bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposure to Amoxicillin in Early Life Is Associated With Changes in Gut Microbiota and Reduction in Blood Pressure: Findings From a Study on Rat Dams and Offspring
Authors: Galla Sarah , Chakraborty Saroj , Cheng Xi , Yeo Ji‐Youn , Mell Blair , Chiu Nathaline , Wenceslau Camilla F. , Vijay‐Kumar Matam , Joe Bina
Published: January 2020

Background

Pediatric hypertension is recognized as an emerging global health concern. Although new guidelines are developed for facilitating clinical management, the reasons for the prevalence of hypertension in children remain unknown. Genetics and environmental factors do not fully account for the growing incidence of pediatric hypertension. Because stable bacterial flora in early life are linked with health outcomes later in life, we hypothesized that reshaping of gut microbiota in early life affects blood pressure (
BP
) of pediatric subjects.

Methods and Results

To test this hypothesis, we administered amoxicillin, the most commonly prescribed pediatric antibiotic, to alter gut microbiota of young, genetically hypertensive rats (study 1) and dams during gestation and lactation (study 2) and recorded their
BP
. Reshaping of microbiota with reductions in Firmicutes/Bacteriodetes ratio were observed. Amoxicillin treated rats had lower
BP
compared with untreated rats. In young rats treated with amoxicillin, the lowering effect on
BP
persisted even after antibiotics were discontinued. Similarly, offspring from dams treated with amoxicillin showed lower systolic
BP
compared with control rats. Remarkably, in all cases, a decrease in
BP
was associated with lowering of Veillonellaceae, which are succinate‐producing bacteria. Elevated plasma succinate is reported in hypertension. Accordingly, serum succinate was measured and found lower in animals treated with amoxicillin.

Conclusions

Our results demonstrate a direct correlation between succinate‐producing gut microbiota and early development of hypertension and indicate that reshaping gut microbiota, especially by depleting succinate‐producing microbiota early in life, may have long‐term benefits for hypertension‐prone individuals.
The Ups and Downs of Head Displacement
Authors: Arregi Karlos , Pietraszko Asia
Published: January 2020

We propose a theory of head displacement that replaces traditional Head Movement and Lowering with a single syntactic operation of Generalized Head Movement. We argue that upward and downward head displacement have the same syntactic properties: cyclicity, Mirror Principle effects, feeding upward head displacement, and being blocked in the same syntactic configurations. We also study the interaction of head displacement and other syntactic operations, arguing that claimed differences between upward and downward displacement are either spurious or follow directly from our account. Finally, we show that our theory correctly predicts the attested crosslinguistic variation in verb and inflection doubling in predicate clefts.
Taxonomic assessment of two pygopodoid gecko subspecies from Western Australia
Authors: Kealley Luke , Doughty Paul , Edwards Danielle , Brennan Ian G.
Published: January 2020

Subspecies designations for herpetofauna in Western Australia were largely coined in the 20th century where rigorous evolutionary concepts to species were not consistently applied. Rather, subspecies tended to designate geographic populations of similar-looking taxa to nominate forms, usually differing in size, pattern or colour and, at best, a few scalation differences. Here we re-evaluate two pygopodoid taxa from Western Australia using a combination of published and original genetic data coupled with a reassessment of morphology. We review these differences in light of an integrative taxonomic approach that looks to find multiple independent lines of evidence to establish the evolutionary independence of populations. For the pygopod species Pletholax gracilis, we found consistent diagnostic characters (e.g. body size, visibility of ear opening, scalation) and a deep genetic divergence between the two subspecies. We therefore raise each subspecies to full species: P. gracilis and P. edelensis. The two subspecies of the carphodactylid gecko Nephrurus wheeleri were also assessed, and we found strong genetic and morphological evidence (e.g. body size, scalation, pattern) to raise these to full species: N. wheeleri and N. cinctus. By revisiting Storr’s morphological insights and newly acquired genetic evidence, in addition to a thorough re-examination of morphological traits, our study provides a robust foundation to raise Storr’s morphological subspecies into full species based upon multiple lines of evidence. Such an approach applied to other subspecies in the Australian herpetofauna also may result in revised taxonomies.
Active vibration control of a rotor-bearing-actuator system using robust eigenvalue placement method
Authors: Lai Tao , Liu Junfeng
Published: January 2020

In order to improve the vibration responses of rotor system, this paper presents an active vibration control technique for a rotor-bearing-actuator system with the use of robust eigenvalue placement method. By analyzing the characteristics of the piezoelectric stack actuator, bearing and rotor, a rotor-bearing-actuator system is modeled. Based on this dynamical model, a reduced-order technique is used to establish the state equation in the modal space. A robust eigenvalue placement method, which can enhance the robustness of system to model error and uncertain factors by optimizing the close-loop eigenmatrix with a small condition number, is proposed to carry out the active vibration control for system. The good results indicate that the eigenvalue can be placed to precise position, and the displacement responses get effectively suppressed with the proposed method. Meanwhile, the optimized close-loop eigenmatrix can possess a small condition number, which means the system has achieved excellent robustness.
A new hydraulic synchronous scheme in open-loop control: Load-sensing synchronous control
Authors: Ding Haigang , Liu Yongzhuang , Zhao Yanbin
Published: January 2020

At present, open-loop synchronous control for hydraulic systems widely using synchronous valves has low synchronous accuracy due to weak anti-bias capacity, and is hard to adjust synchronization velocity, so it could not meet the requirements of accurate synchronization under severe conditions. In this paper, a load-sensing synchronous control is developed to obtain accurate synchronization in open-loop control, which is made up of a load-sensing unit and a synchronous valve. In the load-sensing loop, a load-sensing pump supplies pressure and flow required by the system through pressure closed-loop control, and a load-sensing valve could improve the capability of anti-offset loads by pressure compensation. The synchronous valve is between the load-sensing pump and load-sensing valve, to achieve equal distribution of flow supplied by the pump, which could improve the divider accuracy of the load-sensing system. A test system within load-sensing synchronous control is established, and then comparison experiments under different partial loads are carried out. The experimental results show that, compared with the traditional synchronous valve control, the load-sensing synchronous control has the advantages of higher synchronous precision, higher energy efficiency and also the ability of velocity regulation. Load-sensing synchronous control has the potential of high precision synchronization control in server environments.
Open for business: The impact of creative team environment and innovative behaviour in technology-based start-ups
Authors: Zhou Zhao , Verburg Robert
Published: January 2020

Rather than the view of the entrepreneur as a ‘lone ranger’, recent work has focused on the importance of teams in bringing a start-up to growth and success. Here, we aim to bridge the gap between the individual characteristics of entrepreneurs and the characteristics of their teams by examining openness of founders in relation to creative team environment (CTE), innovative work behaviour (IWB) and performance. On the basis of upper echelon theory and integrating other complementary theories such as the attention-based view, we develop a theoretical framework and test this using a survey of 322 high-tech entrepreneurs. Our findings suggest a mediating role of CTE and IWB in the relation between openness of entrepreneurs and performance. The implications of the results for managerial practices and future research directions are discussed.
Diagnostic performance of whole-lesion apparent diffusion coefficient histogram analysis metrics for differentiating benign and malignant breast lesions: a systematic review and diagnostic meta-analysis
Authors: Xu Fan , Liang Ying-ying , Guo Yuan , Liang Zhi-ping , Wu Mei , Chen Song , Zeng Xu-wen
Published: January 2020

Background

Although whole-lesion apparent diffusion coefficient (ADC) histogram has been increasingly used for breast lesions, it has not been routinely used in clinical practice as an emergent promising imaging tool.

Purpose

To evaluate the performance of whole-lesion ADC histogram analysis metrics for differentiating benign and malignant breast lesions.

Material and Methods

A systematic PubMed/EMBASE/Cochrane electronic database search was performed for original diagnostic studies from 1 January 1970 to 2 January 2019. Summary estimates of diagnostic accuracy were generated and meta-regression was performed to explore sources of heterogeneity according to study and magnetic resonance imaging characteristics.

Results

Five original articles involving 493 patients were included in the meta-analysis. The pooled sensitivity and specificity of whole-lesion ADC histogram analysis were 0.85 (95% confidence interval [CI] = 0.81–0.89) and 0.79 (95% CI = 0.72–0.84) for distinguishing benign and malignant breast lesions, respectively. The area under the curve (AUC) was 0.9178. No publication bias was detected ( P = 0.51). In subgroup analysis, the summary sensitivity and specificity of 50th percentile ADC value were 0.81 (95% CI = 0.71–0.88) and 0.86 (95% CI = 0.74–0.94), respectively. Meta-regression analysis indicated no covariates were sources of heterogeneity ( P > 0.05).

Conclusion

Whole-lesion ADC histogram analysis demonstrated good diagnostic performance for differentiating between benign and malignant breast lesions, with 50th percentile ADC value showing higher diagnostic accuracy than other histogram parameters. Given the limited number of studies included in the analysis, the findings from our meta-analysis will need further confirmation in future research.
Bruce Springsteen fan behavior and identification
Authors: Häkkänen-Nyholm Helinä
Published: January 2020

This research studied Bruce Springsteen fans and investigated their fanship and fandom, fan-related behavior, worship, and psychological functions for listening to Springsteen’s music. In total, 600 Springsteen fans from the United States, Canada, Europe, the Nordic countries, South Africa, and South America filled an online survey distributed to them via fan forums. The results showed that on average the respondents had been Springsteen’s fans for three decades and had attended 27 shows in total. The primary function of listening to Springsteen’s music was to achieve self-awareness. More than half of the respondents listened to Springsteen’s music daily, and on average, more than half of the fans’ total music consumption was by Springsteen. The fans were also heavily involved in popular forms of fan consumption. Analyses showed some gender and cultural differences, particularly with females scoring higher level of fan identification and consumption, but no age differences. These findings indicate that it was possible to identify quantitative differences between fan behavior and identification, which have implications for the rock music marketing and management industry.
Contribution of wind power plants in grid frequency regulation: Current perspective and future challenges
Authors: Sonkar Preeti , Rahi OP
Published: January 2020

As the wind power penetration level has started increasing in the grid, it has become essential to employ wind turbine with frequency regulation capabilities. This has become a challenging issue for researchers working in the area of wind power integration and to seek solution to this problem. To date, a piecemeal approach has been adopted in various review papers in this area, hence lagging completeness. This article presents a comprehensive review of frequency control techniques, various grid codes, load frequency control involving wind power plant with and without frequency control technique and modification in design of wind turbines for frequency regulation. Particularly, load frequency control including wind power plant with and without frequency control techniques at wind turbine manufacturer’s level has not been considered for review so far. More than 100 research publications in the form of research papers, reports, guidelines, and standards on the state of the art in this area have been rigorously examined, critically reviewed with research gaps identified and presented in a systematic manner.
Optimal torque maximum power point technique for wind turbine: Proportional–integral controller tuning based on particle swarm optimization
Authors: Hannachi Marwa , Elbeji Omessaad , Benhamed Mouna , Sbita Lassaad
Published: January 2020

This article presents the problem of the energy system optimization for wind generators. The goal of this work is to maximize power extraction for a permanent magnet synchronous generator–based wind turbine with maximum power point technique. This goal is achieved using a proportional–integral controller for optimal torque tuning with the particle swarm optimization algorithm. In order to indicate the effectiveness and superiority of the particle swarm optimization algorithm–based proposal, a comparison with the genetic algorithm and the artificial bee colony algorithm is studied. The system is modeled and tested under MATLAB/Simulink environment. Simulation results validate the advantages of the designed particle swarm optimization–tuned proportional–integral controller compared to P&O and the proportional–integral controller manually in terms of performance index.
Evaluating the Traffic Capacity of the Zion–Mt. Carmel Tunnel in Zion National Park
Authors: Upchurch Jonathan
Published: January 2020

Constructed in 1930 and recently designated as a National Historic Civil Engineering Landmark, the 1.1 mile long Zion–Mt. Carmel Tunnel has served Zion National Park in Utah well for several decades. With the passage of time, however, vehicles have become larger and this has necessitated the use of one-way operation to allow large vehicles to pass through the narrow tunnel. In recent years the number of visits to National Parks in the Colorado Plateau region has greatly increased. For example, visits to Zion National Park increased by 69% from 2010 to 2017. Accompanying the increase in visitor numbers has been an increase in traffic volume. As traffic volume has grown, two questions have become more obvious: What is the highway capacity of the Zion–Mt. Carmel Tunnel? And, how soon will the tunnel reach capacity? This paper covers a unique traffic engineering/highway capacity problem and describes: (a) the current method of operating the tunnel (both two-way and one-way operation); (b) data collection and analysis; (c) how one-way operation degrades tunnel capacity; (d) calculation of tunnel capacity and waiting times; (e) how soon the tunnel will reach capacity; and (f) alternatives for addressing the capacity problem.
Social and Behavioral Research with Undocumented Immigrants: Navigating an IRB Committee
Authors: Jach Elizabeth , Gloeckner Gene , Kohashi Colleen
Published: January 2020

When conducting human subjects research, social and behavioral researchers seeking to study current issues involving immigrants, refugees, and undocumented students must submit their research to an institutional review board (IRB). Research applications proposing to enroll these populations lie outside the scope of vulnerable populations named in the U.S. Code for Federal Regulations (45 CFR 46). Through a consideration of privacy, confidentiality, flexibility in providing protections, and case study examples, this article examines how researchers and IRBs can negotiate protecting participants who may be undocumented while supporting the advancement of research in the midst of the current, and uncertain, political climate.
Demographic and Socioeconomic Variables Associated With Health Care–Seeking Behavior Among Foreign Workers in Malaysia
Authors: Osman Ahmad Farid , Abdul Mutalib Muzalwana , Tafran Khaled , Tumin Makmor , Chong Chin Sieng
Published: January 2020

Foreign workers in Malaysia face various barriers in accessing health care, which results in many of them being unable to obtain appropriate medical treatment in case of sickness. This study investigates the foreign workers’ health care–seeking behavior and the demographic and socioeconomic variables that influence it. Data were collected from 502 foreign workers using a self-administered questionnaire. Multiple logistic regression was used to estimate the influence of demographic and socioeconomic variables on health care–seeking behavior among foreign workers. In cases of severe sickness, 20.5% of foreign workers stated that they will not go or are unlikely to go to a clinic or hospital. The multiple logistic regression revealed that foreign workers’ tendency to avoid medical treatment is associated with gender, marital status, monthly income, preferred language of communication, and work classification. Nonetheless, in cases of mild sickness, demographic and socioeconomic variables do not influence foreign workers’ health care–seeking behavior.
Learning Needs of Iranian Patients with Coronary Heart Disease: A Cross-sectional, Comparative Study
Authors: Hassankhani Hadi , Haririan Hamidreza , Jafari Arezoo , Porter Joanne E. , O’Brien Frances , Feizollahzadeh Hossein
Published: January 2020

Background:

Patient education requires modification as it is either nonexistent or implemented irregularly or inadequately.

Study’s purpose:

To examine the learning needs of patients with coronary heart disease from the perspective of the patients, their relatives, and health care providers.

Methodology:

The cross-sectional, comparative study conducted at two cardiac hospitals of Tabriz and Ardebil, Iran from May 2016 to September 2016.Through convenience sampling perceptions of 137 patients, 137 relatives, 33 cardiologists, and 108 nurses were compared using the Cardiac Learning Need Inventory questionnaire.

Major results:

The most important learning needs of patients from the perspective of physicians, nurses, and patients’ relatives was information about risk factors. In contrast, patient’s perceived information about medication to be their most important learning need.

Clinical implications:

Patients’ perceptions of their educational needs was different from the perceptions of physicians, nurses, and relatives of the patients. Therefore, when planning patient education a comprehensive review of the patients’ learning needs is required in order to develop a suitable education plan by prioritizing patients’ educational needs.
Hybrid repertoires of photo sharing: exploring the complexities of young adults’ photo-sharing practices
Authors: Lobinger Katharina , Venema Rebecca , Kaufhold Anja
Published: January 2020

Photo sharing has become a routine everyday practice and an object of increasing scholarly interest in visual communication research. Previous studies focused on single photo-sharing practices and on how particular photo-sharing services or devices are used. This article, in contrast, highlights the merits of a repertoire-oriented approach to better understand the complexity and entanglement of photo-sharing practices across various channels in diversified media environments. Based on semi-structured qualitative interviews that are combined with creative visual methods, the present study explores the everyday photo-sharing practices of eight young adults. It examines how they decide and reflect on which pictures are shared with whom and via which communication channel. The analysis shows that photo-sharing repertoires are not just the mere sum of the different platforms used for sending and distributing pictures, but rather a meaningfully structured composition of practices. Sharing repertoires and practices are structured by decisions and considerations based on (1) the imagined affordances of platforms and their expected audiences as well as on (2) interpersonal coordination and matching practices. These decisions require multi-layered media literacy skills that include knowledge of technical aspects of visual media usage, knowledge of platform-specific affordances and norms, as well as knowledge of communication habits, preferences and attitudes of the communication partners. On the methodological level, the study underlines two aspects. First, practices of ‘smartphone photography’ are manifold. They go beyond photo sharing and also include the use of apps as camera tools and photographic software. This needs to be taken into account when examining and discussing the usage of specific apps or platforms. Second, the study highlights that visual creative methods and elicitation techniques can make a fruitful contribution to the methodological repertoire of communication research as they help to explore the complexities of everyday media use.
Collaborative Research: Techniques for Conducting Collaborative Research From the Science of Team Science (SciTS)
Authors: Turner John R. , Baker Rose
Published: January 2020

The Problem

The field of human resource development (HRD) is a multidisciplinary field of research and practice requiring collaboration. Unfortunately, the literature on how to conduct collaborative research is incomplete within HRD and other disciplines. Any breakdown in the communication, exchange of ideas, agreed-upon methodologies, or shared credit for dissemination has the potential of preventing research from moving forward. Promotion and tenure policies also hamper collaborative efforts in that these policies often reward individual initiative as opposed to collaborative outcomes. These behavioral patterns provide constraints to the improvement and betterment of efforts to changing of the guard.

The Solution

This article highlights new and improved methods for working in collaborative environments. During an academic’s transition and professional development, these methods will help emerging scholars, new to collaborative research, when facing the team science revolution.

The Stakeholders

Scholars and scholar-practitioners engaged in collaborative research. Emerging scholars who are beginning their journey into collaborative research. Graduate students preparing for a career in academia.
Manufacturing and drop-weight impact properties of three-dimensional integrated-woven sandwich composite panels with hybrid core
Authors: Mirdehghan Abolfazl , Nosraty Hooshang , Shokrieh Mahmood M , Akhbari Mehdi
Published: January 2020

This paper is concerned with the effect of core pile yarn hybridization on the low-velocity impact response of 3D integrated-woven sandwich composite panels. For this purpose, at first, hybrid yarn was produced by a co-wrapped technique that is composed of polyester and glass fibres as shell and core structure, respectively. Then, 3D-woven samples with glass and hybrid pile yarns were fabricated, and after the impregnation, the behaviour of fabricated samples under low-velocity impact was experimentally investigated. In order to characterize this new type of hybrid structure, the fabricated samples with different pile heights and pile distribution densities were subjected to low-velocity impact tests at an energy level of 8 J. The impact characteristics of all panels including the load–time and load–displacement curves, contact time, absorbed energy and extent of the damage have been studied. Also, the extent of damage is interpreted in terms of the compressive strength loss after the impact of samples. According to the results, in comparison with the homogeneous glass/epoxy composites, contact time and deflection increased in panels with hybrid pile yarn, whereas the impact load decreased for the hybrid one. On the other hand, hybrid samples have a lower impact index than the homogeneous glass/epoxy composites. The compression after impact test results showed that the residual strength in hybrid samples is higher than the glass/epoxy composites.
Predictors of reoperation after internal fixation of intra-articular distal humerus fractures
Authors: Somerson Jeremy S , Morrey Mark E , Sanchez-Sotelo Joaquin , Morrey Bernard F
Published: January 2020

Background

Despite good reported outcomes with open reduction and internal fixation of intra-articular distal humerus fractures, complication rates remain high. The objective of this work is to identify factors associated with reoperation.

Methods

Sixty-three patients treated with open reduction and internal fixation for intra-articular ( Arbeitsgemeinschaft für Osteosynthesefragen type C) distal humerus fractures between 2004 and 2010 were identified using an institutional trauma registry, 62 of which were followed for a minimum of six months. Age, gender, fracture subclassification, open fracture presence, Injury Severity Score, time to definitive surgery, length of postoperative immobilization, and type of approach were recorded. Multivariate analysis was utilized to identify factors independently associated with reoperation.

Results

Complications requiring reoperation developed in 25 (40.3%) elbows. The most common reasons were wound dehiscence or infection in nine elbows (14.5%) and symptomatic hardware in six (9.6%). During multivariate analysis, only olecranon osteotomy remained an independent predictor for reoperation ( P = 0.043).

Discussion

Despite improved internal fixation techniques, a high proportion of elbows require reoperation after open reduction and internal fixation for distal humerus fractures. Higher complication rates in fractures fixed through an olecranon osteotomy may reflect additional reoperations due to nonunion of the osteotomy or need to remove hardware from the ulna.

Level of evidence

Prognostic Level III.
The Potential Role of AI in Anticipating Futures from a Design Process Perspective: From the Reflexive Description of “Design” to a Discussion of Influences by the Inclusion of AI in the Futures Research Process
Authors: Bevolo Marco , Amati Filiberto
Published: January 2020

The key question behind this article is, How is AI impacting futures research, with particular focus on foresight and design futures? To address such question, this article reports on selected epistemological and methodological traits of design futures research, on the nature of Artificial Intelligence (AI), and the potential impact of AI on the design futures domain, offering a conceptual model as theoretical junction between the domains of foresight and design. Key topics and themes addressed were selectively focused on foresight, design, design futures, weak signals, and their role in relationship with visioning and the image, AI, and a multidisciplinary discussion of how these fields relate to each other. This article is based on desk research and dialogue among the two authors, both profiled professional experts in their respective fields of design futures and AI, with a track of experience both in academic and applied research. Therefore, sources include a rich texture of bibliographic information, combined with selected input from ongoing research activities on AI and related trends, as performed in the professional field.
The cost-effectiveness of icosapent ethyl in combination with statin therapy compared with statin alone for cardiovascular risk reduction
Authors: Ademi Zanfina , Ofori-Asenso Richard , Zomer Ella , Owen Alice , Liew Danny
Published: January 2020

Aims

The aim of this study was to estimate the cost-effectiveness, from the perspective of the Australian public healthcare system, of icosapent ethyl in combination with statin therapy compared with statin alone for the prevention of cardiovascular disease.

Methods and results

A Markov model populated with data from the Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial was designed to predict the effectiveness and costs of icosapent ethyl in combination with statins compared with statins alone over a 20-year time horizon. Data inputs for costs and utilities were sourced from published sources. The annual costs of icosapent ethyl were assumed to be AUD1637 (USD2907) per person. All future costs and outcomes were discounted annually by 5%. The main outcome of interest was incremental cost-effectiveness ratios in terms of cost per quality adjusted life year (QALY) gained and per year of life saved (YoLS). Over a 20-year time horizon, compared with statin alone, icosapent ethyl in combination with statin was estimated to cost an additional AUD$13,022 per person, but led to 0.338 YoLS and 0.289 QALYs gained (all discounted). These equated to incremental cost-effectiveness ratios of AUD45,036 per QALY gained and AUD38,480 per YoLS. Sub-analyses for primary and secondary prevention were AUD96,136 and AUD35,935 per QALY gained, respectively. The results were sensitive to time-horizon, age related trends and the acquisition price of icosapent ethyl.

Conclusion

Compared with statin alone, icosapent ethyl in combination with statin therapy is likely to be cost-effective in the prevention of cardiovascular disease assuming a willingness-to-pay threshold of AUD50,000 per QALY gained, especially in the secondary preventive setting.
Brief Education and a Conjoint Valuation Survey May Reduce Decisional Conflict Regarding Lung Cancer Screening
Authors: Studts Jamie L. , Thurer Richard J. , Brinker Kory , Lillie Sarah E. , Byrne Margaret M.
Published: January 2020

Background. Recent data and policy decisions have led to the availability of lung cancer screening (LCS) for individuals who are at increased risk of developing lung cancer. In establishing implementation policies, the US Preventive Services Task Force recommended and the Centers for Medicare and Medicaid Services required that individuals who meet eligibility criteria for LCS receive a patient counseling and shared decision-making consultation prior to LCS. Methods. This study evaluated the potential of a values clarification/preference elicitation exercise and brief educational intervention to reduce decisional conflict regarding LCS. Participants ( N = 210) completing a larger online survey responded to a measure of decisional conflict prior to and following administration of a conjoint survey and brief educational narrative about LCS. The conjoint survey included 22 choice sets (two of which were holdout cards), incorporating 5 attributes with 17 levels. Results. Results pertaining to changes in decisional conflict showed that participants reported statistically significantly and clinically meaningful reductions in decisional conflict following administration of the brief educational narrative and conjoint survey across the total score (Δ = 29.30; d = 1.09) and all four decisional conflict subscales: Uncertainty (Δ = 27.75; d = 0.73), Informed (Δ = 35.32; d = 1.11), Values Clarity (Δ = 31.82; d = 0.85), and Support (Δ = 18.78; d = 0.66). Discussion. While the study design precludes differentiating the effects of the brief educational narrative and the conjoint survey, data suggest that these tools offer a reasonable approach to clarifying personal beliefs and perspectives regarding LCS participation. Given the complicated nature of LCS decisions and recent policies advocating informed and shared decision-making approaches, conjoint surveys should be evaluated as one of the tools that could help individuals make choices about LCS participation.
Democratic decentralization, microcredit, and the workings of local government in rural India
Authors: Daftary Dolly
Published: January 2020

While democratic decentralization in India has commonly been studied as a project of deepening democracy, this article discusses decentralization as a form of state spatial restructuring in the epoch of market reforms. Drawing upon ethnographic fieldwork, I trace the shift in the nature of elected local bodies and their retooling to deepen financial markets in rural India. The case of the Swarnajayanti Gram Swarozgar Yojana, the Indian state’s largest microcredit program, reveals the rise in the salience of local governments as the site of state spatial policy in the 21st century, and the restructuring of decentralized local governance to deepen financial institutions’ penetration in rural areas. Local governments called panchayats have emerged as state organizations of microgovernance as capital moves to new scales in search of value. Findings from Gujarat, India’s leading state of pro-market reforms, reveal panchayats’ role in metagovernance—the governance of government, and the ascendance of information and communication technologies in panchayat practice to annihilate spatio-temporal barriers for the circulation of financial and material capital.
INTERnational Project for the Evaluation of “activE Rehabilitation” (inter-PEER) – a protocol for a prospective cohort study of community peer-based training programmes for people with spinal cord injury
Authors: Divanoglou Anestis , Tasiemski Tomasz , Jörgensen Sophie
Published: January 2020

Background

Active Rehabilitation (AR) is a community peer-based concept for people with spinal cord injury (SCI) that is primarily delivered through brief residential training programmes. Despite a plethora of positive anecdotal evidence of AR programmes as life-changing experiences, the effects of AR-programmes have not been evaluated scientifically. Here, we present the protocol of the INTERnational Project for the Evaluation of “activE Rehabilitation” (inter-PEER) aiming to evaluate the effects of AR training programmes on community-dwelling individuals with SCI.

Methods

International prospective cohort study that recruits consecutive participants in AR training programmes. Evaluation is conducted through a web-based survey at 3 time-points: at the commencement and completion of the training programme, and 3 months after the end of the training programme. Evaluation also includes a practical wheelchair skills test at the first two time-points.

The primary outcome measures are the Spinal Cord Independence Measure Self-report (SCIM-SR), the Queensland Evaluation of Wheelchair Skills test (QEWS), the Wheelchair Skills Test Questionnaire (WST-Q) and the Moorong Self-Efficacy Scale (MSES). The secondary outcome measures are the 11-item Life Satisfaction Questionnaire (LiSat-11), the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation), the Leisure Time Physical Activity Questionnaire for people with SCI (LTPAQ-SCI) and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10).

We piloted the implementation of the protocol in Sweden in 7 participants with diverse SCI and sociodemographic characteristics and collected feedback from participants and peer-mentors about study procedures through interviews, a workshop and field observations.

Discussion

Inter-PEER is the first initiative to propose a systematic evaluation of the effects of AR training programmes among individuals with SCI. The project is a collaborative work of multiple stakeholders, including researchers, clinicians, peer mentors with SCI, and administrators of organisations providing AR programmes. The inter-PEER uses standardised outcome measures relevant to the AR context, it will facilitate quality evaluations of community peer-based programmes, stimulate international collaborations, and inform the design of randomised controlled trials on the effects of AR training programmes.
Pain in children and adolescents with cerebral palsy – a cross-sectional register study of 3545 individuals
Authors: Eriksson Elsa , Hägglund Gunnar , Alriksson-Schmidt Ann I.
Published: January 2020

Background

Pain is a common problem for individuals with cerebral palsy (CP). In Sweden, 95% of children and adolescents with CP are followed in a national follow-up programme (CPUP), which includes data on pain. The purpose of this study was to investigate the prevalence of pain based on age, sex, gross motor function and source of report (self or proxy). Pain intensity, pain site, and how much pain disturbed sleep and daily activities were also studied.

Methods

This was a cross-sectional register study based on all participants in CPUP, 4–18-years of age, with data reported in 2017–2018. Gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Logistic regression was used to analyse prevalence of pain and how much pain had disturbed sleep and daily activities in the last four weeks.

Results

In total, 3545 participants (2065 boys) were included. The overall prevalence of pain was 44%. Older age and female sex were associated with higher risk of pain with odds ratios of 1.07 (95% confidence interval (CI) 1.06–1.09) and 1.28 (CI 1.12–1.47), respectively. Pain was most common in the lower extremities. There was no statistically significant difference in prevalence of pain related to source of report. Pain intensity was higher at older ages and higher GMFCS-levels. Hip/thigh pain and abdominal pain were associated with the most intense pain.

Of those who reported pain, pain disturbed sleep for 36% and daily activities for 61%.

Conclusions

Both pain frequency and pain intensity were higher at higher age. Pain intensity increased with increasing GMFCS-level. Two-thirds of all children and adolescents with CP reported that their pain disturbed their daily activities, and one-third reported that pain disturbed their sleep.
Are parental dietary patterns associated with children’s overweight and obesity in China?
Authors: Tang Daisheng , Bu Tao , Dong Xuefan
Published: January 2020

Background

It is believed that parents have a great influence on their children’s dietary behaviours. However, it is not clear whether parental food patterns are associated with children’s nutritional status in China, which includes a vast territory with rich, diverse cultures. The goal of this project is to systematically study the associations between parental food intake and children’s overweight and obesity in China, according to children’s ages and regional differences.

Methods

Based on individual food consumption data from the China Health and Nutrition Survey (CHNS) package in 2011, cross-sectional studies have previously been conducted to analyse the association between different categories of food intake of parents and children. The current study extends this research by directly.

Results

Our analysis results show that parental food intake is highly correlated with children’s food intake, with the estimated coefficients of most food intake categories being greater than 0.5. Furthermore, this association between parental food intake and children’s overweight and obesity is most significant in young children, but it begins to weaken in relation to children aged between 13 and 18. Additionally, the associations between parental food intake and children’s overnutrition are more significant in rural areas than they are in urban areas.

Conclusions

The association between parental food intake and childhood overweight and obesity is significant, although it varies considerably according to food categories, children’s ages and area differences. These results show promise for intervening in the overnutrition of children by controlling household dietary patterns according to children’s developmental stages and regional differences.
In vitro effects of alendronate on fibroblasts of the human rotator cuff tendon
Authors: Sung Chang-Meen , Kim Ra Jeong , Hah Young-Sool , Gwark Ji-Yong , Park Hyung Bin
Published: January 2020

Background

Bone mineral density of the humeral head is an independent determining factor for postoperative rotator cuff tendon healing. Bisphosphonates, which are commonly used to treat osteoporosis, have raised concerns regarding their relationships to osteonecrosis of the jaw and to atypical fracture of the femur. In view of the prevalence of rotator cuff tear in osteoporotic elderly people, it is important to determine whether bisphosphonates affect rotator cuff tendon healing. However, no studies have investigated bisphosphonates’ cytotoxicity to human rotator cuff tendon fibroblasts (HRFs) or bisphosphonates’ effects on rotator cuff tendon healing. The purpose of this study was to evaluate the cytotoxicity of alendronate (Ald), a bisphosphonate, and its effects on HRF wound healing.

Methods

HRFs were obtained from human supraspinatus tendons, using primary cell cultures. The experimental groups were control, 0.1 μM Ald, 1 μM Ald, 10 μM Ald, and 100 μM Ald. Alendronate exposure was for 48 h, except during a cell viability analysis with durations from 1 day to 6 days. The experimental groups were evaluated for cell viability, cell cycle and cell proliferation, type of cell death, caspase activity, and wound-healing ability.

Results

The following findings regarding the 100 μM Ald group contrasted with those for all the other experimental groups: a significantly lower rate of live cells (p < 0.01), a higher rate of subG1 population, a lower rate of Ki-67 positive cells, higher rates of apoptosis and necrosis, a higher number of cells with DNA fragmentation, higher caspase-3/7 activity (p < 0.001), and a higher number of caspase-3 positive staining cells. In scratch-wound healing analyses of all the experimental groups, all the wounds healed within 48 h, except in the 100 μM Ald group (p < 0.001).

Conclusions

Low concentrations of alendronate appear to have little effect on HRF viability, proliferation, migration, and wound healing. However, high concentrations are significantly cytotoxic, impairing cellular proliferation, cellular migration, and wound healing in vitro.
A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study
Authors: Hov Reidun , Bjørsland Bente , Kjøs Bente Ødegård , Wilde-Larsson Bodil
Published: January 2020

Background

As palliative care increasingly takes place in patients’ homes, perceptions of security among patients in the late palliative phase and their relatives are important.

Aim

To describe and compare patient-relative dyads regarding their perceptions of security in palliative homecare, including the perceived security of the actual care given to the patients, as well as the subjective importance of that care.

Methods

A cross sectional questionnaire study including 32 patient-relative dyads was conducted in an urban municipality in Norway. Patients were in a late palliative phase and received palliative homecare. Each patient proposed one relative. Data were collected using a modified version of the Quality from the Patients’ Perspective instrument (QPP), which focuses on security and comprises three dimensions: medical-technical competence, identity-orientation approach and physical-technical conditions. Context-specific scales containing four aspects (competence, continuity, coordination/cooperation, availability) were added. The instrument contains two response scales; perceived reality (PR) and subjective importance (SI). Data were analysed by descriptive statistics, Chi-squared test, T-test and Wilcoxon’s signed rank test.

Results

Patients had high mean scores on the PR-scale for the sense of security in palliative homecare in the dimensions of medical-technical competence and physical-technical conditions. There were three low mean scores on the PR-scale: the aspect of continuity from patients and the aspects of continuity and coordination/cooperation from relatives.

The patients scored the SI scale statistically significantly higher than the PR scale in the identity-orientation approach dimension and in the aspect of continuity, while relatives did so in all dimensions and aspects.

The intra-dyadic patient-relative comparisons show statistically significant lower scores from relatives on the PR-scale in the dimensions of medical-technical competence, physical-technical conditions, identity-orientation approach and the aspect coordination/cooperation.

Conclusions

There are several statistically significant differences between patients and relatives’ perceptions of security in the palliative homecare received (PR) compared with the subjective importance of the care (SI) and statistically significant differences in the patient-relative dyads in PR. A relatively mutual sense of security in palliative homecare is important for patient-relative dyads, as relatives often provide care and act as patients’ spokespersons. What they assess as important can guide the development of palliative homecare.
Downregulation of MYPT1 increases tumor resistance in ovarian cancer by targeting the Hippo pathway and increasing the stemness
Authors: Muñoz-Galván Sandra , Felipe-Abrio Blanca , Verdugo-Sivianes Eva M. , Perez Marco , Jiménez-García Manuel P. , Suarez-Martinez Elisa , Estevez-Garcia Purificacion , Carnero Amancio
Published: January 2020

Background

Ovarian cancer is one of the most common and malignant cancers, partly due to its late diagnosis and high recurrence. Chemotherapy resistance has been linked to poor prognosis and is believed to be linked to the cancer stem cell (CSC) pool. Therefore, elucidating the molecular mechanisms mediating therapy resistance is essential to finding new targets for therapy-resistant tumors.

Methods

shRNA depletion of MYPT1 in ovarian cancer cell lines, miRNA overexpression, RT-qPCR analysis, patient tumor samples, cell line- and tumorsphere-derived xenografts, in vitro and in vivo treatments, analysis of data from ovarian tumors in public transcriptomic patient databases and in-house patient cohorts.

Results

We show that MYPT1 (PPP1R12A), encoding myosin phosphatase target subunit 1, is downregulated in ovarian tumors, leading to reduced survival and increased tumorigenesis, as well as resistance to platinum-based therapy. Similarly, overexpression of miR-30b targeting MYPT1 results in enhanced CSC-like properties in ovarian tumor cells and is connected to the activation of the Hippo pathway. Inhibition of the Hippo pathway transcriptional co-activator YAP suppresses the resistance to platinum-based therapy induced by either low MYPT1 expression or miR-30b overexpression, both in vitro and in vivo.

Conclusions

Our work provides a functional link between the resistance to chemotherapy in ovarian tumors and the increase in the CSC pool that results from the activation of the Hippo pathway target genes upon MYPT1 downregulation. Combination therapy with cisplatin and YAP inhibitors suppresses MYPT1-induced resistance, demonstrating the possibility of using this treatment in patients with low MYPT1 expression, who are likely to be resistant to platinum-based therapy.