bluuebunny/crossref_metadata_2025 huggingface dataset:
Teaching Home-Based Primary Care
Authors: Reckrey Jennifer M. , Ornstein Katherine A. , Wajnberg Ania , Kopke M. Victoria , DeCherrie Linda V.
Published: May 2018

Despite the growing homebound population and the development of innovative models of care that work to bring care to people in their homes, home visits are not a routine part of education for many healthcare providers. This manuscript describes the experience of Mount Sinai Visiting Doctors teaching home-based primary care to learners of various disciplines and reports the results of a survey performed to assess trainee experience. Mount Sinai Visiting Doctors is the largest academic home-based primary care program in the country and trainees of various disciplines have nearly 1,700 contact days annually of directly supervised clinical teaching. In order to improve trainee education and meet our practice needs, trainees: 1) independently conduct urgent visits, 2) carry longitudinal panels of homebound patients, and 3) perform subspecialist consultations. Mount Sinai Visiting Doctors has exposed thousands of trainees to home-based primary care in the past 20 years and trainees report positive reviews of their experiences. As the need to train future providers in home-based primary care grows, we will be challenged to provide trainees with adequate exposure to multidisciplinary teams and to teach about the importance of continuity of care.
Becoming a Home Care Clinician or Manager Information Needed for Success
Authors: Marrelli Tina
Published: May 2018

This chapter is an excerpt from Home Care Nursing: Surviving in an Ever-Changing Care published by Sigma Theta Tau International (Marrelli and Associates, Inc., 2017) and has been significantly condensed for purpose of publication in Home Healthcare Now. For more information about this book, Home Care Nursing: Surviving in an Ever-Changing Care Environment. Please visit Nursing Knowledge International at https://www.nursingknowledge.org/home-care-nursing-surviving-in-an-ever-changing-care-environment.html
Development of a Home Health-Based Palliative Care Program for Patients With Heart Failure
Authors: Gasper Abigail M. , Magdic Kathy , Ren Dianxu , Fennimore Laura
Published: May 2018

Heart failure is a significant burden to the healthcare system. Approximately 5.7 million adults in the United States were diagnosed with heart failure between 2009 and 2012 (Mozaffarian et al., 2016). The American Heart Association projects that direct costs for heart failure may be as high as $77.7 billion by 2030 (Heidenreich et al., 2011). Technological and pharmaceutical advancements have delayed the progression of the disease; however, it is predicted that close to half of individuals with heart failure will die within 5 years of the initial diagnosis (Braun et al., 2016
;
McIlvennan & Allen, 2016). Current research suggests that the utilization of palliative care and an interdisciplinary team approach to the care of patients with heart failure improves the quality of life and decreases utilization of healthcare resources at the end of life (Evangelista et al., 2014a). This performance improvement project examined the knowledge of a home healthcare interdisciplinary team's knowledge about palliative care in patients with heart failure, the 30-day readmission rate for patients enrolled in a home-based palliative care program, and documentation of advanced directives in a home healthcare organization.
Musculoskeletal Pain and Interest in Meditation and Yoga in Home Health Aides
Authors: Shnayder Michelle M. , Brannan Debi , Murphy Lauren A. , Asfour Lila S. , Hecht Eric M. , Lee David J. , Caban-Martinez Alberto J.
Published: May 2018

Home healthcare aides (HHAs) are a growing U.S. workforce highly susceptible to workplace stressors and musculoskeletal pain. In the present study we: 1) examine the association of musculoskeletal pain to life satisfaction and emotional exhaustion; and 2) characterize interest in meditation and yoga in a sample of HHAs. A nonprobabilistic sample of HHAs employed at home healthcare agencies in Florida, Massachusetts, and Oregon (n = 285 total) completed a self-administered questionnaire with standard survey measures on musculoskeletal pain location, duration, and severity; life satisfaction; emotional exhaustion; and interest in meditation techniques and yoga. Among HHAs responding, 48.4% reported pain in the last 7 days and 46.6% reported pain in the last 3 months. Home healthcare aides who reported current pain and chronic pain had a significant (P < .05) decrease in satisfaction with life score and a significant increase in emotional exhaustion score. The majority of HHAs reported an interest in learning about the benefits (65.6%) and practice (66.4%) of meditation and a willingness to participate in a yoga class (59.2%) or stress management meeting (59.1%). The HHAs reported both acute and chronic musculoskeletal pain that was correlated with lower life satisfaction and greater emotional exhaustion. More efforts are needed to reduce the sources of injury and emotional exhaustion.
Maintaining Professional Nursing Boundaries in the Pediatric Home Care Setting
Authors: Petosa Sarah Diane
Published: May 2018

Pediatric home care nurses often become a valuable part of the family unit, and this can blur the professional boundary between nurse and patient. Home care professionals must educate themselves as well as patients and family members about the integrity of their professional relationship, and prevent boundary crossing before it occurs. This article highlights four case studies that describe situations of boundary crossing that could have been managed differently. Strategies for maintaining professional boundaries with patients and their families are provided.
Dry Eye Disease
Authors: Rouen Patricia A. , White Mary L.
Published: May 2018

Dry eye disease is a chronic condition of the corneal surface marked by persistent symptoms of irritation or burning that can cause inflammatory damage to the cornea and conjunctiva if untreated. Common risk factors for this syndrome include advancing age, female sex, low humidity environments, systemic medications, and autoimmune disorders. Treatments to relieve symptoms include tear replacement, humidification, improved nutrition, and anti-inflammatory ocular agents. Home healthcare nurses can identify signs and symptoms of dry eye syndrome and initiate strategies that range from warm compresses to physician referrals for more aggressive treatment. Consistent management of this condition improves quality of life and minimizes damage to the ocular surface.
Communicating With Older Adults
Authors: White Mary L. , Verdusco L. Michael
Published: May 2018

As people age, physiological changes can occur causing deterioration of one or more of the senses, including hearing, vision, taste, and smell. The loss of sensory function can decrease the extent to which older adults can communicate, especially with their healthcare providers. The purpose of this article is to examine communication between older adults and healthcare providers, focusing on best practices and devices that can enhance and benefit their health and well-being. One consideration is the use of digital technology, such as smart phones, electronic tablets, and computers, to help mitigate the effects of aging on communication.
Reach for the Stars
Authors: Panozzo Gina
Published: May 2018

Star Ratings were implemented by the Centers for Medicare and Medicaid Services for home healthcare agencies with the first release of measures in 2015 and 2016. Hospital Compare also displays Star Ratings, and Hospice also will soon have the Hospice Information Set displayed on Hospice Compare. Star Ratings in home healthcare are determined by a specific methodology and are based on nine quality areas. One set of Stars designates the nine quality areas and a second set of Stars reflects consumer satisfaction. This article discusses quality of patient care Star Ratings but not those based on Consumer Assessment of Healthcare Provider and Systems outcomes. Few agencies reach above 3-Star Ratings; the majority fall within 3 and 3.5 with the national benchmark being 3.5. Agencies should strive for high Star Ratings as consumers, hospitals, and other referral sources may base their decisions on the number of stars received.
Uneven Staining in Automated Immunohistochemistry: Cold and Hot Zones and Implications for Immunohistochemical Analysis of Biopsy Specimens
Authors: Cheung Carol C. , Swanson Paul E. , Nielsen Søren , Vyberg Mogens , Torlakovic Emina E.
Published: May 2018

Objectives:

The occurrence of uneven staining (UES) in automated immunohistochemistry (IHC) has been experienced by clinical laboratories and has the potential to confound readout, interpretation, and reporting of IHC assays despite the presence optimally stained on-slide controls. However, there are no studies of this phenomenon in regard to the type, frequency, and association with different automated IHC platforms. We studied the occurrence of UES in automated IHC assays with real world examples from clinical practice and by using a laboratory developed methodology to monitor baseline and periodic performance of automated IHC instruments.

Materials and Methods:

Sections of formalin-fixed, paraffin-embedded normal liver tissue were mounted on 180 glass slides and stained for HepPar1 on 6 automated IHC instruments (4 different models from 3 different manufacturers). Macroscopic and microscopic defects of staining were recorded.

Results:

Only 8% of slides showed completely uniform staining. UES, including areas of both increased and decreased staining, occurred with all instruments. Decreased staining was often zonal, involving large regions of the slide. Decreased staining mostly localized in an instrument-dependent manner. Increased staining tended to occur in small foci with a random distribution.

Conclusions:

The common occurrence of UES (particularly decreased staining) has important implications for the reliable read-out of IHC assays on biopsy samples. Baseline and periodic quality assurance testing for UES is recommended for all automated IHC instruments.
Unfavorable Pathology, Tissue Biomarkers and Genomic Tests With Clinical Implications in Prostate Cancer Management
Authors: Nguyen Jane Kim , Magi-Galluzzi Cristina
Published: May 2018

Prostate cancer management has traditionally relied upon risk stratification of patients based on Gleason score, pretreatment prostate-specific antigen and clinical tumor stage. However, these factors alone do not adequately reflect the inherent complexity and heterogeneity of prostate cancer. Accurate and individualized risk stratification at the time of diagnosis is instrumental to facilitate clinical decision-making and treatment selection tailored to each patient. The incorporation of tissue and genetic biomarkers into current prostate cancer prediction models may optimize decision-making and improve patient outcomes. In this review we discuss the clinical significance of unfavorable morphologic features such as cribriform architecture and intraductal carcinoma of the prostate, tissue biomarkers and genomic tests and assess their potential use in prostate cancer risk assessment and treatment selection.
Applying Machine Learning to Pediatric Critical Care Data*
Authors: Williams Jon B. , Ghosh Debjit , Wetzel Randall C.
Published: May 2018

Objectives:

To explore whether machine learning applied to pediatric critical care data could discover medically pertinent information, we analyzed clinically collected electronic medical record data, after data extraction and preparation, using k-means clustering.

Design:

Retrospective analysis of electronic medical record ICU data.

Setting:

Tertiary Children’s Hospital PICU.

Patients:

Anonymized electronic medical record data from PICU admissions over 10 years.

Interventions:

None.

Measurements and Main Results:

Data from 11,384 PICU episodes were cleaned, and specific features were generated. A k-means clustering algorithm was applied, and the stability and medical validity of the resulting 10 clusters were determined. The distribution of mortality, length of stay, use of ventilation and pressors, and diagnostic categories among resulting clusters was analyzed. Clusters had significant prognostic information (p < 0.0001). Cluster membership predicted mortality (area under the curve of the receiver operating characteristic = 0.77). Length of stay, the use of inotropes and intubation, and diagnostic categories were nonrandomly distributed among the clusters (p < 0.0001).

Conclusions:

A standard machine learning methodology was able to determine significant medically relevant information from PICU electronic medical record data which included prognosis, diagnosis, and therapy in an unsupervised approach. Further development and application of machine learning to critical care data may provide insights into how critical illness happens to children.
Cross-Cultural Adaptation and Psychometric Evaluation of a Second Victim Experience and Support Tool (SVEST)
Authors: Brunelli Maria Victoria , Estrada Silvina , Celano Constanza
Published: May 2018

Introduction

The second victim is defined as the health professionals who commit an error and are traumatized by the event manifesting psychological, cognitive, and/or physical reactions that have a personal negative impact.

The SVEST (Second Victim Experience and Support Tool) is a survey developed and validated in the United States, which describes the experience of second victims.

The objective of this study was to perform the cross-cultural adaptation of the instrument and to assess the psychometric characteristics in the sociocultural and professional context of Argentina.

Materials and Methods

The back translation of the instrument was carried out, which was approved by the authors. The survey consists of 29 questions divided into 9 dimensions corresponding to psychological stress, physical stress, colleague support, supervisor’s support, institutional support, non–work-related support, professional effectiveness assessment, change intention, and absenteeism. Subsequently, the survey was conducted to nursing professionals who had committed an error in medication. The reliability testing was done for internal consistency and the validity through construct validity using SPSS program.

Results

The population consisted of 452 nurses having an average of 10 years of practice (SD, 8.2). Eighty-two percent of those who made an error stated that they reported the event once it had occurred.

In our exploratory analysis, the survey presented no comprehension difficulties. The internal consistency of the instrument was adequate in its overall evaluation (Cronbach, 0.805).

Conclusion

The adaptation of SVEST is reliable for the use of this instrument in our environment to quantify the phenomenon and to be able to design strategies to reduce the impact of the error in the second victim.
A Standardized Handoff Simulation Promotes Recovery From Auditory Distractions in Resident Physicians
Authors: Matern Lukas H. , Farnan Jeanne M. , Hirsch Kristen W. , Cappaert Melissa , Byrne Ellen S. , Arora Vineet M.
Published: May 2018

Introduction

Despite the increasing use of training simulations to teach and assess resident handoffs, simulations that approximate realistic hospital conditions with distractions are lacking. This study explores the effects of a novel simulation-based training intervention on resident handoff performance in the face of prevalent hospital interruptions.

Methods

After a preliminary educational module, entering postgraduate year 1 residents (interns) completed one of the following three handoff simulations: (1) no interruption, (2) hospital noise, or (3) noise and pager interruptions. Trained receivers rated interns using an evidence-based Handoff Behaviors Checklist and a previously validated Handoff Mini-Clinical Examination Exercise instrument.

Results

Of 127 eligible interns, 125 (98.4%) completed an online preparatory module and a handoff simulation. Interns receiving auditory interruptions were less likely to be heard adequately (48.8% noise and 71.8% noise + pager vs. 100.0% uninterrupted, P < 0.001) and scored lower on establishing appropriate handoff settings (5.7 ± 2.3 noise and 6.2 ± 1.8 noise + pager vs. 8.0 ± 0.8 uninterrupted, P < 0.001). Interns receiving noise only shared a written sign-out document more effectively (71.1% vs. 30.2% uninterrupted and 43.6% noise + pager, P < 0.001). There were no differences in averaged performance metrics on the Handoff Behaviors Checklist.

Discussion

While common hospital interruptions created nonideal circumstances for the handoff, interns receiving interruptions were rated similarly and recovered effectively. However, interns exposed to noise only used the written sign-out form more actively. Our findings suggest that this intervention was successful in promoting handoff proficiency despite exposure to common but significant hospital interruptions.
The Effect of Commonly Performed Exercises on the Levator Hiatus Area and the Length and Strength of Pelvic Floor Muscles in Postpartum Women
Authors: Siff Lauren N. , Hill Audra J. , Walters Samantha J. , Walters Ginny , Walters Mark D.
Published: May 2018

Objective

The aim oft his study was to compare the effects of 10 common exercises to traditional pelvic floor muscle (PFM) contractions (Kegel) on levator hiatus (LH) area and PFM length and strength.

Methods

This is a cross-sectional study of 15 healthy postpartum women. Ten exercises were studied. These were common variations of leg, core, and back exercises used in yoga, Pilates, strength training, and physical therapy. Each participant performed all 10 exercises at a single visit in 2 examination settings: transperineal ultrasound and perineometry. Ultrasound measured the LH area and PFM length, and perineometry measured the muscle strength (peak squeeze pressure).

Results

Kegel generates an increase in squeeze pressure (24.3 cm H2O), shortens the muscles (−0.46 cm) and narrows the LH (−0.13 cm2). The bird-dog and plank exercises were not different from Kegel in any measurement. While the leg-lift ultrasound dimensions are similar to Kegel, leg lifts generated peak squeeze pressures stronger than any other exercise (including Kegel). Whereas ultrasound dimensions were similar to Kegel, tucked and untucked squats and thigh adductions generated weaker contractions than Kegel. While crunch generated a squeeze pressure similar to Kegel, the ultrasound dimensions showed a significantly wider LH and longer muscle than Kegel. Bridge, clam, and plié exercises affected the PFMs differently than Kegel in all measures.

Conclusions

Bird-dog, plank, and leg-lift exercises should be evaluated as alternative exercises to Kegel as they affect PFM strength and length and LH area similarly to Kegel, and leg lifts generate a stronger contraction than Kegel.
Summary: 2017 International Consultation on Incontinence Evidence-Based Surgical Pathway for Pelvic Organ Prolapse
Authors: Maher Christopher F. , Baessler Kaven K. , Barber Matthew D. , Cheon Cecilia , Consten Esther C.J. , Cooper Kevin G. , Deffieux Xavier , Dietz Viviane , Gutman Robert E. , van Iersel Jan J. , Nager Charles W. , Sung Vivian W. , de Tayrac Renaud
Published: May 2018

Objective

The aim of this article is to summarize the relevant findings that inform the 2017 International Consultation on Incontinence pathway for surgical treatment of pelvic organ prolapse (POP).

Methods

We conducted an evidence-based review of the English-language peer-reviewed literature relating to POP surgery published prior to December 2016. Level 1 evidence (randomized controlled trials [RCTs] or systematic reviews of RCTs) was preferred; however, level 2 (poor-quality RCT, prospective cohort studies) or 3 evidence (case series or retrospective studies) has been included if level 1 data were lacking. The committee evaluated the literature and made recommendations based on the Oxford grading system summarized as follows: grade A recommendation usually depends on consistent level 1 evidence; grade B recommendation usually depends on consistent level 2 and/or 3 studies, or “majority evidence” from RCTs; grade C recommendation usually depends on level 3 studies or “majority evidence” from level 2/3 studies or Delphi-processed expert opinion; grade D, “no recommendation possible,” would be used where the evidence is inadequate or conflicting.

Results

The recommendations from each chapter of the review are presented and serve to inform an evidence-based pathway for the surgical treatment of prolapse. A Web-based interactive application of the pathway is presented.

Conclusions

The 2017 International Consultation on Incontinence pathway on surgery for POP is designed as an adjunct to transparent consultation and consent relating to POP surgery. The final decision regarding surgical intervention can be made only after a shared decision-making process between the patient and the clinician that will evaluate a variety of individual factors that cannot be assessed in the pathway.
Reversible two-state folding of the ultrafast protein gpW under mechanical force
Authors: Schönfelder Jörg , De Sancho David , Berkovich Ronen , Best Robert B. , Muñoz Victor , Perez-Jimenez Raul
Published: May 2018

Ultrafast folding proteins have limited cooperativity and thus are excellent models to resolve, via single-molecule experiments, the fleeting molecular events that proteins undergo during folding. Here we report single-molecule atomic force microscopy (AFM) experiments on gpW, a protein that, in bulk, folds in a few microseconds over a marginal folding barrier (~1 kBT). Applying pulling forces of only 5 pN we maintain gpW in quasi-equilibrium near its mechanical unfolding midpoint, and detect how it interconverts stochastically between the folded and an extended state. This binary pattern indicates that, under an external force, gpW (un)folds over a significant free energy barrier. Using molecular simulations and a theoretical model we rationalize how force induces such barrier in an otherwise downhill free energy surface. Force-induced folding barriers are likely a general occurrence for ultrafast folding biomolecules studied with single molecule force spectroscopy.
Calibration, Selection and Identifiability Analysis of a Mathematical Model of the in vitro Erythropoiesis in Normal and Perturbed Contexts
Authors: Duchesne Ronan , Guillemin Anissa , Crauste Fabien , Gandrillon Olivier
Published: May 2018

The in vivo erythropoiesis, which is the generation of mature red blood cells in the bone marrow of whole organisms, has been described by a variety of mathematical models in the past decades. However, the in vitro erythropoiesis, which produces red blood cells in cultures, has received much less attention from the modelling community. In this paper, we propose the first mathematical model of in vitro erythropoiesis. We start by formulating different models and select the best one at fitting experimental data of in vitro erythropoietic differentiation. It is based on a set of linear ODE, describing 3 hypothetical populations of cells at different stages of differentiation. We then compute confidence intervals for all of its parameters estimates, and conclude that our model is fully identifiable. Finally, we use this model to compute the effect of a chemical drug called Rapamycin, which affects all states of differentiation in the culture, and relate these effects to specific parameter variations. We provide the first model for the kinetics of in vitro cellular differentiation which is proven to be identifiable. It will serve as a basis for a model which will better account for the variability which is inherent to experimental protocol used for the model calibration.
Retrosplenial cortical representations of space and future goal locations develop with learning
Authors: Miller Adam M. P. , Mau William , Smith David M.
Published: May 2018

The retrosplenial cortex (RSC) is important for long-term contextual memory and spatial navigation, but little is known about how RSC neural representations develop with experience. We recorded neuronal activity in the RSC of rats as they learned a continuous spatial alternation task and found that the RSC slowly developed a population-level representation of the rat’s spatial location and current trajectory to the goal. After the rats reached peak performance, RSC firing patterns became predictive of navigation accuracy and even began to represent the upcoming goal location as the rats approached the choice point. These neural representations emerged at the same time that lesions impaired performance, suggesting that the RSC gradually acquired task representations that contribute to navigational decision-making.
Phosphatidylinositol 4,5-bisphosphate regulates cilium transition zone maturation inDrosophila melanogaster
Authors: Gupta Alind , Fabian Lacramioara , Brill Julie A.
Published: May 2018

Cilia are cellular antennae that are essential for human development and physiology. A large number of genetic disorders linked to cilium dysfunction are associated with proteins that localize to the ciliary transition zone (TZ), a structure at the base of cilia that regulates trafficking in and out of the cilium. Despite substantial effort to identify TZ proteins and their roles in cilium assembly and function, processes underlying maturation of TZs are not well understood. Here, we report a role for the membrane lipid phosphatidylinositol 4,5-bisphosphate (PIP2) in TZ maturation in theDrosophila melanogastermale germline. We show that reduction of cellular PIP2levels by ectopic expression of a phosphoinositide phosphatase or mutation of the type I phosphatidylinositol phosphate kinase Skittles induces formation of longer than normal TZs. These hyperelongated TZs exhibit functional defects, including loss of plasma membrane tethering. We also report that theonion rings(onr) allele of Drosophilaexo84decouples TZ hyperelongation from loss of cilium-plasma membrane tethering. Our results reveal a requirement for PIP2in supporting ciliogenesis by promoting proper TZ maturation.

Brief summary statement

The authors show that the membrane phospholipid PIP2, and the kinase that produces PIP2called Skittles, are needed for normal ciliary transition zone morphology and function in the Drosophila male germline.
Cerebral organoid proteomics reveals signatures of dysregulated cortical development associated with human trisomy 21
Authors: McClure-Begley Tristan D. , Ebmeier Christopher C. , Ball Kerri E. , Jacobsen Jeremy R. , Kogut Igor , Bilousova Ganna , Klymkowsky Michael W. , Old William M.
Published: May 2018

Human trisomy 21 (Down syndrome) is the most common genetic cause of intellectual disability, and is associated with complex perturbations in protein expression during development. Brain region-specific alterations in neuronal density and composition originate prenatally in trisomy 21 individuals, and are presumed to underlie the intellectual disability and early onset neurodegeneration that characterizes Down syndrome. However, the mechanisms by which chromosome 21 aneuploidy drives alterations in the central nervous system are not well understood, particularly in brain regions that are uniquely human and thus inaccessible to established animal models. Cerebral organoids are pluripotent stem cell derived models of prenatal brain development that have been used to deepen our understanding of the atypical processes associated with human neurobiological disorders, and thus provide a promising avenue to explore the molecular basis for neurodevelopmental alterations in trisomy 21. Here, we employ high-resolution label-free mass spectrometry to map proteomic changes over the course of trisomy 21 cerebral organoid development, and evaluate the proteomic alterations in response to treatment with harmine, a small molecule inhibitor of the chromosome 21 encoded protein kinase DYRK1A. Our results reveal trisomy 21 specific dysregulation of networks associated with neurogenesis, axon guidance and extracellular matrix remodeling. We find significant overlap of these networks show significant overlap with previously identified dysregulated gene expression modules identified in trisomy 21 fetal brain tissue. We show that harmine leads to partial normalization of key regulators of cortical development, including WNT7A and the transcription factors TBR1, BCL11A, and POU3F2, pointing to a causative role for DYRK1A over-expression in neurodevelopmental effects of human trisomy 21.
Selectively increased autofluorescence at certain locations of skin may become a novel diagnostic biomarker for lung cancer
Authors: Zhang Mingchao , Tao Yue , Chang Qing , Li Yujia , Chu Tianqing , Ying Weihai
Published: May 2018

Early diagnosis is critical for improving the 5-year survival rate of lung cancer patients. Our current study tested our hypothesis that increased autofluorescence (AF) of skin and nails may become a novel diagnostic biomarker of lung cancer, which has generated the following findings: First, our study on a mouse model of lung cancer has shown that development of lung cancer led to a marked increase in the epidermal green AF of the mice. Second, the AF intensity of the untreated lung cancer patients was significantly higher than that of the healthy persons and the pulmonary infection patients at certain examined locations of the skin and fingernails. Third, the ‘Pattern of AF’ of healthy controls, pulmonary infection patients and untreated lung cancer patients was markedly different from each other. Fourth, when the number of the locations with increased AF was used as the sole diagnostic parameter, our ROC analysis showed that the AUC was 0.9067 for differentiating the healthy controls and the untreated lung cancer patients. Collectively, our study has indicated that development of lung cancer is sufficient to induce increases in the epidermal green AF of both mice and human subjects. Our study has also indicated that the ‘Pattern of AF’ of lung cancer patients could become a novel biomarker of lung cancer, which holds great promise for non-invasive, rapid and economic diagnosis and screening of lung cancer.
Gauging the development of innovative capabilities in Accounting and Finance students: can they drive the national innovation agenda?
Authors: Jackson Denise
Published: May 2018

As automation catalyses the shift from number‐crunching to more complex roles spanning risk management and strategic decision‐making, it is important that higher education is developing the capabilities for Accounting and Finance graduates to successfully contribute to innovation. The study gauges the development of innovative capabilities among students and new graduates using national data from 2012 to 2015. It identifies gaps in the development of certain capabilities, discusses the implications of these and presents strategies for improvement. Findings will inform stakeholders how to better prepare these graduates to contribute to innovation and, ultimately, improve economic growth and global competitiveness in Australia.
Spatial control and care in Finnish nursing homes
Authors: Repo Virve
Published: May 2018

This paper presents an analysis of the relationship between spatial control and care in nursing homes governed by Finnish municipalities. Although the attitude towards elderly care is gradually changing, most nursing homes governed by Finnish municipalities are still traditional, large institutions. In the study, I examine how care and control emerge spatially in nursing homes and how living in a limited environment shapes the everyday life of the residents. I argue that spatial practices affect the well‐being of the residents, since a great deal of the control in Finnish nursing homes is spatiotemporal. The institutions use multiple methods to control residents, such as limiting mobility and daily routines, which can also result in unintended mistreatment. As the analysis demonstrates, staff and their attitudes have a significant effect on the residents’ well‐being. It also underlines how feelings of self‐determination or “imagined” liberty can relieve anxiety and feelings of being confined. Control may be needed to keep residents safe; however, there is a risk that control can merge into care which affects staff culture and the well‐being of residents. This paper responds to the call for greater diversity within carceral geography, and conceptualises the nursing home as a complex (quasi‐)carceral environment that sits uneasily on the continuum between care and control.
Regional landscape response to thrust belt dynamics: The Iglesia basin, Argentina
Authors: Ruetenik Gregory A. , Hoke Gregory D. , Moucha Robert , Val Pedro
Published: May 2018

Intermontane basins are often the result of regionally variable uplift in tectonic settings. Wedge‐top basins, a type of intermontane basin, form along thrust faults within a fold and thrust belt, and provide an ideal environment to study the regional fluvial and surface response to local variations in rock uplift. This study simulates the formation and evolution of an intermontane basin using a landscape evolution model. The modelling results demonstrate that large trunk streams maintain connectivity during basin formation for two reasons: (1) their stream power is enhanced by the capture of smaller streams, enabling them to incise through the uplifting downstream region, and (2) they acquire increased sediment yield to completely infill the upstream accommodation space rather than forming an endorhic basin. During active deformation of the fold‐and‐thrust belt, both channel slope and erosion rates are reduced upstream of the intermontane basin and these changes propagate as a wave of low erosion into the uplands. For a uniform background uplift rate in a landscape previously at steady state, this reduced rate of erosion results in a net surface uplift upstream of the basin. Following the eventual breach of the basin's bounding structural barrier, a wave of high erosion propagates through the basin and increases the channel slope. This onset of increased erosion can be delayed by up to several million years relative to the onset of downstream uplift. Observed paleoerosion rates in paired wedge‐top and foreland basin sequences, and present‐day stream profiles in the Argentine Precordillera support our modelling results. Our results may be extrapolated to other foreland systems, and are potentially identifed using low‐temperature thermochronometers in addition to paleoerosion rates.
Hydrocortisone inhibition of wild‐type and αD200Q nicotinic acetylcholine receptors
Authors: Dworakowska Beata , Nurowska Ewa , Dołowy Krzysztof
Published: May 2018

Short‐term treatment with large doses of corticosteroids can result in acute weakness of muscles in processes that have not yet been fully characterized. Corticosteroids have been shown to exert direct inhibitory action on the muscle‐type nicotinic acetylcholine receptor (AChR), and therefore can promote pharmacological muscle denervation. The mechanism of hydrocortisone (HC) blockage of AChR has not been fully established yet. It is uncommon for an electrically neutral molecule, for example, HC, to induce voltage‐dependent changes in AChR kinetics. Our experiments aimed to determine the source of voltage‐dependency in HC action. Wild‐type (WT) and αD200Q receptors were transiently expressed in HEK293 cells. Recordings were performed in either the presence or absence of HC. We showed that the D‐to‐Q substitution is capable of suppressing the voltage dependency in the HC‐induced block. We conclude that the distance between αD200 and the agonist‐binding site depends on the membrane potential. The voltage‐dependent changes of the αD200 position have not been considered yet. To our knowledge, the ability to induce voltage‐dependency in blocker action has not been shown previously for an amino acid located outside the transmembrane portion of the receptor. Possible mechanisms of HC block (allosteric and knocking) in WT and αD200Q receptors are discussed.
Discovery of benzimidazole‐based Leishmania mexicana cysteine protease CPB2.8ΔCTE inhibitors as potential therapeutics for leishmaniasis
Authors: De Luca Laura , Ferro Stefania , Buemi Maria Rosa , Monforte Anna‐Maria , Gitto Rosaria , Schirmeister Tanja , Maes Louis , Rescifina Antonio , Micale Nicola
Published: May 2018

Chemotherapy is currently the only effective approach to treat all forms of leishmaniasis. However, its effectiveness is severely limited due to high toxicity, long treatment length, drug resistance, or inadequate mode of administration. As a consequence, there is a need to identify new molecular scaffolds and targets as potential therapeutics for the treatment of this disease. We report a small series of 1,2‐substituted‐1H‐benzo[d]imidazole derivatives (9a–d) showing affinity in the submicromolar range (Ki = 0.15–0.69 μM) toward Leishmania mexicanaCPB2.8ΔCTE, one of the more promising targets for antileishmanial drug design. The compounds confirmed activity in vitro against intracellular amastigotes of Leishmania infantum with the best result being obtained with derivative 9d (IC50 = 6.8 μM), although with some degree of cytotoxicity (CC50 = 8.0 μM on PMM and CC50 = 32.0 μM on MCR‐5). In silico molecular docking studies and ADME‐Tox properties prediction were performed to validate the hypothesis of the interaction with the intended target and to assess the drug‐likeness of these derivatives.
Syntheses and evaluation of 68Ga‐ and 153Sm‐labeled DOTA‐conjugated bisphosphonate ligand for potential use in detection of skeletal metastases and management of pain arising from skeletal metastases
Authors: Chakraborty Sudipta , Goswami Dibakar , Chakravarty Rubel , Mohammed Sahiralam Khan , Sarma Haladhar Deb , Dash Ashutosh
Published: May 2018

This article reports the syntheses and evaluation of 68Ga‐ and 153Sm‐complexes of a new DOTA (1,4,7,10‐tetraazacyclododecane‐1,4,7,10‐tetraacetic acid)‐conjugated geminal bisphosphonate, DOTA‐Bn‐SCN‐BP, for their potential uses in the early detection of skeletal metastases by imaging and palliation of pain arising from skeletal metastases, respectively. The conjugate was synthesized in high purity following an easily adaptable three‐step reaction scheme. Gallium‐68‐ and 153Sm‐complexes were prepared in high yield (>98%) and showed excellent in vitro stability in phosphate‐buffered saline (PBS) and human serum. Both the complexes showed high affinity for hydroxyapatite particles in in vitro binding study. In biodistribution studies carried out in normal Wistar rats, both the complexes exhibited rapid skeletal accumulation with almost no retention in any other major organ. The newly synthesized molecule DOTA‐Bn‐SCN‐BP would therefore be a promising targeting ligand for the development of radiopharmaceuticals for both imaging skeletal metastases and palliation of pain arising out of it in patients with cancer when radiolabeled with 68Ga and 153Sm, respectively. A systematic comparative evaluation, however, showed that there was no significant improvement of skeletal accumulation of the 153Sm‐DOTA‐Bn‐SCN‐BP complex over 153Sm‐DOTMP (1,4,7,10‐tetraazacyclododecane‐1,4,7,10‐tetramethylenephosphonic acid) as the later itself demonstrated optimal properties required for an agent for bone pain palliation.
Enduring Association Between Parenting and Cortisol: A Meta‐analysis
Authors: Hackman Daniel A. , O'Brien Jacqueline R. , Zalewski Maureen
Published: May 2018

Warm caregiving is associated with concurrent hypothalamic–pituitary–adrenocortical (HPA) axis function, although the persistence of this association over time is less established. Using longitudinal and intervention studies, this meta‐analysis examined the enduring association of parental warmth (measured when children were ages < 1 through 15 years) with basal cortisol, reactivity and recovery (measured when children were ages < 1 through 25 years; k = 38; N = 6,608). These studies demonstrate no overall associations between parenting and children's HPA axis; instead there are small associations that vary based on moderators such as socioeconomic status, developmental stage, study design and stressor type, though many moderators are confounded. This first wave of studies indicates that the enduring association between parenting and cortisol is small and only understood in the context of other factors, and directly informs four sets of methodological and theoretical recommendations to strengthen this literature.
Watch‐PAT versus level III device in diagnosing sleep disordered breathing in first myocardial infarction
Authors: Ting Jeanette , Tan Li‐Ling , Balakrishnan Iswaree Devi , Chan Siew‐Pang , Yeo Tiong‐Cheng , Lee Chi‐Hang
Published: May 2018

Background

Watch‐PAT 200, a novel portable sleep device worn on the wrist, has been validated against polysomnography. Although sleep disordered breathing (SDB) screening is recommended in patients with cardiovascular disease, no study has reported a comparison of results from Watch‐PAT 200 and level III portable devices.

Methods

Patients (n = 140) admitted with a first ST‐segment elevation myocardial infarction (STEMI) participated in a hospital‐based sleep study using the Watch‐PAT 200 and a level III portable device (Embletta Gold) simultaneously within five days of admission. SDB was defined as an apnea‐hypopnea index (AHI) of >15 events/h.

Results

The left ventricular ejection fraction was normal (≥50%), impaired (30%‐49%) and poor (<30%) in 66 (47.1%), 71 (50.7%), and three (2.2%) patients, respectively. Among 116 patients with a successful paired sleep study, the prevalence of SDB was 53.5% (Watch‐PAT 200) and 51.7% (Embletta Gold). The agreement of AHI measured by the two devices was moderately good, with an intra‐class correlation value of 0.72 (95% confidence interval, 0.62‐0.80; P < .01). Agreement between the two devices in diagnosing at least mild (AHI ≥5), moderate‐to‐severe (AHI ≥15) and severe (AHI ≥30) SDB was 78% (kappa 0.47; P < .01), 77% (kappa 0.55; P < .01) and 80% (kappa 0.49; P < .01), respectively. At a 15‐month follow‐up, SDB status based on the two devices was associated with the occurrence of adverse cardiovascular events in 48.3% and 44.8%, respectively (P = .56).

Conclusion

We found a high prevalence of SDB in patients presenting with a first STEMI. Agreement between two portable sleep devices was moderately good.
Epstein–Barr virus positivity among surgically resected intramucosal gastric cancer
Authors: Murai Katsuyuki , Kakushima Naomi , Sugino Takashi , Yoshida Masao , Kawata Noboru , Tanaka Masaki , Takizawa Kohei , Muramatu Koji , Kusafuka Kimihide , Bando Etsuro , Ono Hiroyuki
Published: May 2018

Epstein–Barr virus‐associated gastric cancer (EBV‐GC) accounts for approximately 8% of gastric cancers. However, little is known regarding intramucosal EBV‐GC. The present study aimed to evaluate endoscopic and clinicopathological characteristics of intramucosal EBV‐GC. Pathological data of 172 patients with 173 intramucosal gastric cancers who received gastrectomy with lymph node dissection were obtained for review. EBV‐encoded small RNA in situ hybridization (EBER‐ISH) was carried out using a tissue microarray block. Eight intramucosal early gastric cancers (4.6%) were EBER‐ISH positive in which no cases had any lymph node metastasis. Macroscopic types were either depressed or flat, dominant histology was mixed type of moderate and poorly differentiated adenocarcinoma. In detail, histological features of “lace pattern” or “lymphocyte infiltration into the stroma or cancer nests” were observed.
Cardiovascular risk factors in adolescents with prediabetes
Authors: Casagrande S. S. , Menke A. , Linder B. , Osganian S. K. , Cowie C. C.
Published: May 2018

Aims

Adolescents with Type 2 diabetes are more likely to have cardiovascular disease (CVD) risk factors but there are few data available among adolescents with prediabetes. We characterized CVD risk factors among adolescents with prediabetes in the USA and compared levels of those risk factors with adolescents with normal glucose.

Methods

The 2005–2014 National Health and Nutrition Examination Survey, a nationally representative cross‐sectional survey, included 2843 adolescents aged 12–19 years after excluding those with diabetes. Prediabetes was based on an HbA1c, a fasting plasma glucose or a 2‐h plasma glucose. We determined cardiometabolic risk factors in adolescents using age‐appropriate cut‐off points. We calculated odds ratios (OR) and 95% confidence intervals (CI) of these outcomes associated with having prediabetes compared with normal glucose levels.

Results

The weighted prevalence of prediabetes was 17.4%. After adjustment, prediabetes (vs. normal glucose) was associated with obesity (OR 1.86, 95% CI 1.35–2.55), low HDL‐cholesterol (OR 1.62, 95% CI 1.08–2.44), high triglycerides (OR 1.61, 95% CI 1.12–2.30) and elevated liver transaminase (OR 2.09, 95% CI 1.19–3.67), but not with hypertension (OR 1.77, 95% CI 0.88–3.54), elevated total cholesterol (OR 1.30, 95% CI 0.82–2.06), elevated LDL‐cholesterol (OR 1.59, 95% CI 0.88–2.88) or albuminuria (OR 1.24, 95% CI 0.76–2.02).

Conclusions

US adolescents with prediabetes are more likely to have obesity, low HDL‐cholesterol, high triglycerides and elevated liver transaminase than adolescents with normal glucose. Addressing prediabetes in youth is important for the prevention of Type 2 diabetes and long‐term comorbidity.
Nonhemorrhagic joint disorders and vitamin K antagonists: an under‐recognized adverse drug reaction?
Authors: Béné Johana , Rousselin Clémentine , Bagheri Haleh , Vial Thierry , Gautier Sophie , Lambert Marc
Published: May 2018

Isolated arthralgia, without hemorrhagic side effect, exists and is considered as a very rare adverse drug reaction according to vitamin K antagonists’ (VKAs) summary of product characteristics. Up to now, there are no literature reports of isolated, nonhemorrhagic joint complications in patients receiving VKAs. Hence, the objective of this study was to describe cases of VKA‐related nonhemorrhagic joint disorders (fluindione, warfarin, and acenocoumarol) reported in the French Pharmacovigilance Database (FPVD). Sixty‐one reports (male : female ratio, 1.18; median [interquartile range (IQR)] age: 60 [49–72]) were found. Fluindione, warfarin, and acenocoumarol were respectively suspected in 42, 12, and 7 cases. Arthralgia was reported in 47 cases (77%), arthritis in nine cases (15%), capsulitis in three cases (5%), and bursitis in two cases (3%). Although the joint symptoms mainly concerned the lower limbs, all types of joints were affected. Arthralgia was associated with myalgia in 14 cases and with tendinitis in three cases. The median (IQR) time interval between VKA introduction and arthralgia onset was 26 (10–98) days (range: 1–6935). VKA was withdrawn in 44 cases, and a decrease in the intensity of joint symptoms was observed in 30 cases. In three cases, reintroduction of the same VKA led to the recurrence of symptoms. In view of the large prescription of this drug class worldwide, patients and clinicians (and especially primary care physicians and geriatricians) should be aware of this possible adverse drug reaction when confronted with joint disorders in patients of all ages taking VKAs.