
Published: October 2019

Industrial training, or internship program, is always a must in any academic institutions, especially those offering engineering programs. Since industrial training is always structured at the end of the program, students going for internships are considered to be already well prepared with the content knowledge of their field of study. However, the job scope of an engineer does not entail content knowledge only. An engineer still has to carry out various other tasks like writing reports and letters as well as participating in meetings or discussions; thus the needs to ensure that these trainees are competent in the English language and effective as communicators. However, which English communication skills in particular do the industries in general require of these students? Venkatraman&Prema (2007) claim that “In the globalized context, students of Engineering and Technology need a specific set of language skills for their success in education and career.” All academic institutions should balance their curricula between future professionals and workplace needs of their graduates (Kaneko, Rozycki& Orr, 2008). In light of this, this paper will look at the English language needs of 18 organisations related to the chemical engineering industry where industrial trainees from Universiti Kuala Lumpur Malaysian Institute of Chemical & Bioengineering Technology (UniKL MICET) were sent to. A survey conducted found that all but one of the organisations see that English language is important even though not all of them use the language at work. This paper discusses the tasks in which English language is most required and what language functions are most commonly used in the organisations. Trainees’ feedback on the actual usage of English language while they are on industrial training for three months will also be discussed.
Embedded Moves in Abstracts of Research Articles in the Field of International Studies and Their Linguistic Realisations
Authors: Yoke Len Loh , Kean Wah Lee , Yew Meng Lai
Published: October 2019

Writing an abstract requires artful composition and skillful selection of salient information. This is because reducing an extensive volume of research into a precise abstract of limited number of words can pose a challenge to researchers-cum-authors. To provide a guideline for writing abstracts, a genre-based study was conducted on 48 abstracts of research articles from six journals in the field of International Studies. The findings reveal a total of six Moves with frequent occurrences of embedding in complex sentences. The common linguistic features employed to encapsulate two to four Moves in a single sentence are also highlighted. They include a variety of grammatical forms such as infinitives, adjective clauses or phrases, adverb clauses, adverbial phrases, and connectors. It is hoped that the findings can enlighten novices on how to compose a concise abstract with succinct information that is presented within an economical word count