bluuebunny/crossref_metadata_2025 huggingface dataset:
Deprivation, access and outcomes in health psychology treatment
Authors: Oates Lloyd Louis , Firth Nick
Published: June 2020

Purpose

Individuals living in areas of higher deprivation are more likely to have requested mental health treatment but are less likely to have received treatment or benefitted from it. Less is known about the extent of access equality and treatment outcomes for individuals with a long-term health condition who experience mental health difficulties. The purpose of this paper is to evaluate the extent to which the neighbourhood Index of Multiple Deprivation predicted access to treatment, appointment attendance, treatment completion and clinical outcomes in a British health psychology clinic.

Design/methodology/approach

Retrospective data were used from 479 individuals referred to a health psychology clinic over 12 months. Clinical outcomes were measured using the Clinical Outcomes in Routine Evaluation – Outcome Measure. Patient data were linked with their neighbourhood Index of Multiple Deprivation decile. Data were analysed using correlation, linear regression and Fisher’s exact test.

Findings

There were no significant associations between deprivation and whether an individual attended assessment, attended treatment or completed treatment or between deprivation and patients’ clinical outcomes. Exploratory evidence indicated that individuals from higher deprivation neighbourhoods may be over-represented in clinic referrals, and individuals from lower deprivation neighbourhoods may be under-represented, compared with local population distribution estimates.

Originality/value

This evaluation provides insights into treatment outcomes and deprivation in those with physical health difficulties. Further evaluation using a larger sample and comparing referrals with local prevalence estimates of comorbid mental and physical health problems would enable greater confidence in the conclusion that no evidence of inequality on the basis of neighbourhood deprivation was found.
The effect of microcrystalline cellulose (MCC) on coating paint film’s surface performance as non-stick coating
Authors: Sulaiman L. , Hazrin Z.H.Z. , Zakir N.I.M. , Halim N.A. , Rusdi R.A.A. , Khair A.S.A. , Tajuddin H.A.
Published: June 2020

Purpose

The effect of using microcrystalline cellulose (MCC) as an additive in coating paint films for non-stick coatings was studied in this work. This paper aims to discuss the benefits of MCC blended in the coating paint film that consists of poly(methyl methacrylate) (PMMA) and dammar.

Design/methodology/approach

PMMA and dammar mixed at a specific Wt.% ratio with xylene as its solvent. Two sets of mixtures were prepared, where one mixture contained MCC and another, without. The mixtures were applied to metal substrates as coating paint films. The performance of the non-stick coating paint film was observed through the adhesive test between adhesion layers on the coating paint film and also through the cross-hatch test for the adhesion of the non-stick coating paint film to the metal substrate. The results correlate with the surface roughness and glossiness tests.

Findings

The results showed that for the coating paint films, Sample B consisted of 80:20 Wt.% ratio of PMMA-dammar with an addition of 5 Wt.% MCC had an excellent performance as non-stick coating paint films. The MCC formed microparticles on the surface of the coating paint film sample and this causes the coating paint film samples with MCC to develop a rougher surface compared to the coating paint film without MCC. Sample B coating paint film had the highest average surface roughness (Ra) of 383 µm. The cross-hatch test showed the coating paint film with the addition of MCC had stronger adhesiveness on the substrate’s surface thus prevents the coating from peeling off from the surface.

Practical implications

The developed coating paint film in this study would be suitable for outdoor applications to prevent illegal advertisements and stickers.

Originality/value

MCC added to the coating paint film improves the surface performance as a non-stick coating.
The more the better? Rule growth and policy impact from a macro perspective
Authors: LIMBERG JULIAN , STEINEBACH YVES , BAYERLEIN LOUISA , KNILL CHRISTOPH
Published: June 2020

Do more rules improve overall policy performance? To answer this question, we look at rule growth in the area of environmental policy from an aggregate perspective. We argue that impactful growth in rules crucially depends on implementation capacities. If such capacities are limited, countries are at risk of ‘empty’ rule growth where they lack the ability to implement their ever‐growing stock of policies. Hence, rules are a necessary, yet not sufficient condition for achieving sectoral policy objectives. We underpin our argument with an analysis of the impact of a new, encompassing measure of environmental rule growth covering 13 countries from 1980 to 2010. These findings call for ‘sustainable statehood’ where the growth in rules should not outpace the expansion in administrative capacities.
The Estimation of Postmortem Serum Urea via the Ultrafiltration of Hemolyzed Blood
Authors: Jia Yuqing , Tian Meihui , Wang Tianqi , Wu Shuqin , Zhu Baoli , Cao Zhipeng
Published: June 2020

Postmortem serum urea has been demonstrated as an objective indicator for the forensic diagnosis of cause of death. However, samples used in postmortem biochemical analysis are always affected by hemolysis. To investigate whether hemolysis affects the biochemical analysis of urea and to explore the feasibility of using ultrafiltration to process hemolyzed blood samples, three different levels of hemolyzed blood samples were used to assess the influence of hemolysis on postmortem biochemical analysis of urea, and two ultrafiltration methods were used to process the hemolyzed blood samples. Bias% was used to assess the interference of hemolysis. Our results showed that heavy hemolysis had a significant influence on the biochemical analysis of urea. Both ultrafiltration methods in the present study could significantly reduce the interference of hemolysis, with the |bias%| of methods A and B decreasing from 69.74% ± 99.14% to 12.18% ± 7.23% and 10.77% ± 8.09%, respectively, compared to the original serum. After regression correction, there was no significant difference between the urea concentration in the ultrafiltrates of the two ultrafiltration methods and that in the original serum, which suggested that the postmortem serum urea concentration could be estimated by the corrected urea concentration in the ultrafiltrate. The current study also provided possible pretreatment methods for postmortem biochemical analysis of other biomarkers in hemolyzed blood samples of forensic practice.
Evaluation of Two New Methods for DNA Extraction of “Legal High” Plant Species
Authors: Ryan Angelique L. , O’Hern Cassandra P. , Elkins Kelly M.
Published: June 2020

A quick, simple, and high‐yield nucleic acid isolation process is crucial for high‐quality DNA analysis. The ability of the MicroGEM PDQeX phytoGEM system and Omega Bio‐tek E.Z.N.A.® Plant DS Mini kit to extract PCR‐ready DNA was evaluated by extracting the forensically relevant “legal high” plant species: Ipomoea purpurea, Artemisia absinthium, Mitragyna speciosa, Datura stramonium, and Papaver somniferum. The plant material was pulverized, processed using the manufacturer’s plant protocol for the PDQeX Nucleic Acid Extraction or the manufacturer’s protocol for the Omega extraction, quantified using the Invitrogen Qubit 2.0 Fluorometer, and analyzed for amplifiability by PCR using a Qiagen Rotor‐Gene Q instrument and published assays. The DNA amplicons for the legal high species produced high‐resolution melt curves concordant with the melts observed when DNA was isolated using the Qiagen DNeasy Plant Mini Kit in previous studies.
Oxycodone prescribing in the emergency department during the opioid crisis
Authors: Pouryahya Pourya , Birkett William , McR Meyer Alastair D , Louey Stephen , Belhadfa Miriam , Ferdousi Sapphire , Imperial Kimberly , Nguyen Phi , Wang Amber
Published: June 2020

Objective

Misuse of prescription opioids is a significant public health issue in Australia. There has been a rapid rise in prescription opioid use, with an associated increase in overdose and death. The over‐prescribing of oral opioids, especially oxycodone, in the ED has been identified as a contributor to this problem overseas. It is unclear if similar practice occurs in the Australian ED. The primary aim of our study was to identify the incidence of oral oxycodone administration to patients within the ED. The secondary outcome was to identify the incidence of oxycodone prescribed to patients on discharge from the ED into the community.

Methods

Our study was designed as an observational, retrospective data analysis of the incidence of oxycodone prescribed within the three EDs of a large Australian public health service. All immediate‐release (IR) and slow‐release (SR) oral oxycodone prescribed over a 4‐year period (2015–2018) was included.

Results

There were 890 557 presentations to the three EDs during the period, which resulted in 288 242 episodes of oxycodone administration within department, equivalent to 324 administrations per 1000 presentations. There were 39 381 prescriptions for oxycodone provided on discharge, resulting in an incidence of 44 prescriptions per 1000 discharged. The most frequently prescribed opioid medication in the ED was oxycodone IR 5 mg, 78.6% of discharge prescriptions generated provided a maximum quantity (20 for IR formulation or 28 for SR) of tablets allowable under the pharmaceutical benefits scheme.

Conclusions

There is a higher incidence of oxycodone prescribing in the Australian ED than previously recognised. An overuse of oxycodone may be contributing to adverse patient outcomes and a public health crisis. Hospitals should consider appropriate steps to reduce the incidence of opioid prescribing and the supply of these medications into the community.
Identification of G protein‐coupled receptors required for vitellogenesis and egg development in an insect with panoistic ovary
Authors: Zheng Hongyuan , Zeng Baojuan , Shang Tiantian , Zhou Shutang
Published: June 2020

G protein‐coupled receptors (GPCRs), a superfamily of integral transmembrane proteins regulate a variety of physiological processes in insects. Juvenile hormone (JH) is known to stimulate Vitellogenin (Vg) synthesis in the fat body, secretion into the hemolymph and uptake by developing oocytes. However, the role of GPCRs in JH‐dependent insect vitellogenesis and oocyte maturation remains elusive. In the present study, we performed transcriptomic analysis and RNA interference (RNAi) screening in vitellogenic females of the migratory locust Locusta migratoria. Of 22 GPCRs identified in ovarian transcriptome, LGR4, OR‐A1, OR‐A2, Mthl1, Mthl5 and Smo were most abundant in the ovary. By comparison, mAChR‐C expressed at higher levels in the fat body, whereas Oct/TyrR, OARβ, AdoR and ADGRA3 were at higher expression levels in the brain. Our RNAi screening demonstrated that knockdown of six GPCRs resulted in defective phenotypes of Vg accumulation in developing oocytes, accompanied by blocked ovarian development and impaired oocyte maturation. While LGR4 and Oct/TyrR appeared to control Vg synthesis in the fat body, OR‐A1, OR‐A2, mAChR‐C and CirlL regulated Vg transportation and uptake. The findings provide fundamental evidence for deciphering the regulatory mechanisms of GPCRs in JH‐stimulated insect reproduction.
Cone‐beam computed tomography guided unipedicular central stentoplasty of the thoracolumbar spine: Early technical experience and results
Authors: Huang Ivan Kuang Hsin , Pua Uei , Quek Lawrence Han Hwee , Kwan Justin , Lim Gavin Hock Tai
Published: June 2020

Introduction

An unipedicular vertebral body stenting technique, termed ‘central stentoplasty’, was developed at our institution. With this technique, a single vertebral body stent was deployed percutaneously in the midline of the vertebral body using cone‐beam computed tomography (CBCT) guidance.

Methods

From September 2013 to July 2015, forty‐four patients with fifty‐six vertebral bodies underwent central stentoplasty. All fractures were of osteoporotic, traumatic or malignant aetiology. Information on vertebral body deformity, pre‐ and post‐procedure sagittal index (SI), wedge angle (WA) and anterior vertebral height ratio was analysed. Two patients had combined ablation and stentoplasty for painful spinal metastases.

Results

There were 11 male and 33 female patients with mean age of 71.5 years (51–90 years). 19 fractured vertebral bodies had more than 30% loss of height. The mean pre‐procedure SI was 0.82, and the mean post‐procedure SI was 0.90. The pre‐procedure WA was −5.56° compared with post‐procedure mean WA of −3.47°. The mean pre‐procedure segmental kyphosis was −4.58°, and the mean post‐procedure segmental kyphosis was −1.46°. Six cases had minimal cement leak, and two cases had a haematoma at the puncture site. None of the patients underwent revision surgery, and postoperative neurological sequelae were not observed.

Conclusion

‘Central stentoplasty’ is a promising percutaneous vertebral fracture augmentation technique, which is shown to have low complication rates in the treatment of spinal compression fractures or metastases. However, long‐term results need to be further evaluated.
Geriatric fragility fractures are associated with a human skeletal stem cell defect
Authors: Ambrosi Thomas H. , Goodnough L. Henry , Steininger Holly M. , Hoover Malachia Y. , Kim Emiley , Koepke Lauren S. , Marecic Owen , Zhao Liming , Seita Jun , Bishop Julius A. , Gardner Michael J. , Chan Charles K. F.
Published: June 2020

Fragility fractures have a limited capacity to regenerate, and impaired fracture healing is a leading cause of morbidity in the elderly. The recent identification of a highly purified bona fide human skeletal stem cell (hSSC) and its committed downstream progenitor cell populations provides an opportunity for understanding the mechanism of age‐related compromised fracture healing from the stem cell perspective. In this study, we tested whether hSSCs isolated from geriatric fractures demonstrate intrinsic functional defects that drive impaired healing. Using flow cytometry, we analyzed and isolated hSSCs from callus tissue of five different skeletal sites (n = 61) of patients ranging from 13 to 94 years of age for functional and molecular studies. We observed that fracture‐activated amplification of hSSC populations was comparable at all ages. However, functional analysis of isolated stem cells revealed that advanced age significantly correlated with reduced osteochondrogenic potential but was not associated with decreased in vitro clonogenicity. hSSCs derived from women displayed an exacerbated functional decline with age relative to those of aged men. Transcriptomic comparisons revealed downregulation of skeletogenic pathways such as WNT and upregulation of senescence‐related pathways in young versus older hSSCs. Strikingly, loss of Sirtuin1 expression played a major role in hSSC dysfunction but re‐activation by trans‐resveratrol or a small molecule compound restored in vitro differentiation potential. These are the first findings that characterize age‐related defects in purified hSSCs from geriatric fractures. Our results provide a foundation for future investigations into the mechanism and reversibility of skeletal stem cell aging in humans.
Bidirectional effects between loneliness, smoking and alcohol use: evidence from a Mendelian randomization study
Authors: Wootton Robyn E. , Greenstone Harriet S. R. , Abdellaoui Abdel , Denys Damiaan , Verweij Karin J. H. , Munafò Marcus R. , Treur Jorien L.
Published: June 2020

Background and Aims

Loneliness is associated with cigarette smoking and problematic alcohol use. Observational evidence suggests these associations arise because loneliness increases substance use; however, there is potential for reverse causation (problematic drinking damages social networks, leading to loneliness). With conventional epidemiological methods, controlling for (residual) confounding and reverse causality is difficult. This study applied Mendelian randomization (MR) to assess bidirectional causal effects among loneliness, smoking behaviour and alcohol (mis)use. MR uses genetic variants as instrumental variables to estimate the causal effect of an exposure on an outcome, if the assumptions are satisfied.

Design

Our primary method was inverse‐variance weighted (IVW) regression and the robustness of these findings was assessed with five different sensitivity methods.

Setting

European ancestry.

Participants

Summary‐level data were drawn from the largest available independent genome‐wide association studies (GWAS) of loneliness (n = 511 280), smoking (initiation (n = 249 171), cigarettes per day (n = 249 171) and cessation (n = 143 852), alcoholic drinks per week (n = 226 223) and alcohol dependence (n = 46 568).

Measurements

Genetic variants predictive of the exposure variable were selected as instruments from the respective GWAS.

Findings

There was weak evidence of increased loneliness leading to higher likelihood of initiating smoking, smoking more cigarettes, and a lower likelihood of quitting smoking. Additionally, there was evidence that initiating smoking increases loneliness [IVW, β = 0.30, 95% confidence interval (CI) = 0.22–0.38, P = 2.8 × 10−13]. We found no clear evidence for a causal effect of loneliness on drinks per week (IVW, β = 0.01, 95% CI = −0.11, 0.13, P = 0.865) or alcohol dependence (IVW, β = 0.09, 95% CI = −0.19, 0.36, P = 0.533) nor of alcohol use on loneliness (drinks per week IVW, β = 0.09, 95% CI = −0.02, 0.22, P = 0.076; alcohol dependence IVW, β = 0.06, 95% CI = −0.02, 0.13, P  =  0.162).

Conclusions

There appears to be tentative evidence for causal, bidirectional, increasing effects between loneliness and cigarette smoking, especially for smoking initiation increasing loneliness.
Theileria orientalis Ikeda genotype infection associated with anaemia, abortion and death in beef cattle in Western Australia
Authors: Forshaw D , Alex SM , Palmer DG , Cotter J , Roberts WD , Jenkins C , Hair S
Published: June 2020

Background

Theileria orientalis infection causes a clinical syndrome in cattle characterised by weakness, reluctance to walk, anaemia, jaundice and death in peri‐parturient cows and young calves, referred to as bovine anaemia caused by Theileria orientalis group (BATOG). Abortions in pregnant cows are also reported. Pallor, pyrexia and elevated heart and respiratory rates are typical findings on physical examination.

Case Report

A syndrome of abortions, lethargy, inappetence, jaundice and deaths in beef cattle on two separate properties and a separate cluster of three properties within 15 km west of the town of Denmark in Western Australia was associated with the presence of severe regenerative anaemia and the presence of Theileria orientalis Ikeda genotype in blood samples taken from affected cattle and their cohorts. A diagnosis of bovine anaemia caused by the T. orientalis group was based on consistent clinical, haematological, biochemical and PCR findings. Conventional PCR testing detected only the T. orientalis Ikeda type. On the two properties where it was investigated, quantitative PCR testing for parasite load was suggestive of recent infections. Sequencing of T. orientalis major piroplasm surface protein gene PCR products demonstrated that they were identical to those from similar bovine cases in New South Wales.

Conclusion

The clinical history of affected cattle and the biochemical, haematological and PCR findings were consistent with bovine anaemia caused by the T. orientalis Ikeda genotype. This clinical syndrome had not been recognised in Western Australia before this series of cases.
Renin‐angiotensin system blockade modulates both the peripheral and central components of neuropathic pain in rats: Role of calcitonin gene–related peptide, substance P and nitric oxide
Authors: Hegazy Nora , Rezq Samar , Fahmy Ahmed
Published: June 2020

Nonetheless, renin‐angiotensin‐aldosterone system (RAAS) blockers attenuate neuropathic pain (NP), the exact molecular mechanisms of this effect are not completely understood. The study aimed to investigate the role of calcitonin gene–related peptide (CGRP), substance P (SP) and nitric oxide (NO), which are all involved in pain modulation, in the analgesic effect of different RAAS blockers in NP both on the peripheral and on the central levels. NP was induced by sciatic nerve chronic constriction injury (CCI, 14 days) in rats, that were given either centrally (telmisartan and ramipril) or peripherally (losartan and enalapril) acting angiotensin‐converting enzyme inhibitors (ACE‐Is) or angiotensin receptor blockers (ARBs). Behavioural assessment was performed, and CGRP, SP and NO levels were detected in the injured sciatic nerve and the brainstem at the end of experiment. CCI rats showed increased spontaneous pain response and foot deformity along with elevated CGRP, SP and NO levels. ARBs and ACE‐Is treatment improved pain behaviour and reduced SP and NO levels. However, sciatic CGRP was increased with different interventions and brainstem CGRP was only elevated in the losartan group. These findings suggest an intermediary role of CGRP, SP and NO in RAAS blockers analgesic effect in NP.
Moody and thin‐skinned? The interplay of neuroticism and momentary affect in older romantic couples
Authors: Mueller Swantje , Wagner Jenny , Hueluer Gizem , Hoppmann Christiane A. , Ram Nilam , Gerstorf Denis
Published: June 2020

Neuroticism is associated with heightened reactivity to social stressors. However, little is known about the micro‐processes through which neuroticism shapes – and is shaped by – affective experiences in close relationships. We examine the extent to which momentary affect is coupled with one’s relationship partner, whether the strength of this coupling differs depending on levels of neuroticism, and whether this coupling and partner’s overall level of positive or negative affect prospectively contribute to differential (rank‐order) changes in neuroticism. Older couples (N = 82, aged 67–93 years) rated their momentary affect six times per day for one week and provided ratings of trait neuroticism at baseline and 18 months later. Multilevel models revealed that among individuals high in neuroticism, individual positive affect was more closely coupled with partner positive affect compared with individuals low in neuroticism. Moreover, neuroticism decreased over time in those participants who showed a higher degree of coupling with partner positive affect and also had a partner with higher overall positive affect. In contrast, neuroticism increased in individuals whose partner had lower overall positive affect. Similar effects were not observed for negative affect. Our findings highlight how relationship partners contribute to daily affective experiences and longer‐term changes in neuroticism.
Risk factors of local recurrence after surgery in extraabdominal desmoid‐type fibromatosis: A multicenter study in Japan
Authors: Nishida Yoshihiro , Hamada Shunsuke , Kawai Akira , Kunisada Toshiyuki , Ogose Akira , Matsumoto Yoshihiro , Ae Keisuke , Toguchida Junya , Ozaki Toshifumi , Hirakawa Akihiro , Motoi Toru , Sakai Tomohisa , Kobayashi Eisuke , Gokita Tabu , Okamoto Takeshi , Matsunobu Tomoya , Shimizu Koki , Koike Hiroshi
Published: June 2020

This study was undertaken to clarify the risk factors, including the mutation status of CTNNB1, for the local recurrence after surgery of the rare disease desmoid‐type fibromatosis. It was designed as a multiinstitutional joint research project with 7 major centers in Japan participating. The committee members of 7 major medical centers specializing in bone and soft tissue tumors formed this study group to develop clinical care guidelines. Of 196 cases with specimens and medical records collected from the 7 institutions, 88 surgically treated ones were analyzed regarding clinicopathologic prognostic factors including CTNNB1 mutation status. Excluding R2 cases (n = 3), 5‐year local recurrence‐free survival (LRFS) was 52.9%. No case had received pre‐ or postoperative radiotherapy. Univariate analysis revealed that extremity location (P < .001) and larger size (8 cm or more, P = .036) were significant adverse risk factors for LRFS. Multivariate analysis indicated that extremity location (P < .001) was a significantly adverse factor in addition to recurrent tumor (P = .041), S45F mutation (P = .028), and R1 surgical margin (P = .039). Preoperative drug treatment, including nonsteroidal antiinflammatory drugs, did not reduce the incidence of local recurrence (P = .199). This is the first study to analyze the factors correlating with outcomes of surgical treatment, including CTNNB1 mutation status, in a relatively large number of cases from an Asian country. Tumor location was found to be the most influential prognostic factor for local recurrence, similar to the results from Europe and North America. The development of more sensitive method(s) for determination of CTNNB1 mutation is a priority for future study.
Ubiquitin C‐terminal hydrolase L1 promotes expression of programmed cell death‐ligand 1 in non‐small‐cell lung cancer cells
Authors: Mao Rudi , Tan Xiao , Xiao Ying , Wang Xinyu , Wei Zhixing , Wang Jianing , Wang Xiaoyan , Zhou Huaiyu , Zhang Lining , Shi Yongyu
Published: June 2020

Programmed cell death‐ligand 1 (PD‐L1) expressed on cancer cells can cause immune escape of non‐small‐cell lung cancer (NSCLC). Elucidation of the regulatory mechanisms of the PD‐L1 expression is a prerequisite for establishing new tumor immunotherapy strategies. Ubiquitin C‐terminal hydrolase L1 (UCHL1) is a regulator of cellular signaling transduction that is aberrantly expressed in NSCLC. However, it is not known whether UCHL1 regulates the expression of PD‐L1 in NSCLC cells. In the present study, we found that UCHL1 promotes the expression of PD‐L1 in NSCLC cell lines. In addition, UCHL1 expressed in NSCLC cells inhibited activation of Jurkat cells through upregulation of PD‐L1 expression in in vitro experiments. Moreover, UCHL1 upregulates PD‐L1 expression through facilitating activation of the AKT‐P65 signaling pathway. In conclusion, these results indicated that UCHL1 promoted PD‐L1 expression in NSCLC cells. This finding implied that inhibition of UCHL1 might suppress immune escape of NSCLC through downregulation of PD‐L1 expression in NSCLC cells.
Soluble Vegfr3 gene therapy suppresses multi‐organ metastasis in a mouse mammary cancer model
Authors: Shibata Masa‐Aki , Shibata Eiko , Tanaka Yoshihisa , Shiraoka Chinatsu , Kondo Yoichi
Published: June 2020

Accumulating evidence on the association of VEGF‐C with lymphangiogenesis and lymph node metastasis implicates lymphatic vessels as a potential target in anti‐cancer therapy. To evaluate whether blocking VEGF‐C and VEGFR‐3 signaling can inhibit multi‐organ metastases, a mouse metastatic mammary cancer model was subjected to gene therapy using a soluble VEGFR‐3 expression vector (psVEGFR‐3). We showed that psVEGFR‐3 significantly diminished cell growth in vitro with or without added VEGF‐C, and significantly reduced primary tumor growth and tumor metastases to wide‐spectrum organs in vivo. Although apoptotic cell death and angiogenesis levels did not differ between the control and psVEGFR‐3 groups, cell proliferation and lymphangiogenesis in the mammary tumors were significantly decreased in the psVEGFR‐3 group. Furthermore, lymphatic vessel invasion was significantly inhibited in this group. Real‐time RT‐PCR analysis revealed significantly high expression of the Vegfr3 gene due to gene therapy, and the transcriptional levels of Pcna and Lyve1 tended to decrease in the psVEGFR‐3 group. Immunofluorescence staining indicated that phospho‐tyrosine expression was considerably lower in tumor cells of psVEGFR‐3‐treated mammary carcinomas than those of control tumors. Double immunofluorescence staining indicated that phospho‐tyrosine+/LYVE‐1+ (a lymphatic vessel marker) tended to decrease in psVEGFR‐3‐treated mammary carcinomas compared with control mice, indicating a decline in the activity of the VEGF‐C/VEGFR‐3 axis. These findings showed that a blockade of VEGF‐C/VEGFR‐3 signaling caused by sVEGFR‐3 sequestered VEGF‐C and prevented the side‐effects of anti‐angiogenesis and suppressed overall metastases, suggesting their high clinical significance.
Hoof kinetic patterns differ between sound and laminitic horses
Authors: Al Naem Mohamad , Litzke Lutz‐Ferdinand , Failing Klaus , Burk Janina , Röcken Michael
Published: June 2020

Background

No kinetic data on hoof loading in laminitic horses are available, despite their importance for optimising supportive shoeing therapies.

Objectives

To quantify the load distribution pattern in laminitic and sound horses.

Study design

Controlled observational study.

Methods

Fifty‐four sound and laminitic horses were assigned to three groups: control group (sound horses), group 1 (G1) horses with acute laminitis, evaluated immediately after acute clinical signs subsided, and group 2 (G2) horses that had been free of acute laminitis signs for 6‐12 weeks. Measurements on both forelimbs in barefoot condition were performed during walk using the Hoof™ System. Kinetic parameters were recorded and compared between hoof regions and groups using covariance analyses and t tests (P < .05).

Results

Peak loading in the toe region occurred during midstance phase in control group, but during break‐over in laminitic horses. This is reflected by the time to peak vertical force in the toe, which was significantly shorter in the control group compared to laminitic horses (G1 and G2) (76% ± 6% vs 89% ± 9 [P = .002], 86% ± 7 [P = .001] of stance duration respectively). The relative vertical force in the toe in the control group (46% ± 7%) was significantly higher compared to laminitic horses (G1: 29% ± 9% [P = .001]; G2: 32% ± 10% [P = .003]). The main shift of the load occurred between toe and middle hoof regions in laminitic horses as compared with the control group. No significant differences were found between G1 and G2.

Main limitations

Measurements were not obtained in horses with acute laminitis on admission, to avoid risk of further damage to the lamellae.

Conclusions

Supportive therapy in laminitis should focus on supporting both caudal and middle hoof areas to decrease the peak pressure in these regions, and ease break‐over during which the maximal loading of the toe occurs.
Rab family of small GTPases: an updated view on their regulation and functions
Authors: Homma Yuta , Hiragi Shu , Fukuda Mitsunori
Published: June 2020

The Rab family of small GTPases regulates intracellular membrane trafficking by orchestrating the biogenesis, transport, tethering, and fusion of membrane‐bound organelles and vesicles. Like other small GTPases, Rabs cycle between two states, an active (GTP‐loaded) state and an inactive (GDP‐loaded) state, and their cycling is catalyzed by guanine nucleotide exchange factors (GEFs) and GTPase‐activating proteins (GAPs). Because an active form of each Rab localizes on a specific organelle (or vesicle) and recruits various effector proteins to facilitate each step of membrane trafficking, knowing when and where Rabs are activated and what effectors Rabs recruit is crucial to understand their functions. Since the discovery of Rabs, they have been regarded as one of the central hubs for membrane trafficking, and numerous biochemical and genetic studies have revealed the mechanisms of Rab functions in recent years. The results of these studies have included the identification and characterization of novel GEFs, GAPs, and effectors, as well as post‐translational modifications, for example, phosphorylation, of Rabs. Rab functions beyond the simple effector‐recruiting model are also emerging. Furthermore, the recently developed CRISPR/Cas technology has enabled acceleration of knockout analyses in both animals and cultured cells and revealed previously unknown physiological roles of many Rabs. In this review article, we provide the most up‐to‐date and comprehensive lists of GEFs, GAPs, effectors, and knockout phenotypes of mammalian Rabs and discuss recent findings in regard to their regulation and functions.
Dynamic changes in American lobster suitable habitat distribution on the Northeast U.S. Shelf linked to oceanographic conditions
Authors: Mazur Mackenzie D. , Friedland Kevin D. , McManus M. Conor , Goode Andrew G.
Published: June 2020

American lobster (Homarus americanus) supports one of the most valuable regional fisheries in the United States, with its abundance and distribution profoundly influenced by environmental conditions. To explain how lobster distribution has changed over time and assess the role of environmental variables on these changes, we used random forest classification and regression tree models to estimate occupancy and biomass in two seasonal periods. The occupancy models were fit to static and dynamic variables, which yielded model fits with AUC scores of 0.80 and 0.78 for spring and fall, respectively. Biomass models were fit with the same data and resulted in models explaining 61% and 63% of the spring and fall biomass variance, respectively. Significant variables scored in the formation of the regression trees were secondary productivity (i.e., zooplankton), bathymetry characteristics, and temperature. American lobster suitable habitat has changed regionally; habitat has increased in the Gulf of Maine and declined in Southern New England. There is also evidence of declining habitat along the inshore margin of the Gulf of Maine, which has been accompanied by a shift in occupancy probability offshore. Habitat suitability results from the random forest models provide insights on the structure and function of lobster habitat and context to understand recent population trends.
Looking into digestive mixed neuroendocrine – nonneuroendocrine neoplasms: subtypes, prognosis, and predictive factors
Authors: Uccella Silvia , La Rosa Stefano
Published: June 2020

Mixed neuroendocrine – nonneuroendocrine neoplasms (MiNENs) of the digestive system represent a challenge for both pathologists and clinicians. Their nomenclature has changed several times, and their diagnostic criteria, classification and clinical behaviour have been matter of debate over the years. Although several attempts have been made to elucidate the pathogenesis and biology of MiNENs, some issues remain open. This review will provide: a historical background that helps in understanding the evolution of the concept and nomenclature of mixed neoplasms; a revision of the knowledge on this topic, including molecular aspects, to give the reader a comprehensive and practical overview on this challenging field of pathology; a focus on the diagnostic criteria and on the determination of prognostic and predictive factors; and a description of the different tumour types in the different sites of origin.
Hemoglobin‐bound platelets correlate with the increased platelet activity in hemoglobin E/β‐thalassemia
Authors: Chamchoi Attaphon , Srihirun Sirada , Paiboonsukwong Kittiphong , Sriwantana Thanaporn , Kongkaew Peerawich , Fucharoen Suthat , Pattanapanyasat Kovit , Sibmooh Nathawut
Published: June 2020

Introduction

An increase in platelet activity is a contributing factor to vascular complications in hemoglobin E/β‐thalassemia (HbE/β‐thal). Plasma‐free hemoglobin (Hb) increases in HbE/β‐thal patients and correlates with platelet activation, but the levels of Hb‐bound platelets have never been reported. In this study, we aimed to investigate the levels of Hb‐bound platelets and its association with platelet activity in HbE/β‐thal patients.

Methods

Hb‐bound platelets were measured by flow cytometry in 22 healthy subjects and 26 HbE/β‐thal patients (16 nonsplenectomized and 10 splenectomized HbE/β‐thal patients). Plasma Hb was measured by the chemiluminescence method based on the consumption of nitric oxide (NO) by Hb. Expression of P‐selectin and activated glycoprotein (aGP) IIb/IIIa on platelets was measured by flow cytometry as a marker of platelet activity.

Results

Both nonsplenectomized and splenectomized HbE/β‐thal patients had higher levels of Hb‐bound platelets and plasma Hb than healthy subjects. In vitro incubation of dialyzed Hb from patients with platelets of healthy subjects caused an increase in Hb‐bound platelets, which was partially inhibited by anti‐GPIbα antibody. Plasma Hb positively correlated with Hb‐bound platelets. Platelet P‐selectin expression at baseline and in response to adenosine diphosphate (ADP, 1 µM) stimulation was higher in nonsplenectomized and splenectomized HbE/β‐thal patients than healthy subjects. The ADP‐induced aGPIIb/IIIa expression on platelets was also higher in HbE/β‐thal patients than healthy subjects. Hb‐bound platelets correlated with baseline P‐selectin expression and ADP‐induced P‐selectin expression.

Conclusion

HbE/β‐thal patients have increased Hb‐bound platelets, which is associated with increased baseline platelet activation and reactivity.
Investigation burden for patients with fibrotic interstitial lung disease at the end of life
Authors: Guo Hui , Mann Jennifer , Goh Nicole , Smallwood Natasha
Published: June 2020

Fibrotic interstitial lung disease (f‐ILD) has a guarded prognosis, and the goal of therapy in advanced‐stage disease should be symptom‐based. Despite this, patients may still undergo burdensome investigation at the end of life. A retrospective audit was performed on 67 patients who died from f‐ILD at the Royal Melbourne and Austin Hospitals between 2012 and 2016. Increased investigation burden was associated with lack of outpatient palliative care referral and documented advance care plan, and admission to a high‐dependency unit. Eighteen per cent of patients underwent ongoing investigations after the institution of comfort care. These findings highlight the unmet end‐of‐life care needs of people with f‐ILD.
Complicated skin and soft tissue infections in remote indigenous communities
Authors: Thomas Lauren , Bowen Asha C. , Tong Steven Y. C.
Published: June 2020

The burden and consequences of skin infections for remote living indigenous people are high. While skin infections are recognised as an antecedent to conditions such as acute rheumatic fever in children, data are limited concerning skin infection complications such as cellulitis, abscesses and osteomyelitis in older children and adults. In a 1‐year retrospective audit of 439 patients presenting to two remote health clinics, 330/439 (75%) patients presented with a skin infection and 18 (4%) developed a complication.
Don't forget shared decision‐making in the COVID‐19 crisis
Authors: Simpson Nicholas , Milnes Sharyn , Steinfort Daniel
Published: June 2020

Mechanical ventilation as a resource is limited and may lead to poor outcomes in at‐risk populations. Critical care supports may not be preferred by those at risk of deterioration in the COVID‐19 setting. Patient‐centred communication and shared decision‐making should continue to remain central to clinical practice.
To Work or Not to Work? The Effect of Higher Pension Age on Cardiovascular Health
Authors: Ardito Chiara , Leombruni Roberto , Blane David , d’Errico Angelo
Published: June 2020

This study investigates the effect of pension age on hospitalization for cardiovascular diseases using administrative social security and hospital discharge records in Italy. The endogeneity of the retirement decision is addressed using an instrumental variable strategy exploiting the exogenous variation in pension age determined by quarter of birth. Results indicate a detrimental effect of higher pension age only for retirees who, before retirement, were suffering worse health and were employed in lower quality and more physically demanding jobs. Among them, a 1‐year delay in pension claiming increases the risk of hospitalization for cardiovascular diseases by approximately 2.6 percentage points.
The critical points of production rate under vendor–buyer coordination: explicit solutions
Authors: David Israel , Herbon Avi
Published: June 2020

This paper revisits the deterministic joint vendor–buyer production‐inventory problem and assumes that the production rate can be controlled. To guard against unwarranted extreme solutions, such as too abrupt production or, on the other hand, everlasting production aligned with demand, we place lower and upper bounds on the production rate. In addition, we incorporate an independent upper bound on the overall cycle of producing and remaining idle. Through identifying several critical points of the production rate, we solve the resulting problem for the optimal triplet (P, Q, n), where P is the constant production rate, a key decision variable, Q is the entire lot size produced in a cycle, and n is the number of equal successive shipments of this lot to the buyer. Our own treatment is purely analytical, which adds value from a theoretical perspective. Worst values of the production rate, when the other decision values are optimal for P, are found. We prove that only two production rates, the lowest and the highest, can yield minimal joint costs, and we identify which of the two is optimal under given relative positions of the defined critical points. Numerical illustration indicates that the joint cost sharply increases for small values of the bound on the overall cycle length. This study highlights the importance of solving variants of the suggested model and of developing managerial alternatives that relax this constraint as much as possible.
A Q‐methodology study of the type of support mentors need when assessing underperforming nursing students
Authors: Gronvik Cecilie K. U. , Hauge Kari W.
Published: June 2020

Aims

To identify and describe patterns of the shared viewpoints of nurse mentors about the support obtained from link lecturer in assessing underperforming students.

Design

Non‐experimental, exploratory research design.

Methods

Q‐methodology was applied to explore the viewpoints of 26 mentors about support. The data were collected from May–September 2018. During the development of the Q‐set, we combined a naturalistic and theoretical approach, resulting in 27 statements. The participants ranked statements into a Q‐sort grid. PQ‐Method 2.35 software was used to perform a principal component analysis to identify different patterns of the mentors' viewpoints.

Results

Five factors of shared viewpoints, which accounted for 62% of the total variance, were derived from the factor analysis: (a) Confident in professional assessment and expects respect from link lecturer; (b) confident about the limit but need guidance in documentation. (c) Confident in the assessment but need support to manage concerns; (d) require knowledge and skills but not emotional support; and (e) dialogue and collaboration rather than information.

Conclusions

Based on our findings, all mentors need different types of support from the link lecturer, depending on their experience as a mentor and nurse and educational credits in mentorship. The central principle identified in this study was that mentors need to feel secure in their role. The accessibility, approachability, and willingness of the link lecturer to participate in dialogue and collaboration are important, but emotional support is not.

Impact

Our findings provide insights into the type of support mentors need when assessing underperforming students. The findings highlight the necessity of a link lecturer who is accessible and is meeting the mentors' need for knowledge and skills about assessment and mentoring. The nurse education programme must prioritize resources to ensure that the link lecturer can follow‐up with the student and the mentor.
Decision‐making among the substitute decision makers in intensive care units: An investigation of decision control preferences and decisional conflicts
Authors: Wu Feixia , Zhuang Yiyu , Chen Xiangping , Wen Huan , Tao Wenwen , Lao Yuewen , Zhou Hongchang
Published: June 2020

Aims

To explore decision control preferences and decisional conflicts and to analyse their association among the surrogate decision makers in the intensive care unit.

Design

The study carried out a cross‐sectional survey among the surrogates.

Methods

The participants were 115 surrogate decision makers of critical patients, from August to September 2019. A Chi‐squared test and logistic regression were used to assess decision control preferences and decisional conflicts, and Spearman's rank correlation coefficient was employed to examine their association.

Results

Of the 115 surrogate decision makers, 51.3% preferred a collaborative role, and 63.48% were somewhat unsure about making decisions. Logistic regression analysis identified decision control preferences was associated with surrogates’ age, education level, and personality traits, while decisional conflicts was associated with surrogates’ age, education level, character, medical expense burden, and Acute Physiology and Chronic Health Evaluation‐II score. Cohen's kappa statistics showed a bad concordance of decision‐making expectations and actuality, with kappa values of 0.158 (p < .05). Wherein surrogates who experienced discordance between their preferred and actual roles, have relatively higher decisional conflicts.

Conclusion

This study identified individual differences of surrogate decision makers in decision control preferences and decisional conflicts. These results imply that incorporation of the individual decision preferences and communication styles into care plans is an important first step to develop high quality decision support.

Impact

This research is a contribution to the limited study on decision control preferences and decisional conflicts among surrogate decision makers of critically ill patients. Moreover based on the investigation of understanding the status and related factors of decision preferences and decisional conflicts set the stage for developing effective decision support interventions.
Thriving with Down syndrome: A qualitative multiple case study
Authors: Thompson Talia , Talapatra Devadrita , Hazel Cynthia E. , Coleman Jeanine , Cutforth Nicholas
Published: June 2020

Background

Down syndrome (DS) is the most common genetic cause of intellectual disability. Prior research has primarily focused on associated medical problems and skill deficits. This study takes a novel positive psychology approach by examining critical individual characteristics and environmental factors that facilitate exceptional quality of life for people with DS.

Method

A qualitative multiple case study design was used to document the lives of four adults thriving with DS. Thriving was defined as high subjective well‐being coupled with continued personal development.

Results

Descriptive contexts were provided for each case along with four overarching themes: a supportive social ecology, high expectations for independence, advocacy, and strengths facilitating happiness. A new conceptual framework for understanding thriving with DS was proposed.

Conclusions

These findings provide insight as to what is possible for people with DS, including ideas for future research and practice to promote thriving in the DS population.