bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression and clinical significance of p62 protein in colon cancer
Authors: Lei Cheng , Zhao Bing , Liu Lin , Zeng Xiangyue , Yu Zhen , Wang Xiyan
Published: January 2020

p62 is a multifunctional protein involved in multiple cellular processes including proliferation, drug sensitivity and autophagy-associated cancer cell growth. However, the role of p62 in colon cancer remains controversial. Here we investigated the expression of p62 protein in colon cancer and its clinical significance.

Patients with colon adenocarcinoma who underwent resection at the Third Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital) were retrospectively analyzed. The expression of p62 protein in tumor tissues and adjacent normal tissues was detected by immunohistochemistry and western-blotting. Real-time quantitative polymerase chain reaction was used to detect the expression level of p62 messenger ribonucleic acid in specimens. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier method and the log-rank test.

A total of 85 colon cancer patients were enrolled, including 55 (64.71%) patients with high p62 expression, and 30 (35.29%) patients with low p62 expression. The transcription and expression level of p62 in colon cancer tissues were higher than those in adjacent normal tissues (P < .01). High expression of p62 was an independent risk factor for the poor prognosis (PFS and OS) of colon cancer.

p62 may be a potential indicator of determining the progression and prognosis evaluation of colon cancer.
Tranexamic acid for postpartum hemorrhage prevention in vaginal delivery
Authors: Xia Yimeng , Griffiths Brian B. , Xue QingSheng
Published: January 2020

Background:

Tranexamic acid (TA) has been demonstrated to reduce blood loss and the incidences of postpartum hemorrhage (PPH) during caesarean sections. We compared the clinical efficacy of TA administration on vaginal deliveries with recently published papers.

Methods:

Electronic databases of PubMed, Cochrane Library, Embase and Chinese CNKI (Chinese database) and Wanfang were searched through November 2019.The randomized controlled trials were selected between TA and control groups. The relevant studies included four trials with a total of 4579 patients.

Results:

Patients treated with TA had a reduction in total blood loss (P = .009), lower postoperative blood loss (P < .00001), a reduced number of PPH (P = .02). However, the occurrence of nausea or/and vomiting is higher in the TA group (the incidence of nausea or vomiting [P < .00001], nausea [P < .00001] and vomiting [P < .00001]).

Conclusion:

TA resulted in fewer occurrence rates of PPH, and no significant increase in occurrences of dizziness or photopsia, but higher incidence of vomiting and nausea.
Catheter directed diagnosis of ST-segment elevation myocardial infarction induced by type A aortic dissection
Authors: Huang Chi-Yao , Hung Yu-Po , Lin Tzu-Hsiang , Chang Szu-Ling , Lee Wen-Lieng , Lai Chih-Hung
Published: January 2020

Rationale:

Type A aortic dissection (TAAD) is a life-threatening disorder yet it is hard to diagnose. The dissection might extend to the coronary artery causing ST-segment elevation myocardial infarction (STEMI). Physicians might not recognize this particularly early in its presentation and patients proceed to receive the primary percutaneous coronary intervention. We present such a case and found that the marked pressure difference between the radial and ascending aortae could be a useful clue for diagnosing the aortic dissection-related myocardial infarction.

Patient concerns:

A 58-year-old male was presented to our emergency department for the complaint of left side chest pain that lasted for an hour with concomitant hypotension. STEMI was diagnosed at that time.

Diagnosis:

The emergent primary percutaneous intervention was performed. When the diagnostic catheter was advanced to the ascending aorta, the systolic aorta pressure became 20 mm Hg higher than radial systolic pressure. Due to the abnormally large pressure differential between the peripheral radial artery and central ascending aorta, TAAD was suspected.

Interventions:

After angiography and computer tomography confirmed the diagnosis of TAAD, the patient was sent for emergent surgery.

Outcomes:

The patient was died because of extensive dissection and shock.

Lessons:

We present such a case and found that the marked pressure difference between the radial and ascending aortae during catheterization could be a useful clue for diagnosing the aortic dissection-related myocardial infarction. This clue had hinted our speedy examination of the occluded coronary artery and dissection flap, and led to an early and accurate diagnosis.
Renal hemosiderosis secondary to intravascular hemolysis after mitral valve repair
Authors: Lee In Hee , Kang Gun Woo , Kim Chang-Yeon , Lee Sun-Jae , Kim Min-Kyung , Ahn Dong Jik
Published: January 2020

Rationale:

Renal hemosiderosis is a disease in which hemosiderin deposits in the renal cortex as a form of iron overload. However, cases of renal hemosiderosis due to intravascular hemolysis following mitral valve repair have been rarely reported.

Patient concerns:

We present the case of a 62-year-old woman who developed asymptomatic urinary abnormalities including microscopic hematuria and proteinuria due to renal hemosiderosis following a mitral valve repair surgery performed two years earlier.

Diagnoses:

A percutaneous renal biopsy showed no specific glomerular abnormality, tubular atrophy, or interstitial fibrosis but extensive deposition of hemosiderin in the proximal tubule. The patient was diagnosed with renal hemosiderosis and chronic intravascular hemolysis following mitral valve repair.

Interventions:

Our patient refused a mitral valve repeat surgery and hence was treated with oral iron preparations, N-acetylcysteine, and a β-receptor blocker.

Outcomes:

Moderate mitral regurgitation with the regurgitant blood striking against the annuloplasty ring was confirmed on follow-up echocardiography. After the 24-month follow-up period, hemolytic anemia persisted, but there was no significant decline of renal function.

Lessons:

For cases of chronic intravascular hemolysis accompanied with asymptomatic urinary abnormalities, a renal biopsy is required to exclude underlying kidney pathology and predict potential renal insufficiency.
MRI findings of an atypical testicular epidermoid cyst
Authors: Liu Renwei , Li Aibo , Jiang Yixiang , Ji Jiayin , Yu Shulin , Chen Nengxue
Published: January 2020

Introduction:

Typical testicular epidermoid cysts (TECs) manifestate as a target sign or onion skin sign on ultrasonography and magnetic resonance (MR) imaging. Clinicians are increasingly aware of the imaging characteristics of typical TECs, which allow accurate diagnosis and successful treatment while preserving the testicle, but atypical TECs are likely to be misdiagnosed as a malignant intratesticular neoplasm, leading to complete testicular resection.

Patient concerns:

A 26 year-old male patient complained of a painless enlargement of the left testicle that had been present for 1 month. The patient had no recent medical history of scrotal trauma or systemic infection.

Diagnosis:

A round 48 mm × 45 mm × 43 mm mass was seen inside the left testicle. T2-weighted images of the lesion showed a thin hypointense capsule. T1-weighted images of the lesion showed a hyperintense nodule on the cyst wall, which appeared hypointense on T2-weighted and SPAIR images. After Gd-DTPA injection, the lesion was not enhanced; however, the nodule was enhanced on THRIVE images. These manifestations were consistent with a benign intratesticular lesion, and MR imaging diagnosed atypical TEC, which was confirmed by pathology after surgery.

Interventions:

The patient was treated with organ-sparing surgery with testicular enucleation.

Outcomes:

The patient was re-examined with ultrasonography 3 months after surgery. The left residual testicular tissue appeared normal, and reproductive function was preserved.

Conclusion:

Urologists must be aware of the clinical and MR imaging characteristics of atypical TECs and the utility of preoperative MR imaging for the diagnosis of testicular lesions to ensure that organ-sparing surgery is performed rather than unnecessary orchiectomy.
Efficacy of Phellinus linteus (sanghuang) extract for improving immune functions
Authors: Jung Ga Hyeon , Kang Jae Hui
Published: January 2020

Background:

With the increase in the prevalence of chronic diseases, enhancing immunity has become an important challenge. Health functional foods, such as Phellitus linteus (PL), are known to improve immune function. In previous laboratory studies, it has been reported that PL has anticancer activities. In this study, we will evaluate if PL improves immune functions in adults with reduced immunity and identify its effects on immunity factors.

Methods:

This study will be a single-center, randomized, double-blinded, and placebo-controlled trial. Study participants will be randomly allocated to 3 experimental groups: those taking PL 1000 mg, PL 2000 mg, or placebo. Total duration of the clinical trial will be 8 to 10 weeks. Study participants will have follow-up visits every 4 weeks and the effect and safety will be assessed at the second and third visits. All participants will be asked to maintain a dosage schedule for this protocol. The primary outcome will be natural killer (NK) cell activity and the secondary outcomes will include peripheral white blood cell (WBC) count; levels of tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and interleukin (IL)-1β, IL-2, IL-6, and IL-12 to assess autoimmune reactivity; and levels of immunoglobulin (Ig)G1, IgG2, and Immunoglobulin M (IgM) to assess allergic activity. Repeated measure analysis will be used to measure primary efficacy based on full analysis set.

Discussion:

This study has limited inclusion and exclusion criteria and a well-controlled intervention. It will be the first randomized controlled trial to assess the efficacy and safety of PL in adults with reduced immunity. This study will provide insights into the mechanisms underlying the immune-stimulating effects of PL and lay the groundwork for further studies.
Incomplete recovery from rocuronium-induced muscle relaxation in patients with amyotrophic lateral sclerosis using sugammadex
Authors: Chun Hea Rim , Chung Jinhun , Kim Nan Seol , Kim A. Joo , Kim Suro , Kang Kyu Sik
Published: January 2020

Introduction:

Patients with motor neuron diseases, such as amyotrophic lateral sclerosis (ALS), have higher sensitivity to nondepolarizing neuromuscular blocking agents (NMBAs) and are at higher risk for a residual block. For this reason, the use of NMBAs such as rocuronium has been limited owing to the delayed reversal of muscle relaxation. It was recently reported that rapid and effective reversal of muscle relaxation occurs when sugammadex, a muscle relaxant reversal drug, is administered to patients in ALS with rocuronium-induced muscle relaxation. However, in this paper, we report the incomplete recovery and recurarization of muscle relaxation after sugammadex administration in ALS patients, and delayed recovery of muscle relaxation after additional administration of sugammadex.

Patient concerns:

A 71-year-old male patient with ALS received general anesthesia for laparoscopic nephroureterectomy.

Diagnosis:

The patient was diagnosed with ALS 2 years earlier, and scheduled to undergo laparoscopic nephroureterectomy for ureteral cancer.

Intervention:

We used sugammadex for the reversal of deep neuromuscular block. We measured a train-of-four (TOF) count of 4 and a TOF ratio of 54% at about 8 min after administration of 4 mg/kg sugammadex. However, then the TOF count decreased to 1 to 3 and tidal volume (TV) decreased to < 100 mL. Therefore, an additional 50 mg sugammadex was administered intravenously 12 min after the first dose of sugammadex was injected.

Outcomes:

The patient's vital signs were stable and his recovery from anesthesia was uneventful. Therefore, he was discharged to the intensive care unit. The patient had aspiration pneumonia symptoms owing to dysphagia on the third postoperative day, but after the symptoms improved he was transferred to the hospital for rehabilitation of dysphagia and dyspnea.

Conclusion:

It is critical to monitor whether muscle relaxation is sufficiently reversed when using sugammadex in ALS patients. Further research is needed to determine the appropriate dose of sugammadex for muscle relaxation reversal.
Rare clinical presentations of pleomorphic xanthoastrocytoma with a high proliferative index
Authors: Nagaishi Masaya , Nakae Ryuta , Fujii Yoshiko , Inoue Yuki , Sugiura Yoshiki , Takano Issei , Tanaka Yoshihiro , Suzuki Kensuke
Published: January 2020

Introduction:

Pleomorphic xanthoastrocytomas (PXA) are rare, typically benign, slow-growing tumors that commonly occur in the cerebral hemispheres. We describe two cases of clinically aggressive PXA with uncommon locations; one was in the tectal plate, and the other had simultaneous multicentric lesions.

Patient Concerns:

The both cases presented with severe headache with no significant past medical history.

Diagnosis:

PXA World Health Organization grade II were histopathologically diagnosed from surgically resected specimens, and immunohistochemical and sequence analysis revealed a high Ki-67 proliferative index and BRAF V600E mutation in both the cases.

Interventions:

The first case presented with multicentric lesions and underwent partial resection, whereas the second case presented with a tectal plate tumor that was managed by gross total surgical resection. Strong 5-aminolevulinic acid (5-ALA)-induced fluorescence was observed in both the lesions. Postoperative radiotherapy plus concomitant and adjuvant temozolomide was administered to both the patients.

Outcomes:

Despite completing adjuvant chemo-radiotherapy, both the patients had local tumor recurrence at 2 and 5 months after the operation, respectively.

Conclusion:

The progressive clinical courses in our cases suggest that additional postoperative therapy should be considered during the treatment of PXA with a high Ki67 index, and that temozolomide with radiotherapy, followed by temozolomide maintenance therapy, may not prevent recurrence in such tumors. Importantly, our experience implies that unlike other subtypes of low grade gliomas, 5-ALA fluorescence is useful for intraoperative visualization of PXA.
Nursing Students' Attitudes Toward Nursing Education Research and Participation in Pedagogical Research
Authors: Burrell Sherry A. , Ross Jennifer Gunberg , Heverly Mary Ann , Menginie Tina M.
Published: January 2020

Background

Nursing students overall have positive attitudes toward research, but no studies have explored students' attitudes toward education research or pedagogical research participation.

Purpose

The purposes of this study were to explore nursing students' attitudes toward research in general, education research, and participation as subjects in pedagogical research; describe the relationships among these attitudes; and identify associated factors.

Methods

A mixed-methods, descriptive, cross-sectional study design was used.

Results

Nursing students' (N = 195) attitudes about research in general, education research, and participation in pedagogical research were predominantly positive and directly correlated. Age was significantly associated with attitudes about education research and research participation, whereas program year was associated only with research participation. The most prevalent barrier to research participation was time.

Conclusions

Findings provide valuable insight about nursing students' attitudes toward research that may be used to design protocols to enhance student participation in pedagogical research.
Evidence-Based Interventions for Retention of Nursing Students
Authors: Bumby James Colin
Published: January 2020

Background

There is a need to better understand effective student retention strategies in nursing.

Purpose

This review of course and program interventions reported in the nursing literature is intended to highlight interventions, supported by evidence, to graduate more enrolled students and recommend areas of retention efforts that need further research.

Methods

The PRISMA search strategy was used to identify and narrow the number of relevant studies. A scoring instrument to evaluate rigor, reliability, and validity of interventions was adapted from a valid and reliable tool used to evaluate studies using a health care education intervention.

Results

Evidence-based interventions that improved retention included retention program/specialist, robust orientation, mentoring and tutoring, stipends, and remediation.

Conclusion

Nurse educators are independently striving to improve retention rates of nursing students. Implementing evidence-based interventions will advance this effort.
Mobile Health Technology for Pediatric Symptom Monitoring
Authors: Vaughn Jacqueline , Gollarahalli Siddharth , Shaw Ryan J. , Docherty Sharron , Yang Qing , Malhotra Chandni , Summers-Goeckerman Erika , Shah Nirmish
Published: January 2020

Background

Pediatric blood and marrow transplant (PBMT) patients experience significant symptom distress. Mobile health (mHealth) technologies can be leveraged to improve understanding of the patient’s symptom experience by providing continuous, real-time, in situ, patient-generated symptom data. This rich data stream can subsequently enhance symptom management strategies. However, limited research has been conducted in this area.

Objectives

This pilot study seeks to (a) explore the feasibility of integrating mHealth technologies to monitor symptom data for PBMT patients and (b) evaluate the study design, measures, and procedures.

Methods

An exploratory longitudinal design was employed to assess the feasibility of monitoring 10 PBMT patients’ symptoms using data from two mHealth technologies: (a) a smartphone mHealth application (app) to collect symptom data and (b) a wearable tracking device (Apple watch) to collect physiological data. Feasibility was measured as usability and acceptability. Monthly patient interviews and an end-of-study feasibility survey were employed and analyzed to further understand reasons for sustained interest in and attrition from the study.

Results

Overall usability of the wearable was 51%, and app was 56%. Children reported devices were easy to use and acceptable. The study demonstrated acceptability with an enrollment rate of 83% and an attrition rate of 30%, with 70% of the children remaining in the study for at least 40 days.

Discussion

This pilot study is among the first to explore the feasibility of using mobile technologies to longitudinally obtain patient-generated symptom data to enhance understanding of the PBMT symptom experience. In addition, it will improve our understanding of how these data present, interact, and cluster together throughout the posttransplant period.
Perceived Infant Well-Being and Self-Reported Distress in Neonatal Nurses
Authors: Fortney Christine A. , Pratt Mercedes , Dunnells Zackery D. O. , Rausch Joseph R. , Clark Olivia E. , Baughcum Amy E. , Gerhardt Cynthia A.
Published: January 2020

Background

Infants who are admitted to a neonatal intensive care unit (NICU) may experience significant symptom burden. Parents are often distressed by these symptoms, which can affect their long-term coping and distress. There is limited research examining nurse perceptions of infant well-being (symptoms, suffering, and quality of life [QOL]) and associations with nurse distress.

Objective

The objective of this descriptive study was to explore associations between nurse perceptions of infant well-being and self-reported distress.

Methods

Nurses caring for infants with potentially life-threatening/life-limiting conditions were recruited from a Level IV NICU in the Midwestern United States as a part of a study on infant symptom burden. Nurses reported their perceptions of infant well-being and their own distress on a 5-point Likert scale. Surveys were administered at the bedside weekly for up to 12 weeks, depending on length of stay. Infant suffering and QOL were examined in relation to nurse distress. A cross-classified multilevel model was used to account for dependence within nurse and within patient.

Results

A total of 593 surveys were collected from nurses. Using a cross-classified multilevel model with variables entered simultaneously, nurse perceptions of greater infant suffering and lower infant QOL were significantly associated with greater nurse distress.

Discussion

Preliminary evidence shows that greater perceived infant suffering and lower perceived infant QOL may be associated with greater levels of self-reported distress in NICU nurses. Further work is needed to better understand factors related to symptom management in the NICU and the potential role of caregiver distress and compassion fatigue in NICU nurses.
Adherence Self-Management and the Influence of Contextual Factors Among Emerging Adults With Human Immunodeficiency Virus
Authors: Dunn Navarra Ann-Margaret , Whittemore Robin , Bakken Suzanne , Rosenberg Michael J. , Gormley Maurade , Bethea John , Gwadz Marya , Cleland Charles , Liang Eva , D’Eramo Melkus Gail
Published: January 2020

Background

Maintaining adherence to antiretroviral therapy (ART) is a significant challenge for human immunodeficiency virus (HIV)-infected racial and ethnic minority adolescents and young adults (youth). Given the consequences of suboptimal ART adherence, there is a pressing need for an expanded understanding of adherence behavior in this cohort.

Objectives

As part of an exploratory sequential, mixed-methods study, we used qualitative inquiry to explore adherence information, motivation, and behavioral skills among HIV-infected racial and ethnic minority youth. Our secondary aim was to gain an understanding of the contextual factors surrounding adherence behavior.

Methods

The information–motivation–behavioral skills model (IMB model) was applied to identify the conceptual determinants of adherence behavior in our target population, along with attention to emergent themes. In-depth, individual, semistructured interviews, including open-ended questions with probes, were conducted with a convenience sample of HIV-infected racial and ethnic minority youth (ages 16–29 years), receiving ART and with evidence of virologic failure (i.e., detectable HIV viral load). New participants were interviewed until information redundancy was reached. Qualitative interviews were digitally recorded, transcribed verbatim, and analyzed using Atlas.ti (v8). Directed content analysis was performed to generate categories and broad themes. Coding was initially conceptually driven (IMB model) and shifted to a data-driven approach, allowing for the discovery of key contextual factors that influence adherence behavior in this population. Methodological rigor was ensured by member checks, an audit trail, thick descriptive data, and triangulation of data sources.

Results

Twenty racial and ethnic minority participants (mean age = 24.3 years, 55.0% male) completed interviews. We found adherence information was understood in relation to HIV biomarkers; adherence motivation and behavioral skills were influenced by stigma and social context. We identified five primary themes regarding ART self-management: (a) emerging adulthood with a chronic illness, (b) stigma and disclosure concerns, (c) support systems and support deficits, (d) mental and behavioral health risks and challenges, and (e) mode of HIV transmission and perceptions of power and control.

Discussion

Key constructs of the IMB model were applicable to participating HIV-infected youth yet did not fully explain the essence of adherence behavior. As such, we recommend expansion of current adherence models and frameworks to include known contextual factors associated with ART self-management among HIV-infected racial and ethnic minority youth.
Neoadjuvant Chemoradiotherapy and Liver Transplantation for Unresectable Hilar Cholangiocarcinoma: The Irish Experience of the Mayo Protocol
Authors: Zaborowski Alexandra , Heneghan Helen M. , Fiore Barbara , Stafford Anthony , Gallagher Tom , Geoghegan Justin , Maguire Donal , Hoti Emir
Published: January 2020

Background.

Pioneered by the Mayo Clinic, multimodal therapy with neoadjuvant chemoradiotherapy and orthotopic liver transplant has emerged as a promising option for unresectable hilar cholangiocarcinoma (hCCA). This study reports the experience of the Irish National Liver Transplant Programme with the Mayo Protocol.

Methods.

All patients diagnosed with unresectable hCCA between 2004 and 2016, who were eligible for the treatment protocol, were prospectively studied.

Results.

Thirty-seven patients commenced chemoradiotherapy. Of those, 11 were excluded due to disease progression and 26 proceeded to liver transplantation. There were 24 males, the median age was 49, and 88% had underlying primary sclerosing cholangitis. R0 and pathologic complete response rates were 96% and 62%, respectively. Overall median survival was 53 months and 1-, 3-, and 5-year survival was 81%, 69%, and 55%, respectively. The median survival of patients achieving a pathologic complete response was 83.8 months compared with 20.9 months in the group with residual disease (P = 0.036). Six patients (23%) developed disease recurrence. Among the patients who developed metastatic disease during neoadjuvant treatment, median survival was 10.5 months compared with 53 months in patients who proceeded to transplant (P < 0.001).

Conclusions.

Neoadjuvant chemoradiotherapy followed by liver transplantation substantially increases the survival of patients with unresectable hCCA. Achieving a pathologic complete response confers a significant survival benefit.
The Incidence of Dental Fracturing in Electroconvulsive Therapy in Sweden
Authors: Göterfelt Linda , Ekman Carl Johan , Hammar Åsa , Landén Mikael , Lundberg Johan , Nordanskog Pia , Nordenskjöld Axel
Published: January 2020

Objectives

One adverse effect of electroconvulsive therapy (ECT) is dental fracture; thus, a bite guard and muscle relaxants are used to prevent it. Earlier research reported varying rates of dental fracture, but there is no large-scale study on the incidence of dental fracture during ECT. This study aimed to examine the incidence of dental fracture during ECT and to investigate whether the incidence differs between different sexes, age groups, diagnosis groups, electrode placements, or number of treatment sessions.

Methods

This register-based study used data from the Swedish national quality register for ECT. All hospitals offering ECT report to this register, and the coverage ratio is about 90%. All registered patients who started an ECT series between January 2012 and January 2019 were included in this study, with the data representing 16,681 individuals, 38,862 series, and 254,906 sessions.

Results

Forty-six dental fractures were identified, giving an incidence of dental fracture of 0.2% per series, 0.02% per session, and 0.3% per individual. We did not find any significant associations between dental fracture rates and male or female populations, age, or different diagnosis groups, nor was there any significant difference between dental fracture rates and electrode placement. The mean number of treatments was significantly higher in the dental fracture group than in patients without dental fracture.

Conclusions

There is a minimal risk of dental fracture during ECT. Our findings, together with those of other studies, provide further motivation for the use of a bite guard and muscle relaxant.
Life course exposures continually shape antibody profile and risk of seroconversion to influenza
Authors: Yang Bingyi , Lessler Justin , Zhu Huachen , Jiang Chao Qiang , Read Jonathan M. , Hay James A. , Kwok Kin On , Shen Ruiyin , Guan Yi , Riley Steven , Cummings Derek A.T.
Published: January 2020

Complex exposure histories and immune mediated interactions between influenza strains contribute to the life course of human immunity to influenza. Antibody profiles can be generated by characterizing immune responses to multiple antigenically variant strains, but how these profiles vary across individuals and determine future responses is unclear. We used hemagglutination inhibition titers from 21 H3N2 strains to construct 777 paired antibody profiles from people aged 2 to 86, and developed novel metrics to capture features of these profiles. Total antibody titer per potential influenza exposure increases in early life, then decreases in middle age. Increased titers to one or more strains were seen in 97.8% of participants, suggesting widespread influenza exposure. While titer changes were seen to all strains, recently circulating strains exhibited the greatest variation. Higher pre-existing, homologous titers reduced the risk of seroconversion to recent strains. After adjusting for homologous titer, we also found an increased frequency of seroconversion among those with higher immunity to older previously exposed strains. Our results suggest that a comprehensive quantitative description of immunity encompassing past exposures could lead to improved correlates of risk of influenza.
Glucocorticoid Receptor ablation promotes cardiac regeneration by hampering cardiomyocyte terminal differentiation
Authors: Pianca Nicola , Pontis Francesca , Chirivì Maila , Papa Valentina , Braga Luca , Patnala Rahul Shastry , Bongiovanni Chiara , Mazzeschi Martina , Umansky Kfir-Baruch , Cenacchi Giovanna , Lauriola Mattia , Giacca Mauro , Rizzi Roberto , Tzahor Eldad , D’Uva Gabriele
Published: January 2020

In mammals, glucocorticoid levels rise dramatically shortly before birth and prepare the foetus for post-natal life by promoting the maturation of the lungs and other organs. However, their impact on cardiac postnatal growth and regenerative plasticity is unknown.

Here, we demonstrate that exposure to endogenous glucocorticoids facilitates cell cycle exit and reduces the proliferation of neonatal cardiomyocytes. This cytostatic activity is shared by several synthetic glucocorticoid receptor (GR) agonists routinely used in clinical settings. We also observed that GR levels increase in cardiomyocytes during early post-natal development. Importantly,in vivocardiomyocyte-specific GR ablation delayed the transition from hyperplastic (increase in cell number) to hypertrophic (increase in cell size) growth. Further, GR ablation partially impaired cardiomyocyte maturation, reducing myofibrils-mitochondria organization along with the expression of genes involved in fatty acid metabolism, mitochondrial respiration and energy transfer from mitochondria to the cytosol. Finally, we show increased cardiomyocyte proliferation in GR ablated juvenile and adult cardiomyocytes in response to myocardial infarctionin vivo, thus promoting cardiac tissue regeneration.

We suggest that GR antagonization could serve as a strategy for heart regeneration based on endogenous cardiomyocyte renewal.
Human CTC1 primarily functions in telomere maintenance/protection and promotes CHK1 phosphorylation in response to global replication stress
Authors: Ackerson Stephanie M. , Gable Caroline I. , Stewart Jason A.
Published: January 2020

CST (CTC1-STN1-TEN1) is a heterotrimeric, RPA-like protein that binds to single stranded DNA (ssDNA) and functions in the replication of telomeric and non-telomeric DNA. Previous studies have shown that deletion of CTC1 results in decreased cell proliferation and telomeric DNA damage signaling. However, a detailed analysis of the consequences of conditional CTC1 knockout (KO) have not been fully elucidated. Here, we investigated the effects of CTC1 KO on cell cycle progression, genome-wide replication and activation of the DNA damage response. We find that CTC1 KO results in p53-mediated G2 arrest and increased apoptosis, but not genome-wide replication defects or DNA damage. Instead, the G2 arrest is dependent on the accumulation of telomeric RPA following CTC1 KO, suggesting that the primary function of CST is in telomere end protection and maintenance not genome-wide replication. However, despite increased RPA-ssDNA, global CHK1 phosphorylation was not detected in CTC1 KO cells. Further analysis revealed that CTC1 KO significantly inhibits CHK1 phosphorylation following hydroxyurea-induced replication stress, due to decreased levels of the ATR activator TopBP1. Overall, our results identify that telomere not genome-wide DNA damaging signaling leads to decrease proliferation following CTC1 deletion and that CST promotes ATR-CHK1 signaling through the regulation of TopBP1.
The media roller coaster: The Dawn and evolution of Multimedia Ventures in Middle East and beyond
Authors: Spraggon Martin , Bodolica Virginia
Published: January 2020

Learning outcomes

Upon completion of this case study analysis, students should be able to: perform a detailed diagnosis of an entrepreneurial venture, applying relevant strategic management tools and techniques; evaluate the effectiveness of managerial actions and decisions at different stages of organizational lifecycle; and demonstrate the importance of strategic adaptation of organizations through the deployment of viable decision-making skills.

Case overview/synopsis

This case describes the story of Multimedia Ventures, a small business located in the UAE that provides media solutions to cleaning and hygiene-related technology sectors. The company was founded through a partnership arrangement and later transformed into a family enterprise. The case study illustrates the firm operations from its grass root stages to being a well-known name in the cleaning industry, both within the Middle East and beyond. Since its establishment in 2008, Multimedia Ventures has embarked on a path of continuous growth with the ambition of globalizing activities to offer various media solutions to customers worldwide. To achieve this objective, the company engaged in collaborations with many international partners to facilitate the exchange of expertise and increase the scale of operations. Yet, the Managing Director of Multimedia Ventures, Mr Arjun Khatri, was currently faced with two difficult strategic decisions that were critically important for the future development of his enterprise.

Complexity academic level

Undergraduate courses.

Supplementary materials

Teaching Notes are available for educators only.

Subject code

CSS 11: Strategy.
Exploitation of shared knowledge and creative behavior: the role of social context
Authors: Kim Sang Soo
Published: January 2020

Purpose

This study aims to examine how exploitation of shared knowledge is related to creative behavior by focusing on the roles of social contextual factors – perceived co-worker support and perceived relationship conflict.

Design/methodology/approach

The proposed research model in this study posits the following: exploitation mediates the relationship between shared knowledge and creative behavior and perceived co-worker support and perceived relationship conflict moderate the relationship between shared knowledge and creative behavior. For an empirical examination, the model was tested by PLS-SEM using 457 responses gathered from workers of different companies in Korea.

Findings

It turned out that knowledge exploitation fully mediates the relationship between shared knowledge and creative behavior. Also, the findings revealed that the stronger the perceived co-workers support is the stronger the relationship between shared knowledge and knowledge exploitation becomes. In contrast, perceived relationship conflict has a negative moderating effect on the relationship.

Originality/value

This study helps to deepen the understanding of how knowledge sharing impacts creative behavior in light of social context and the active utilization of shared knowledge. In addition, this study attempts to provide new perspectives by suggesting double aspects of perceived relationship conflict, which eventually extending the previous research on conflict in the field of knowledge management and creative behavior.
Crystal orientation dependence of alternating current photo-assisted (ACPEC) porous silicon for potential optoelectronic application
Authors: Abd Rahim Alhan Farhanah , Mustakim Aida Azrenda , Mohd Razali Nurul Syuhadah , Mahmood Ainorkhilah , Radzali Rosfariza , Zoolfakar Ahmad Sabirin , Mohd Ali Yusnita
Published: January 2020

Purpose

Porous silicon (PS) was successfully fabricated using an alternating current photo-assisted electrochemical etching (ACPEC) technique. This study aims to compare the effect of different crystal orientation of Sin(100) andn(111) on the structural and optical characteristics of the PS.

Design/methodology/approach

PS was fabricated using ACPEC etching with a current density of J = 10 mA/cm2and etching time of 30 min. The PS samples denoted by PS100and PS111were etched using HF-based solution under the illumination of an incandescent white light.

Findings

FESEM images showed that the porous structure of PS100was a uniform circular shape with higher density and porosity than PS111. In addition, the AFM indicated that the surface roughness of porousn(100) was less than porousn(111). Raman spectra of the PS samples showed a stronger peak with FWHM of 4.211 cm−1and redshift of 1.093 cm−1. High resolution X-ray diffraction revealed cubic Si phases in the PS samples with tensile strain for porousn(100) and compressive strain for porousn(111). Photoluminescence observation of porousn(100) and porousn(111) displayed significant visible emissions at 651.97 nm (Eg = 190eV) and 640.89 nm (Eg = 1.93 eV) which was because of the nano-structure size of silicon through the quantum confinement effect. The size of Si nanostructures was approximately 8 nm from a quantized state effective mass theory.

Originality/value

The work presented crystal orientation dependence of Sin(100) andn(111) for the formation of uniform and denser PS using new ACPEC technique for potential visible optoelectronic application. The ACPEC technique has effectively formed good structural and optical characteristics of PS.
Urbanization and translocation disrupt the relationship between host density and parasite abundance
Authors: DeVore Jayna L. , Shine Richard , Ducatez Simon
Published: January 2020

The species interactions that structure natural communities are increasingly disrupted by radical habitat change resulting from the widespread processes of urbanization and species translocations. Although many species are disadvantaged by these changes, others thrive in these new environments, achieving densities that exceed those in natural habitats. Often the same species that benefit from urbanization are successful invaders in introduced habitats, suggesting that similar processes promote these species in both environments.

Both processes may especially benefit certain species by modifying their interactions with harmful parasites (‘enemy release’). To detect such modifications, we first need to identify the mechanisms underlying host–parasite associations in natural populations, then test whether they are disrupted in cities and introduced habitats.

We studied the interaction between the cane toadRhinella marina, a globally invasive species native to South America, and itsAmblyommaticks. Our field study of 642 cane toads across 46 sites within their native range in French Guiana revealed that 56% of toads carried ticks, and that toads with ticks were in poor body condition relative to uninfected conspecifics. Across natural and disturbed habitats tick prevalence and abundance increased with toad density, but this association was disrupted in the urban environment, where tick abundance remained low even where toad densities were high, and prevalence decreased with density.

Reductions in the abundance of ticks in urban habitats may be attributable to pesticides (which are sprayed for mosquito control but are also lethal to ticks), and our literature review shows that tick abundance is generally lower in cane toads from urban habitats across South America. In the invasive range, ticks were either absent (in 1,960 toads from Puerto Rico, Hawai'i, Japan and Australia) or less abundant (in Florida and the Caribbean; literature review).

The positive relationship between host density and parasite abundance is thought to be a key mechanism through which parasites regulate host populations; anthropogenic processes that disrupt this relationship may allow populations in urban and introduced habitats to persist at densities that would otherwise lead to severe impacts from parasites.
Crowned with knowledge
Authors: Thorp JM
Published: January 2020

Deputy Editor‐in‐Chief John Thorp highlights articles from this themed issue in
an audio podcast available at https://soundcloud.com/bjog/february-editorial-2020
Automatic Classification of Bloodstain Patterns Caused by Gunshot and Blunt Impact at Various Distances
Authors: Liu Yu , Attinger Daniel , De Brabanter Kris
Published: January 2020

The forensics discipline of bloodstain pattern analysis plays an important role in crime scene analysis and reconstruction. One reconstruction question is whether the blood has been spattered via gunshot or blunt impact such as beating or stabbing. This paper proposes an automated framework to classify bloodstain spatter patterns generated under controlled conditions into either gunshot or blunt impact classes. Classification is performed using machine learning. The study is performed with 94 blood spatter patterns which are available as public data sets, designs a set of features with possible relevance to classification, and uses the random forests method to rank the most useful features and perform classification. The study shows that classification accuracy decreases with the increasing distance between the target surface collecting the stains and the blood source. Based on the data set used in this study, the model achieves 99% accuracy in classifying spatter patterns at distances of 30 cm, 93% accuracy at distances of 60 cm, and 86% accuracy at distances of 120 cm. Results with 10 additional backspatter patterns also show that the presence of muzzle gases can reduce classification accuracy.
Estimating density from presence/absence data in clustered populations
Authors: Ekström Magnus , Sandring Saskia , Grafström Anton , Esseen Per‐Anders , Jonsson Bengt Gunnar , Ståhl Göran
Published: January 2020

Inventories of plant populations are fundamental in ecological research and monitoring, but such surveys are often prone to field assessment errors. Presence/absence (P/A) sampling may have advantages over plant cover assessments for reducing such errors. However, the linking between P/A data and plant density depends on model assumptions for plant spatial distributions. Previous studies have shown, for example, how that plant density can be estimated under Poisson model assumptions on the plant locations. In this study, new methods are developed and evaluated for linking P/A data with plant density assuming that plants occur in clustered spatial patterns.

New theory was derived for estimating plant density under Neyman–Scott‐type cluster models such as the Matérn and Thomas cluster processes. Suggested estimators, corresponding confidence intervals and a proposed goodness‐of‐fit test were evaluated in a Monte Carlo simulation study assuming a Matérn cluster process. Furthermore, the estimators were applied to plant data from environmental monitoring in Sweden to demonstrate their empirical application.

The simulation study showed that our methods work well for large enough sample sizes. The judgment of what is' large enough’ is often difficult, but simulations indicate that a sample size is large enough when the sampling distributions of the parameter estimators are symmetric or mildly skewed. Bootstrap may be used to check whether this is true. The empirical results suggest that the derived methodology may be useful for estimating density of plants such asLeucanthemum vulgareandScorzonera humilis.

By developing estimators of plant density from P/A data under realistic model assumptions about plants' spatial distributions, P/A sampling will become a more useful tool for inventories of plant populations. Our new theory is an important step in this direction.
Patient‐reported Outcome Measures in Emergency Care Research: A Primer for Researchers, Peer Reviewers, and Readers
Authors: Kim Howard S. , Courtney D. Mark , McCarthy Danielle M. , Cella David
Published: January 2020

Patient‐reported outcomes (PROs) are of increasing importance in clinical research because they capture patients’ experience with well‐being, illness, and their interactions with health care. Because PROs tend to focus on specific symptoms (e.g., pain, anxiety) or general assessments of patient functioning and quality of life that offer unique advantages compared to traditional clinical outcomes (e.g., mortality, emergency department revisits), emergency care researchers may benefit from incorporation of PRO measures into their research design as a primary or secondary outcome. Patients may also benefit from the ability of PROs to inform clinical practice and facilitate patient decision making, as PROs are obtained directly from the lived experience of other patients with similar conditions or health status. This review article introduces and defines key terminology relating to PROs, discusses reasons for utilizing PROs in clinical research, outlines basic psychometric and practical assessments that can be used to select a specific PRO measure, and highlights examples of commonly utilized PRO measures in emergency care research.
Another window into tumor microenvironment: a case of Β‐cell rich folliculotropic mycosis fungoides responding to rituximab
Authors: Nikolaou Vasiliki , Iliakis Theodoros , Marinos Leonidas , Voudouri Dimitra , Sidiropoulou Polytimi , Rigopoulos Dimitris , Stratigos Alexander J.
Published: January 2020

The role of tumor infiltrating immune cells in cancer development and progression is a new, promising field in oncological research. An increasing number of novel anti‐cancer agents are focussing on the tumor microenvironment. Various studies have reported on B‐cell infiltrates in mycosis fungoides (MF), but despite the substantial volume of interesting findings, solid evidence regarding their specific role in cancer is still vague. We present a case of tumor stage  MF responding to rituximab. We support the hypothesis that lymphoma‐infltrating B‐cells have a significant impact on cutaneous lymphoma course and seem to be both an important and effective therapeutic target. The reduction of B‐cell population led to disease’s overall remission, probably by restoring patient’s immunologic tumor control.