bluuebunny/crossref_metadata_2025 huggingface dataset:
Superficial malignant ossifying fibromyxoid tumors harboring the rare and recently described ZC3H7B‐BCOR and PHF1‐TFE3 fusions
Authors: Linos Konstantinos , Kerr Darcy A , Baker Michael , Wong Sandra , Henderson Eric , Sumegi Janos , Bridge Julia A
Published: April 2020

Ossifying fibromyxoid tumor (OFMT) is a rare soft tissue neoplasm of uncertain differentiation and intermediate biologic potential. Up to 85% of OFMTs, including benign, atypical, and malignant forms, harbor fusion genes. Most commonly, the PHF1 gene localized to 6p21 is fused with EP400, but other fusion partners, such as MEAF6, EPC1, and JAZF1 have also been described. Herein, we present two rare cases of superficial OFMTs with ZC3H7B‐BCOR and the very recently described PHF1‐TFE3 fusions. The latter also exhibited moderate to strong diffuse immunoreactivity for TFE3. Reciprocally, this finding expands the entities with TFE3 rearrangements. Accumulation of additional data is necessary to determine if OFMTs harboring these rare fusions feature any reproducible clinicopathologic findings or carry prognostic and/or predictive implications.
Construction workers' alcohol use, knowledge, perceptions of risk and workplace norms
Authors: Roche Ann M. , Chapman Janine , Duraisingam Vinita , Phillips Brooke , Finnane Jim , Pidd Ken
Published: April 2020

Introduction and Aims

Globally, there is growing concern regarding workers' alcohol use and its implications for health, wellbeing and workplace safety. Male‐dominated industries are more susceptible to risky alcohol consumption and its associated harms. This paper investigated the patterns, prevalence and predictors of risky drinking among construction workers.

Design and Methods

Male construction workers (n = 511) completed a survey measuring alcohol‐related measures including Alcohol Use Disorders Identification Test ‐ Concise (AUDIT‐C), which was compared with population data. Hierarchical multiple regression examined alcohol‐related knowledge, perception of risk to workplace safety, psychological distress, job stress, general health, quality of life and workplace alcohol culture variables as predictors of risky drinking.

Results

Prevalence of risky drinking was higher than the national average, particularly for younger (<25 years) and mid‐aged (45–54 years) workers. One in six construction workers reported workmates being visibly affected by alcohol in the workplace. Key predictors of risky drinking were perception of alcohol‐related risks to workplace safety, general health, alcohol knowledge and descriptive norms regarding workmates' alcohol use.

Discussion and Conclusions

These findings provide useful insights into the patterns and predictors of risky drinking in construction and can inform future preventive programs and interventions in high‐risk workplaces. In addition to tailoring programs to both young and mid‐aged workers, this work highlights the importance of implementing strategies to increase awareness of risks to workplace safety; and the adoption of norms that inhibit the social acceptability of risky drinking behaviour in the wider workplace.
Screen‐time influences children's mental imagery performance
Authors: Suggate Sebastian P. , Martzog Philipp
Published: April 2020

Mental imagery is a foundational human faculty that depends on active image construction and sensorimotor experiences. However, children now spend a significant proportion of their day engaged with screen‐media, which (a) provide them with ready‐made mental images, and (b) constitute a sensory narrowing whereby input is typically focused on the visual and auditory modalities. Accordingly, we test the idea that screen‐time influences the development of children's mental imagery with a focus on mental image generation and inspection from the visual and haptic domains. In a longitudinal cross‐lagged panel design, children (n = 266) aged between 3 and 9 years were tested at two points in time, 10 months apart. Measures of screen‐time and mental imagery were employed, alongside a host of control variables including working memory, vocabulary, demographics, device ownership, and age of exposure to screen‐media. Findings indicate a statistically significant path from screen‐time at time 1 to mental imagery at time 2, above and beyond the influence of the control variables. These unique findings are discussed in terms of the influence of screen‐time on mental imagery.
Hyperoxia improves autonomic function in individuals with long‐duration type 1 diabetes and macroalbuminuria
Authors: Laursen J. C. , Hansen C. S. , Bordino M. , Vistisen D. , Zobel E. H. , Winther S. A. , Groop P‐H. , Frimodt‐Møller M. , Bernardi L. , Rossing P.
Published: April 2020

Aim

Acute oxygen inhalation and slow deep breathing improve measures of autonomic function transiently in individuals with short‐duration type 1 diabetes. Our aims were to examine these interventions and changes in autonomic function in individuals with long‐duration type 1 diabetes and to explore interactions with the presence of macroalbuminuria or existing cardiovascular autonomic neuropathy.

Methods

Individuals with type 1 diabetes (n = 54) were exposed to acute oxygen inhalation, slow deep breathing and a combination of both (hereafter ‘the combination’). Primary outcomes were change in baroreflex sensitivity and heart rate variability. Associations between changes in outcomes were evaluated using mixed effects models.

Results

Mean age ± sd was 60 ± 10 years and diabetes duration was 38 ± 14 years. Changes are presented as per cent difference from baseline with 95% confidence intervals. Acute oxygen inhalation, slow deep breathing and the combination increased baroreflex sensitivity by 21 (10, 34)%, 32 (13, 53)% and 30 (10, 54)%, respectively. Acute oxygen inhalation trended towards increasing heart rate variability 8 (−1, 17)% (P = 0.056), and slow deep breathing and the combination increased heart rate variability by 33 (18, 49)% and 44 (27, 64)% respectively. Macroalbuminuria or cardiovascular autonomic neuropathy did not modify results.

Conclusion

Autonomic function is improved transiently in individuals with long‐duration type 1 diabetes and normoalbuminuria or macroalbuminuria by acute oxygen inhalation and slow deep breathing. There is a risk of survival bias. Autonomic dysfunction might be a reversible condition, and hypoxia might represent a target of intervention.
High‐protein diet: A barrier to the nephroprotective effects of sodium‐glucose co‐transporter‐2 inhibitors?
Authors: Mazzucato Marta , Fioretto Paola , Avogaro Angelo
Published: April 2020

Glomerular hyperfiltration is a common finding in patients with diabetes and poor glycaemic control; whole‐kidney hyperfiltration, with glomerular filtration rate (GFR) values above normal, should be differentiated from single nephron hyperfiltration, consequent to nephron loss and compensatory hyperfiltration of the remnant nephrons. This is the result of an imbalance between the vascular tone of the afferent and efferent arterioles. Hormonal influences and/or an impaired tubuloglomerular feedback (TGF) system, because of excessive sodium (Na+) and glucose reabsorption in the proximal tubule, contribute to determine hyperfiltration. Sodium‐glucose co‐transporter‐2 inhibitors (SGLT2is), by decreasing Na+ reabsorption and increasing the delivery of Na+ to the macula densa, lead to normalization of TGF, and, consequently, decrease GFR (both whole and single nephron). High‐protein diets are popular among patients with type 1 and type 2 diabetes; importantly, 80% of the amino acids are also reabsorbed in the proximal tubule of the nephron and are transported by symporters that use the electro‐chemical gradient of Na+. Indeed, an acute protein load is associated with increased Na+ reabsorption and an increase in GFR. Here, we hypothesize that high‐protein diets, by increasing Na+ reabsorption and GFR, may offset the positive renal effects of SGLT2is.
Childhood medical history and psychosis in adult life: Findings from the Bologna EU‐GEI incidence and case–control study
Authors: D'Andrea Giuseppe , Suprani Federico , Tolomelli Elena , Gennari Monia , Lanari Marcello , Faldella Giacomo , Muratori Roberto , Berardi Domenico , Tarricone Ilaria
Published: April 2020

Aim

To estimate the association between the inpatient admissions and Emergency Department (ED) visits before age of 18 years and adulthood‐onset first‐episode psychosis (FEP).

Methods

We conducted a FEP incidence and case–control study and calculated the odds ratios (ORs) for incident FEP associated with inpatient admissions and ED visits prior to age of 18 years, adjusting our results for cannabis use, parental socio‐economic class and childhood trauma.

Results

In multivariate logistic regression analysis, odds of FEP increased significantly if the participant had a history of at least one inpatient admission (OR = 3.52; 95% confidence interval [95%CI] 1.07‐11.54; P = .04) or at least one ED visit (OR = 8.93; 95%CI 2.41‐33.14; P = .001) before age of 18. The associations remained significant adjusting for cannabis use, education, parental socio‐economic class and childhood trauma.

Conclusion

Consistently with the socio‐neurodevelopmental model, we found a significant association between a positive history of hospital care in childhood and adulthood‐onset psychosis.
Personnel time required for supported employment and education services for individuals in a recent‐onset psychosis treatment program
Authors: Humensky Jennifer L. , Turner Luana R. , Dixon Lisa B. , Drake Robert E. , Becker Deborah R. , Subotnik Kenneth L. , Ventura Joseph , Nuechterlein Keith H.
Published: April 2020

Aim

Individual Placement and Support (IPS) improves vocational outcomes in first‐episode psychosis patients, but policy makers need information on costs (and personnel time required) to conduct effective IPS.

Methods

Using chart records of 42 clients in a first‐episode psychosis study, we examined service time for specific activities over 18 months.

Results

The IPS specialist averaged 92 (SD = 62) minutes per client per week: 39% of time was spent in direct client contact, 9% in meetings without the client, 14% in meetings with the treatment team, 14% in supervision and 24% on travel time. Time required was significantly higher when participants were seeking work/school placements, decreased over duration of enrolment and was similar for those using work vs school support.

Conclusions

IPS service time covers numerous activities, is reduced when not seeking work/school placements and required less time over enrolment duration. Financing structures should support the full range of IPS services.
Is identity illusory?
Authors: Mogensen Andreas L.
Published: April 2020

Certain of our traits are thought more central to who we are: they comprise ourindividual identity. What makes these traits privileged in this way? What accounts for theiridentity centrality? Although considerations of identity play a key role in many different areas of moral philosophy, I argue that we currently have no satisfactory account of the basis of identity centrality. Nor should we expect one. Rather, we should adopt an error theory: we should concede that there is nothing in reality corresponding to the perceived distinction between the central and peripheral traits of a person.
Diversified crop rotation with no‐till changes microbial distribution with depth and enhances activity in a subtropical Oxisol
Authors: Bonini Pires Carlos A. , Amado Telmo J. C. , Reimche Geovane , Schwalbert Raí , Sarto Marcos V. M. , Nicoloso Rodrigo S. , Fiorin Jackson E. , Rice Charles W.
Published: April 2020

Soil microbial community and enzyme activity regulate carbon and nutrient cycling in soils. No‐till has elevated levels of carbon at the soil surface compared to intensively tilled soils. The introduction of crop diversification in agricultural systems increases soil carbon protection and aggregate stability. Thus, the association of no‐till with crop diversification may change the soil microbial distribution and enhance activity in comparison with tilled soils with no crop diversification. We tested this hypothesis assessing the soil microbial community and enzyme activity in a long‐term (32 yr) experiment with contrasting soil management (no‐tillage, (NT) and conventional tillage (CT)) and cropping systems in southern Brazil. Long‐term NT increased microbial biomass at 0–5 cm. In contrast, soil microbial biomass was higher in deeper soil layers (10–30 cm) of CT. No‐tillage and crop diversification increased the activity of β‐glucosidase, acid phosphatase and N‐acetyl‐glucosaminidase. The benefits of an intensified/diversified crop rotation were offset by soil tillage. The higher abundance of PLFA groups at 0–5 cm and 10–30 cm of respective NT and CT soils were correlated with increased C and nutrient levels (N, Ca2+, Mg2+) and decreased Al3+.

Highlights

Crop diversification increased the soil microbial biomass and individual PLFA groups.

No‐till without crop diversification did not change microbial biomass.

No‐till with crop diversification increased enzyme activity.

Subsoil fertility restricted microbial responses in a no‐till Oxisol.
Methylation patterns of cutaneous T‐cell lymphomas
Authors: Iżykowska Katarzyna
Published: April 2020

In cutaneous T‐cell lymphoma (CTCL), global hypomethylation of the genome and hypermethylation of tumor suppressor genes were detected. Studies show that methylation dysregulation is often a starting point for processes that might lead to malignant transformation. In this review, all data regarding copy‐number variations (CNVs) and mutations in main methylation players DNA methyltransferases/TET in CTCL were summarized. An overview of studies on gene‐specific hypomethylation and hypermethylation in CTCL, including methylation of microRNA genes, was presented. The possibility of using the methylation pattern in diagnosis and methylation inhibitors in treatment of CTCL was discussed.
Bio‐energetic data show weak spatial but strong seasonal differences in wetland quality for waders in a Mediterranean migration bottleneck
Authors: Deboelpaep Evelien , Coenegracht Tina , De Wolf Lore , Libert Alexandre , Vanschoenwinkel Bram , Koedam Nico
Published: April 2020

Assessing the quality of wetlands as refuelling areas for migrating waterbirds based on resource distribution patterns is challenging. Resources in wetlands can vary both horizontally and vertically and may be differentially available to different bird species at different times of the year. Therefore, the extent to which wetland quality can be generalised across seasons and for a diversity of birds remains unresolved.

Spatiotemporal variation in abundance and quality of macrobenthos as food for migrating waders was studied in a set of wetland areas near a Mediterranean migration bottleneck in the Balkan peninsula, during both spring and autumn migration. Samples were subdivided into different depth layers to differentiate between parts of the sediment that are accessible to different groups of wader species. To quantify food availability and the resulting refuelling capacity in different wetland habitat types, abundance, wet weight, and lipid and protein content of invertebrate taxa were determined for each sample.

Invertebrate food availability and quality were markedly higher in spring than in autumn. Given the higher abundance and protein and lipid content of prey in spring, the total energy that could be harvested in spring (3.81 ± 0.79 kJ/m2) was about 7 times higher than in autumn (0.56 ± 0.12 kJ/m2). Most prey were found in the top layer of the sediment (0–22 mm depth), but about a third of the total energy was present in the deepest soil layer that only longer‐billed species could reach (55–200 mm depth). Higher quality prey items such as larger‐bodied and heavier polychaetes and bivalves were found in the deeper sediment layers.

For other taxa, there was no evident vertical pattern of increasing individual body size. Prey abundance differed between certain habitat types but, overall, food availability could not be linked to distinct habitats. In spring, redox potential tended to be higher, while pH, vegetation cover, conductivity, and temperature were lower than in autumn.

Different wetland habitat classes used in a conservation framework may provide similar food resources for waders. As a result, linking food availability to habitat classifications is not straightforward. Furthermore, seasonal variation in wetland quality requires a re‐evaluation of the importance of wetland areas during spring and autumn migration. Finally, nutritional analyses are essential for determining the capacity of wetlands to support refuelling by migratory waterbirds.
Investigations of vegetable tannins as hair dyes and their interactions with pre‐bleached hair fibres
Authors: Sargsyan L. , Vill V. , Hippe T.
Published: April 2020

Objective

The aim of this work was to investigate an alternative hair‐dyeing method with vegetable colourants as the tannins, as well as the impact of pre‐treatment as the bleaching process.

Methods

Untreated, 1, 2 and 3 times bleached hair tresses that were dyed with tannins in combination with metal salts were characterized. The wash fastness and the colour strength of the vegetable‐dyed hair tresses were spectrophotometrically investigated.

Results

To determine the colour strengthKSand the wash fastness of vegetable‐dyed and pre‐bleached hair tresses, a three‐dimensional colour coordinate system – CIELab – which describes the visual spectra is used. The distance between two colours in the CIELab colour space is expressed by ∆E‐values, which are used to identify the wash fastness of the vegetable dye. The hair tresses that had been 3 times pre‐bleached showed the highest colour strength and the best wash fastness. The fixation of the tannin–mordant complexes on the hair fibre proceeded effectively just when the hair tresses were bleached before the dying process. It is suggested that the sulphonic acid groups, which increase after bleaching hair, interact with the tannin–mordant hair dye and lead to stronger cross‐links between keratinous fibres and tannin–mordant complexes. It was observed that the colour strength of the vegetable‐dyed tresses correlates with the bleaching process.

Conclusion

The presented results demonstrate that the fixation of the vegetable tannin–mordant dying solution on the hair fibres succeed effectively on pre‐bleached hair tresses.
Do plasma cells contribute to the determination of their lifespan?
Authors: Tarlinton David
Published: April 2020

Longevity of plasma cells is dependent on their ability to access and reside in so‐called survival niches that are predominantly located in the bone marrow. It is proposed that by some process a small fraction of the plasma cells generated in response to new antigen challenges can enter into the long‐lived repertoire by displacing existing plasma cells. Several lines of research show that this process is not stochastic as not all resident, long‐lived plasma cells appear equally likely to be displaced. The basis of these differences might reside in the niches, the plasma cells or a combination of both factors that intersect to create a distribution of susceptibility to replacement and lifespans. In this review, I consider factors that might vary in plasma cells and thus influence their access to niches and the ability of newly generated plasma cells to survive over the long term.
In search of theory? The workplace case study tradition in the 21st century
Authors: McGovern Patrick
Published: April 2020

Workplace case studies have been valued by some for their ability to advance theory while others dismiss them as little more than descriptive stories. This paper presents a detailed content analysis of case study articles to assess the relative balance between theory, conceptual analysis and description. Drawing on a random sample of papers (n = 173) published in leading journals, I find that fewer than one in seven are descriptive papers while only  one in ten  are theory oriented. Using three criteria, I identify exemplars of theoretical and conceptual analysis and show how these may be used to advance the field.
Association between plasma retinol levels and the risk of all‐cause mortality in general hypertensive patients: A nested case‐control study
Authors: Li Huan , He Panpan , Lin Tengfei , Guo Huiyuan , Li Youbao , Song Yun , Wang Binyan , Liu Chengzhang , Liu Lishun , Li Jianping , Zhang Yan , Huo Yong , Zhou Houqing , Yang Yan , Ling Wenhua , Wang Xiaobin , Zhang Hao , Xu Xiping , Qin Xianhui
Published: April 2020

To evaluate the association between plasma retinol levels with all‐cause mortality and investigate the possible effect modifiers in general hypertensive patients with no previous cardiovascular disease (CVD). This case‐control study was nested in the China Stroke Primary Prevention Trial (CSPPT), a randomized, double‐blind, controlled trial conducted in 32 communities in Anhui and Jiangsu provinces in China. The current study included 617 cases of all‐cause mortality and 617 controls matched on age (≤1 year), sex, treatment group, and study site. All‐cause mortality was the main outcome in this analysis, which included death due to any reason. The median follow‐up duration was 4.5 years. Overall, there was a U‐shaped relation of plasma retinol with all‐cause mortality. In the threshold effect analysis, the risk of all‐cause mortality significantly decreased with the increase in plasma retinol (per 10 μg/dL increments: OR, 0.73; 95% CI: 0.61‐0.87) in participants with plasma retinol <58.3 μg/dL and increased with the increase in plasma retinol (per 10 μg/dL increments: OR, 1.08; 95% CI: 1.01‐1.16) in those with plasma retinol ≥58.3 μg/L. In participants with plasma retinol <58.3 μg/dL, a stronger inverse association was observed in those with higher time‐averaged SBP (≥140 vs <140 mm Hg; P‐interaction = .034), or higher vitamin E levels (≥11.5 [quartile 4]; vs <11.5 μg/mL; P‐interaction = .013). The present study demonstrated that there was a U‐shaped relationship of plasma retinol levels with the risk of all‐cause mortality in general hypertensive patients, with a turning point around 58.3 μg/dL.
Retrospective assessment of cyclin‐dependent kinase 5 mRNA and protein expression and its association with patient survival in breast cancer
Authors: Saidy Behnaz , Rakha Emad A. , Green Andrew R. , Ellis Ian O. , Martin Stewart G. , Storr Sarah J.
Published: April 2020

Cyclin‐dependent kinase 5 (Cdk5) is an atypical member of the cyclin‐dependent kinase family and functions as a serine/threonine kinase that can be activated by non‐cyclin binding activators p35 or p39. Cdk5 expression and activity has been linked with the development and progression of cancer; however, its expression in breast cancer has not been fully described. Protein expression of Cdk5 was determined in a large cohort of early‐stage invasive breast cancer tumours (n = 1110) with long‐term follow‐up data using immunohistochemistry. Expression of CDK5 mRNA was assessed in the METABRIC cohort (n = 1980). Low nuclear and cytoplasmic expression of Cdk5 expression was significantly associated with shorter breast cancer‐specific survival (P = .004 and P = .001, respectively). Importantly, low nuclear and cytoplasmic expression of Cdk5 remained associated with survival in multivariate analysis, including potentially confounding factors (hazard ratio (HR) = 0.612, 95% confidence interval (CI) = 0.418‐0.896, P = .011 and HR = 0.507, 95% CI = 0.318‐0.809, P = .004, respectively). In addition, low nuclear and cytoplasmic expression of Cdk5 was significantly associated with clinicopathological criteria associated with adverse patient prognosis. Low CDK5 mRNA expression was associated with shorter patient survival (P = .005) in the METABRIC cohort; no associations between copy gain or loss and survival were observed. These data suggest that low Cdk5 expression is associated with poor clinical outcome of breast cancer patients and may be of clinical relevance.
High central venous oxygen saturation is associated with mitochondrial dysfunction in septic shock: A prospective observational study
Authors: Wittayachamnankul Borwon , Apaijai Nattayaporn , Sutham Krongkarn , Chenthanakij Boriboon , Liwsrisakun Chalerm , Jaiwongkam Thidarat , Chattipakorn Siriporn C. , Chattipakorn Nipon
Published: April 2020

To test the hypothesis that an impaired mitochondrial function is associated with altered central venous oxygen saturation (ScvO2), venous‐to‐arterial carbon dioxide tension difference (delta PCO2) or serum lactate in sepsis patients. This prospective cohort study was conducted in a single tertiary emergency department between April 2017 and March 2019. Patients with suspected sepsis were included in the study. Serum lactate was obtained in sepsis, ScvO2 and delta PCO2 were evaluated in septic shock patients. Mitochondrial function was determined from the peripheral blood mononuclear cells. Forty‐six patients with suspected sepsis were included. Of these, twenty patients were septic shock. Mitochondrial oxidative stress levels were increased in the high ScvO2 group (ScvO2 > 80%, n = 6), compared with the normal (70%‐80%, n = 9) and low ScvO2 (<70%, n = 5) groups. A strong linear relationship was observed between the mitochondrial oxidative stress and ScvO2 (r = .75; P = .01). However, mitochondrial respiration was increased in the low ScvO2 group. In addition, mitochondrial complex II protein levels were significantly decreased in the high ScvO2 group (P < .05). Additionally, there was no correlation between serum lactate, delta PCO2, and mitochondria oxidative stress or mitochondria function. ScvO2 can be potentially useful for developing new therapeutics to reduce mitochondrial dysfunction in septic shock patient.
A randomized controlled trial of the effects of non‐surgical periodontal therapy on cardiac function assessed by echocardiography in type 2 diabetic patients
Authors: Wang Yi , Liu Hin Nam , Zhen Zhe , Pelekos George , Wu Mei Zhen , Chen Yan , Tonetti Maurizio , Tse Hung Fat , Yiu Kai Hang , Jin Lijian
Published: April 2020

Background

Periodontitis significantly increases the risk of diabetic complications. This clinical trial investigated the effects of periodontal therapy on cardiac function in patients with type 2 diabetes mellitus (T2DM) and periodontitis.

Materials and methods

Fifty‐eight subjects with T2DM and periodontitis were randomly allocated to Treatment Group (n = 29) receiving non‐surgical periodontal therapy, and Control Group (n = 29) having only oral hygiene instructions with delayed periodontal treatment until completion of this 6‐month study. The left ventricle (LV) diastolic function was assessed by echocardiography with the tissue Doppler imaging index (E/e' ratio); and LV hypertrophy was evaluated by LV mass index (LVMI). Blood samples were collected for biochemical analysis.

Results

The intention‐to‐treat analysis showed that periodontal treatment significantly reduced the E/e' ratio by 1.66 (95% CI: −2.64 to −0.68, p < .01), along with marked improvement of periodontal conditions (p < .05). LVMI was not altered at the 6‐month follow‐up. The serum levels of N‐terminal pro‐B type natriuretic peptide (NT‐proBNP) as a cardiac stress biomarker, C‐reactive protein and interleukin‐6 decreased numerically without reaching statistical significance.

Conclusion

The present study provides the first evidence that non‐surgical periodontal therapy may improve cardiac diastolic function in type 2 diabetic patients with periodontitis.
Research Review: Conflicts of Interest (COIs) in autism early intervention research – a meta‐analysis of COI influences on intervention effects
Authors: Bottema‐Beutel Kristen , Crowley Shannon , Sandbank Micheal , Woynaroski Tiffany G.
Published: April 2020

Background

The presence, types, disclosure rates, and effects of conflicts of interest (COIs) on autism early intervention research have not previously been studied. The purpose of this study was to examine these issues.

Methods

This study is a secondary analysis of a comprehensive meta‐analysis of all group‐design, nonpharmacological early intervention autism research conducted between 1970 and 2018. We coded reports for the presence/absence of COI statements, the types of COIs that were disclosed, and for 8 types of COIs, including (a) the author developed the intervention, (b) the author is affiliated with a clinical provider, (c) the author is employed by a clinical provider, (d) the author is affiliated with an institution that trains others to use the intervention, (e) the author receives payment or royalties related to the intervention, (f) the study was funded by an intervention provider, (g) the study used a commercially available measure developed by the author, and (h) proceeds of the intervention fund the author’s research. Frequencies and proportions were calculated to determine prevalence of COIs and COI disclosures. Meta‐analysis was used to estimate summary effects by COI type and to determine if they were larger than for reports with no coded COIs.

Results

Seventy percent of reports were coded for ≥ 1 COI, but only ~ 6% of reports contained COI statements fully accounting for all coded COIs. Metaregressions did not detect significant influences of any COI type on summary effects; however, point estimates for each COI type were larger than for reports with no coded COIs.

Conclusions

Conflicts of interest are prevalent but under‐reported in autism early intervention research. Improved reporting practices are necessary for researcher transparency and would enable more robust examination of the effects of COIs on research outcomes.
Vehicle‐related flood fatalities in Australia, 2001–2017
Authors: Ahmed Mozumdar A. , Haynes Katharine , Taylor Mel
Published: April 2020

This study analyses the circumstances of vehicle‐related flood fatalities between 2001 and 2017, in Australia. The research identified 96 deaths from 74 incidents during this period. The aim of this analysis is to understand the demographic, spatial and temporal patterns, and the situational conditions in which those (n = 96) deaths have occurred. This is important for informing efficient and strategic risk reduction strategies to reduce vehicle related deaths and injuries in floodwater. Data were accessed from the Australian National Coronial Information System (NCIS), which includes witness and police statements, forensic documents, and detailed coronial findings. Analysis was conducted in two phases. In phase one, data were coded and categorised according to a range of factors previously identified as significant in vehicle‐related flood fatalities internationally. In phase two, a detailed analysis was conducted on 11 selected incidents for which there were complete sets of records. This detailed analysis provides insight into the multifaceted nature of fatal vehicle‐related flood fatality incidents. The overall results reveal that, for drivers, middle‐aged and elderly males are over‐represented in the fatality statistics. As passengers, young women and children are vulnerable. The study also identified deep floodwater with high flow contributes more to vehicle immersion, and the presence of alcohol and drugs, leading to impaired responses, reduces the chance of survival for the vehicle occupants.
Studying physiology within a flipped classroom: The importance of on‐campus activities for nursing students’ experiences of mastery
Authors: Bingen Hanne Maria , Steindal Simen A. , Krumsvik Rune Johan , Tveit Bodil
Published: April 2020

Aims and objectives

To explore the on‐campus activities of the flipped classroom and their role in nursing students’ experiences of mastering physiology.

Background

A nurse must be confident in their knowledge of physiology to feel confident as a nurse. However, many nursing students do not believe in their ability to master physiology. The flipped classroom design could facilitate active learning and promote students’ confidence and competence in physiology.

Design

A design‐based research design was employed.

Methods

Twenty‐three nursing students enrolled in an anatomy and physiology course participated in two focus group interviews and wrote two individual reflective notes. The data were analysed by means of systematic text condensation and activity theory. Reporting was guided by the Consolidated Criteria for Reporting Qualitative Studies (COREQ).

Results

The study findings underscore the importance of careful design of on‐campus activities within the flipped classroom to support students’ experiences of mastery in physiology. Four themes were identified: (a) preparation which builds a foundation for learning; (b) the use of digital tools; (c) learning through dialogue with peers; and (d) experience of the expected learning outcomes.

Conclusions

On‐campus learning activities within a flipped classroom design could support students’ experiences of confidence in and mastery of physiology. However, the study participants found learner‐centred activities challenging and described feeling doubtful of their ability to master physiology. A didactic framework could take into account the circumstance that students perceive educational technology differently. When designing on‐campus activities, emphasis should be placed on collaboration rather than competition to help students develop confidence in their knowledge of physiology.

Relevance to clinical practice

It is important to support nursing students’ knowledge acquisition in bioscience and their development of confidence as these skills could enhance their clinical judgment in practice. Comprehension of bioscience is necessary to provide safe patient care and competent nursing.
Caring in community nursing practice: Inductive content analysis reveals an inter‐dynamic system between patients and nurses
Authors: Yue Peng , Xu Tianmeng , Greene Brian , Wang Yongli , Wang Rongjin , Dai Guizhi , Xu Lijie
Published: April 2020

Aims and objectives

To examine the understanding of caring in the practice of community nursing from the perspectives of patients and nurses.

Background

An increasing population of patients with chronic disease has produced a need for humanistic caring in communities. As a result, caring has become a core value of community nursing professionals. However, community nurses meet many difficulties in trying to practice person‐centred care with their clients. Furthermore, most community nurses—especially in China—lack systematic education and training about caring because the practical meaning of caring in community practice is unknown.

Design

The qualitative study described herein employed inductive content analysis.

Methods

Eleven community patients with chronic disease and fifteen community nurses who were nominated as a caring nurse from different community clinics in Beijing, China, participated in thirty‐one interviews during January to August in 2018. Nine documents from the interviewed nurses were collected. Both interview data and documents were analysed using strategies of inductive content analysis. The COREQ checklist was used.

Results

Patients and their corresponding nurses described a wide range of caring experiences that were generalised into 28 concepts. Caring emerged as an inter‐dynamic system that comprised the foundation and quality of a caring relationship, the caring philosophy and behaviours of interactions, and positive feedback from caring interactions. A relationship‐based framework of caring in community nursing practice was constructed.

Conclusions

Identifying this systematic concept of caring provides insights that are applicable to the creation of targeted management, education and practice interventions to ultimately enhance the quality of community health care—in China or elsewhere.

Relevance to clinical practice

The systematic understanding of caring in community nursing practice will inform nurses in community health clinics, their educators and their managers on how to provide care to community patients and how to develop caring competence for community nurses.
Any Willing Provider and Negotiated Retail Pharmaceutical Prices*
Authors: Hosken Daniel , Schmidt David , Weinberg Matthew C.
Published: April 2020

Any Willing Provider (AWP) regulations require insurers to allow health care providers network membership, eliminating an insurer’s ability to commit to a limited network of providers. We study the effect of AWP on prices negotiated between insurers and providers by exploiting the introduction of a regulation targeting retail pharmacies in the state of Maine. Using insurance claim level data and across state variation in exposure to the regulation, we estimate increases in negotiated pharmaceutical prices. Our results are consistent with AWP regulations’ reducing competition by inhibiting the ability of insurers to move demand across competing pharmacies.
Using Customer Service to Build Clients’ Trust*
Authors: Fong Yuk‐Fai , Hu Xiaoxiao , Liu Ting , Meng Xiaoxuan
Published: April 2020

It is well known in the credence‐good literature that in an expert‐client relationship, under the Liability assumptions, clients have to reject the expert’s serious‐treatment recommendations with a positive probability to ensure that the expert honestly recommends treatments. Inefficiency arises because some socially efficient treatments are not provided. We show that the expert can enhance clients’ trust, or acceptance rate of the serious treatment, by providing intrinsically socially inefficient customer service upon recommending the serious treatment. Enhanced clients’ trust leads to higher efficiency and higher profit for the expert. However, trust cannot be enhanced by providing customer service with different timing.
Cardiac troponin is associated with cardiac outcomes in men and women with atrial fibrillation, insights from the ARISTOTLE trial
Authors: Røsjø H. , Hijazi Z. , Omland T. , Westerbergh J. , Lyngbakken M.N. , Alexander J.H. , Gersh B.J. , Granger C.B. , Hylek E.M. , Lopes R.D. , Siegbahn A. , Wallentin L.
Published: April 2020

Background

Cardiac troponin T (cTnT) and I (cTnI) concentrations provide strong prognostic information in anticoagulated patients with atrial fibrillation (AF). Whether the associations between cardiac troponin concentrations and mortality and morbidity differ by sex is not known.

Objectives

To assess whether men and women have different concentrations and prognostic value of cTnT and cTnI measurements in anticoagulated patients with AF.

Methods

cTnT and cTnI concentrations were measured with high‐sensitivity (hs) assays in EDTA plasma samples obtained from the multicentre ARISTOTLE trial, which randomized patients with AF and at least one risk factor for stroke or systemic embolic event to warfarin or apixaban. Patients were stratified according to sex and the associations between hs‐troponin concentrations, and all‐cause death, cardiac death, myocardial infarction, stroke or systemic embolic event and major bleeding were assessed in multivariable regression models.

Results

We found higher cardiac troponin concentrations in men (n = 9649) compared to women (n = 5331), both for hs‐cTnT (median 11.8 [Q1‐3 8.1–18.0] vs. 9.6 [6.7–14.3] ng L−1, P < 0.001) and hs‐cTnI (5.8 [3.4–10.8] vs. 4.9 [3.1–8.8] ng L−1, P < 0.001). Adjusting for baseline demographics, comorbidities and medications, men still had significantly higher hs‐troponin concentrations than women. C‐reactive protein and N‐terminal pro‐B‐type natriuretic peptide concentrations were higher in female patients. Both hs‐cTnT and hs‐cTnI concentrations were associated with all clinical outcomes similarly in men and women (p‐value for interaction >0.05 for all end‐points).

Conclusion

Men have higher hs‐troponin concentrations than women in AF. Regardless of sex, hs‐troponin concentrations remain similarly associated with adverse clinical outcomes in anticoagulated patients with AF.
Clinical and epidemiological characteristics of 1420 European patients with mild‐to‐moderate coronavirus disease 2019
Authors: Lechien Jerome R. , Chiesa‐Estomba Carlos M. , Place Sammy , Van Laethem Yves , Cabaraux Pierre , Mat Quentin , Huet Kathy , Plzak Jan , Horoi Mihaela , Hans Stéphane , Rosaria Barillari Maria , Cammaroto Giovanni , Fakhry Nicolas , Martiny Delphine , Ayad Tareck , Jouffe Lionel , Hopkins Claire , Saussez Sven ,   COVID‐19 Task Force of YO‐IFOS
Published: April 2020

Background

The clinical presentation of European patients with mild‐to‐moderate COVID‐19 infection is still unknown.

Objective

To study the clinical presentation of COVID‐19 in Europe.

Methods

Patients with positive diagnosis of COVID‐19 were recruited from 18 European hospitals. Epidemiological and clinical data were obtained through a standardized questionnaire. Bayesian analysis was used for analysing the relationship between outcomes.

Results

A total of 1,420 patients completed the study (962 females, 30.7% of healthcare workers). The mean age of patients was 39.17 ± 12.09 years. The most common symptoms were headache (70.3%), loss of smell (70.2%), nasal obstruction (67.8%), cough (63.2%), asthenia (63.3%), myalgia (62.5%), rhinorrhea (60.1%), gustatory dysfunction (54.2%) and sore throat (52.9%). Fever was reported by 45.4%. The mean duration of COVID‐19 symptoms of mild‐to‐moderate cured patients was 11.5 ± 5.7 days. The prevalence of symptoms significantly varied according to age and sex. Young patients more frequently had ear, nose and throat complaints, whereas elderly individuals often presented fever, fatigue and loss of appetite. Loss of smell, headache, nasal obstruction and fatigue were more prevalent in female patients. The loss of smell was a key symptom of mild‐to‐moderate COVID‐19 patients and was not associated with nasal obstruction and rhinorrhea. Loss of smell persisted at least 7 days after the disease in 37.5% of cured patients.

Conclusion

The clinical presentation of mild‐to‐moderate COVID‐19 substantially varies according to the age and the sex characteristics of patients. Olfactory dysfunction seems to be an important underestimated symptom of mild‐to‐moderate COVID‐19 that needs to be recognized as such by the WHO.
Obesity in African‐Americans: The role of physiology
Authors: Gower B. A. , Fowler L. A.
Published: April 2020

The disproportionate obesity in African American (AA) women has a physiologic basis and can be explained by the interactive effects of insulin secretion, insulin clearance, insulin sensitivity and the glycaemic load of the diet. This review will present data supporting a physiologic basis for obesity propensity in obesity‐prone AA women that resides in their unique metabolic/endocrine phenotype: high beta‐cell responsiveness, low hepatic insulin extraction and relatively high insulin sensitivity, which together result in a high exposure of tissues and organs to insulin. When combined with a high‐glycaemic (HG) diet (that stimulates insulin secretion), this underlying propensity to obesity becomes manifest, as ingested calories are diverted from energy production to storage. Our data indicate that both weight loss and weight loss maintenance are optimized with low‐glycaemic (LG) vs HG diet in AA. Whether greater obesity in AA is mechanistically related to their greater prevalence of type 2 diabetes is debatable. This review provides data indicating that obesity is not strongly related to insulin resistance in AA. Rather, insulin resistance in AA is associated with relatively low adipose tissue in the leg, consistent with a genetic predisposition to impaired lipid storage. Greater bioenergetic efficiency has been reported in AA and, via resultant oxidative damage, could plausibly contribute to insulin resistance. In summary, it is proposed here that a subset of AA women are predisposed to obesity due to a specific metabolic/endocrine phenotype. However, greater diabetes risk in AA has an independent aetiology based on impaired lipid storage and mitochondrial efficiency/oxidative stress.
Endurance measurement of hyoid muscle activity and hyoid‐laryngeal position during tongue lift movement
Authors: Sunada Yukako , Magara Jin , Tsujimura Takanori , Ono Kazuhiro , Inoue Makoto
Published: April 2020

Background

Tongue lift movement (TLM) is used as a therapy to improve tongue pressure against the hard palate for dysphagic patients.

Objective

The present study aimed to characterize the time‐dependent endurance changes in hyoid muscle activity and hyoid‐laryngeal displacement during TLM in different ways.

Methods

Sixteen young healthy volunteers were instructed to perform TLM at maximum effort (100%) against the anterior and posterior parts of the hard palate using a balloon‐type tongue pressure instrument, followed by a 10‐second recording during anterior 80% TLM, anterior 100% TLM, posterior 80% TLM and posterior 100% TLM with visual feedback. Electromyography (EMG) of suprahyoid (S‐Hyo) and infrahyoid (I‐Hyo) muscles and videofluorography were simultaneously recorded. To evaluate temporal changes, the recording period was divided into three substages: early, middle and late. Tongue pressure, integrated EMG (iEMG), power frequency of EMG burst and hyoid‐laryngeal position were compared among the conditions (80% vs 100%, anterior vs posterior and early vs middle vs late).

Results

Tongue pressure was stably maintained for 10 seconds in all conditions. S‐Hyo iEMG and I‐Hyo iEMG were significantly greater at 100% than at 80%, while no significant difference was observed between positions. S‐Hyo iEMG and I‐Hyo iEMG significantly increased at the late stage, while power frequency of EMG burst gradually decreased. Significant temporal changes in laryngeal elevation were observed only in posterior 100% TLM.

Conclusion

The current results suggested that isometric posterior TLM may be more useful compared with anterior TLM in clinical situations for dysphagic patients to elevate the hyolaryngeal complex.
Sleep neurophysiology in childhood onset schizophrenia
Authors: Markovic Andjela , Buckley Ashura , Driver David I. , Dillard‐Broadnax Diane , Gochman Peter A. , Hoedlmoser Kerstin , Rapoport Judith L. , Tarokh Leila
Published: April 2020

Altered sleep neurophysiology has consistently been reported in adult patients with schizophrenia. Converging evidence suggests that childhood onset schizophrenia (COS), a rare but severe form of schizophrenia, is continuous with adult onset schizophrenia. The aim of the current study was to characterize sleep neurophysiology in COS. An overnight sleep electroencephalogram (EEG) was recorded in 17 children and adolescents with COS (16 years ± 6.6) and 17 age and gender‐matched controls. Non‐rapid eye movement (NREM) and rapid eye movement (REM) sleep EEG power and coherence for the frequency bands delta (1.6–4.8 Hz), theta (5–8.4 Hz), alpha (8.6–11 Hz), beta 1 (16.4–20.2 Hz) and beta 2 (20.4–24.2 Hz) were compared between COS patients and controls. COS patients exhibited significant and widespread deficits in beta power during NREM and REM sleep. With regard to coherence, we found increases in COS patients across brain regions, frequency bands and sleep states. This study demonstrates the utility of the sleep EEG for studying vulnerable populations and its potential to aid diagnosis.