bluuebunny/crossref_metadata_2025 huggingface dataset:
Cultural Beliefs of Turkish Women for Breast Cancer and Screening
Authors: Tosun Hale , Isik Andsoy Isil , Gul Asiye
Published: December 2020

Introduction:

Breast cancer is an important health problem and early diagnosis is important in its treatment. Women’s approach and cultural beliefs are effective in ensuring early diagnosis. This study examined psychometric properties of the Ferrans Cultural Beliefs Scale and assessed cultural beliefs on breast cancer and screening programs among Turkish women.

Method:

The study was performed in a descriptive and cross-sectional design with 420 women using the Ferrans Cultural Beliefs Scale that is considered reliable and valid in Turkey.

Results:

The mean total score of the Ferrans Cultural Beliefs Scale was 3.24 ± 3.16. The highest “yes” responses were for the statement “If breast cancer is treated correctly, it can be cured” ( n = 387, 92.1%).

Discussion:

This study, which is the first in Turkey, highlights the importance of measuring the effects of Turkish healthy women’s cultural beliefs in breast cancer and screening for early diagnosis. Determining women’s cultural beliefs will make known the attitudes and behaviors toward breast cancer, so that the nurse will provide sensitive and effective nursing care, develop nursing knowledge, and integrate this knowledge with clinical practice.
The Power of ePortfolio Development to Foster Reflective and Deeper Learning in an Online Graduate Adult Education Program
Authors: Di Silvestro Frank , Nadir Hamid
Published: December 2020

The current study addressed two problems in adult education: the lack of published research on the use of ePortfolios in graduate adult education, and more specifically, how can graduate adult educators utilize ePortfolios to foster reflective and deeper learning in a graduate adult education program? This was a 3-year qualitative study of 36 master’s students in their final capstone course in an online graduate adult education program. The primary research question was Can developing ePortfolios foster reflective and deeper learning in an online graduate adult education program? Researchers analyzed student responses to three guideline questions for the development of their ePortfolios: (a) What story did your ePortfolio tell?, (b) What surprised you?, and (c) What did you learn about yourself? These questions were designed to stimulate students’ thinking about their learning from the ePortfolio process, artifacts, and experience in the degree program. Through thematic analysis of student responses to these questions, three predominant themes emerged that provided evidence for reflective and deeper learning. The three themes were as follows: (a) Students became more reflective learners who frequently experienced deeper transformative learning, (b) Students were surprised by greater self-discovery and significant personal growth exceeding their expectations, and (c) Students found new personal strengths. Specific recommendations were provided about how to use ePortfolios in graduate adult education programs to foster reflective and deeper learning.
How Adults With Serious Mental Illness Learn and Use Wellness Recovery Action Plan’s Recovery Framework
Authors: Petros Ryan , Solomon Phyllis
Published: December 2020

This study was conducted to investigate how adults with serious mental illness learn and utilize an illness self-management framework for pursuing recovery through a program called Wellness Recovery Action Plan (WRAP). The researchers employed an interpretive descriptive methodology with thematic analysis. Data were collected from three focus groups ( n = 26) and in-depth interviews with follow-up member checks with 10 participants ( n = 20 interviews). Findings aligned with main constructs of self-determination theory (SDT) to explain how an autonomy-supportive environment created opportunities for participants to build competency, implementing personalized recovery strategies that are socially endorsed by peers, resulting in internalized motivation for continued application of WRAP’s framework. SDT appears to explain mechanisms of change for WRAP. Recommendations for mental health organizations include broadly ensuring autonomy-supportive environments and services that maximize opportunities to build competence in recovery strategies in collaboration with peers. Future research may utilize SDT as the theoretical basis for investigating self-management programs.
“We All Join Hands”: Perceptions of the Kangaroo Method Among Female Relatives of Newborns in The Gambia
Authors: Brotherton Helen , Daly Maura , Johm Penda , Jarju Bintou , Schellenberg Joanna , Penn-Kekana Loveday , Lawn Joy Elizabeth
Published: December 2020

Family support is essential for kangaroo mother care (KMC), but there is limited research regarding perceptions of female relatives, and none published from West African contexts. In-depth interviews were conducted from July to August 2017 with a purposive sample of 11 female relatives of preterm neonates admitted to The Gambia’s referral hospital. Data were coded in NVivo 11, and thematic analysis was conducted applying an inductive framework. Female relatives were willing to support mothers by providing KMC and assisting with domestic chores and agricultural labor. Three themes were identified: (a) collective family responsibility for newborn care, with elder relatives being key decision makers, (b) balance between maintaining traditional practices and acceptance of KMC as a medical innovation, and (c) gendered expectations of women’s responsibilities postnatally. Female relatives are influential stakeholders and could play important roles in KMC programs, encourage community ownership, and contribute to improved outcomes for vulnerable newborns.
Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature
Authors: Bazargan Mohsen , Bazargan-Hejazi Shahrzad
Published: December 2020

Objectives:

Published research in disparities in advance care planning, palliative, and end-of-life care is limited. However, available data points to significant barriers to palliative and end-of-life care among minority adults. The main objective of this scoping review was to summarize the current published research and literature on disparities in palliative and hospice care and completion of advance care planning and directives among non-Hispanc Blacks.

Methods:

The scoping review method was used because currently published research in disparities in palliative and hospice cares as well as advance care planning are limited. Nine electronic databases and websites were searched to identify English-language peer-reviewed publications published within last 20 years. A total of 147 studies that addressed palliative care, hospice care, and advance care planning and included non-Hispanic Blacks were incorporated in this study. The literature review include manuscripts that discuss the intersection of social determinants of health and end-of-life care for non-Hispanic Blacks. We examined the potential role and impact of several factors, including knowledge regarding palliative and hospice care; healthcare literacy; communication with providers and family; perceived or experienced discrimination with healthcare systems; mistrust in healthcare providers; health care coverage, religious-related activities and beliefs on palliative and hospice care utilization and completion of advance directives among non-Hispanic Blacks.

Discussion:

Cross-sectional and longitudinal national surveys, as well as local community- and clinic-based data, unequivocally point to major disparities in palliative and hospice care in the United States. Results suggest that national and community-based, multi-faceted, multi-disciplinary, theoretical-based, resourceful, culturally-sensitive interventions are urgently needed. A number of practical investigational interventions are offered. Additionally, we identify several research questions which need to be addressed in future research.
Vertical Facial Skeletal Asymmetry and Occlusal Cant Relationship in Patients With Unilateral Cleft Lip and Palate
Authors: Akarsu-Guven Bengisu , Atik Ezgi , Gorucu-Coskuner Hande , Aksu Muge
Published: December 2020

Objective:

To evaluate the maxillary and mandibular vertical skeletal asymmetries, and the correlation between these asymmetries and occlusal cant in patients with unilateral cleft lip–palate (UCLP).

Methods:

Anteroposterior radiographs of 25 patients with UCLP (UCLP group, mean age: 20.98 ± 4.88 years) and 25 subjects without cleft (control group, mean age: 19 ± 2.86 years) were included. Independent samples t test, Mann-Whitney U test and Pearson correlation analysis were performed based on linear and angular measurements.

Results:

Lower facial horizontal asymmetry did not show statistically significant difference between the UCLP and control groups. However, vertical asymmetry of (a) the lateral cranial base ( P = .014), (b) the nasomaxillary region ( P < .001), (c) the maxillary dentoalveolus ( P = .001), and (d) the lower face ( P = .038) were all found to be significantly greater in UCLP group. The occlusal cant angle was also significantly greater in patients with UCLP compared to the controls ( P = .016). While the occlusal cant angle was found to be correlated with the vertical asymmetry of the occlusal cant ( r = 0.931, P < .001), maxillary cant angle was found to be correlated with the vertical asymmetry of the maxillary dentoalveolus ( r = 0.655, P < .001).

Conclusions:

There was no correlation between the occlusal cant and the vertical and horizontal skeletal asymmetries. Vertical asymmetries of the lower face and the medial cranial base were negatively correlated with the horizontal lower facial asymmetry.
School Nurses’ Experiences of Health Promotion for School-Age Asylum Seekers
Authors: Inkeroinen Saija , Hupli Maija , Stolt Minna
Published: December 2020

The number of school-age asylum seekers and refugees worldwide is increasing. Health promotion provided by school nurses can be crucial for the well-being of young asylum seekers, yet research on these nurses’ experiences is limited. This qualitative study aims to describe school nurses’ experiences of providing health promotion to school-age asylum seekers. Semistructured interviews were conducted with 12 school nurses, and inductive content analysis was then used. The results were grouped under the following themes: (1) difficulties in providing health services to school-age asylum seekers, (2) considering the vulnerable circumstances of asylum seekers, (3) the importance of family-centered health promotion, and (4) the importance of time management. School nurses face challenges that stem from individual asylum seekers’ unique circumstances, nursing competency, and the school health care system. To deepen the existing knowledge, further research is needed from the perspective of asylum seekers.
Examination of Family Counseling Coursework and Scope of Practice for Professional Mental Health Counselors
Authors: Williams Amy E. , Weinzatl Olivia L. , Varga B. L.
Published: December 2020

This study examined couple and family counseling coursework in the Council for the Accreditation of Counseling and Related Educational Programs (CACREP)–accredited clinical mental health counseling (CMHC) programs and scope of practice related to couple and family counseling based on each state’s licensure regulations for mental health counselors (MHCs). Required and offered courses in couple/family-related content areas for 331 CACREP-accredited CMHC programs were analyzed. In addition, state licensure regulations for all 50 states and Washington, DC, were examined to determine whether MHCs can conduct couple and family counseling based upon licensure regulations. The results of this study indicated a mean of 1.1 couple/family-related courses required and a mean of 2.3 of these courses offered within CMHC programs. All but one of the 51 licensure regulations analyzed either permits or does not specify whether couple/family counseling falls within the scope of practice of MHCs; these 50 state/territory regulations also lack concrete guidelines related to required training or supervised experience in couple and family counseling to provide this service competently as an MHC. Limitations and areas for future research and training opportunities are discussed in light of these results.
TROP-2, 5hmC, and IDH1 Expression in Anaplastic Thyroid Carcinoma
Authors: Seok Jae Yeon , Astvatsaturyan Kristine , Peralta-Venturina Mariza De , Lai Jinping , Fan Xuemo
Published: December 2020

Background

Anaplastic thyroid carcinoma (ATC), a highly aggressive malignancy, has no effective treatment to date. Trophoblast cell-surface antigen 2 (TROP-2), a transmembrane glycoprotein, has been suggested to be a promising novel target for sacituzumab govitecan, an antibody-drug conjugate. 5-Hydroxymethylcytosine (5hmC) has a role in tumor suppression and promoting modification. Additionally, isocitrate dehydrogenase 1 (IDH1) mutations are strongly associated with increased overall survival in gliomas and worse prognosis in leukemias. This study attempts to evaluate the immunoexpression of TROP-2, 5hmC, and IDH1 in ATCs and to determine their potential impact in targeted therapy.

Methods

Twenty-four ATCs were retrieved, with 9 cases that occurred de novo and 15 cases derived from either papillary thyroid carcinoma (PTC) or follicular thyroid carcinoma (FTC). Sections were immunostained with TROP-2, 5hmC, and IDH1 antibodies, and evaluated using the QuPath program. The t tests were performed using SPSS software.

Results

TROP-2 was detected in 12 ATCs with 9 cases demonstrating a high expression and in all PTC components, and absent in all FTC components of secondary ATCs. 5hmC expression was moderately reduced in PTC and FTC components and markedly reduced in ATC. The entire cohort showed a total absence of IDH1.

Conclusions

Increased TROP-2 immunoexpression in some ATCs supports that these patients may potentially benefit from an antibody-drug conjugate therapy targeting TROP-2. Markedly reduced 5hmC expression suggests that 5hmC may be used as potential therapeutic targets for ATC. The total lack of IDH1 R132H mutation by immunostain indicates that it has no prognostic and therapeutic value in ATC.
Histopathology of SPINK-1 Hereditary Pancreatitis
Authors: Felicelli Christopher , Pezhouh Maryam K.
Published: December 2020

Hereditary pancreatitis is a rare form of recurrent acute pancreatitis that typically has an onset in early adulthood. We report a rare case of hereditary pancreatitis in an individual with a serine protease inhibitor Kazal type 1 ( SPINK1) mutation. Histologically the pancreas showed features of chronic pancreatitis with variable fibrosis, acinar destruction, and prominent inspissated secretions within the pancreatic ducts. Additionally, focal areas of low-grade pancreatic intraepithelial neoplasia (PanIN) were present. Although the histopathology of common gene mutations resulting in hereditary pancreatitis have been well described, the histopathology of pancreatitis secondary to SPINK1 mutation has been described in only one previous study.
Not All Wrongdoers Are Equal in the Public Eye: A Moderated Mediation Model of Country Stereotypes, Condemning Emotions, and Retaliatory Intent in Corporate Crises
Authors: Barbarossa Camilla , Mandler Timo
Published: December 2020

Corporate crises generate condemning emotions and retaliatory intent toward the offending companies. However, not all wrongdoers are equal in the public eye. Consumers’ prior beliefs about a company’s country of origin may bias these responses. In three experimental studies (combined N = 1,008), the authors (1) establish that country stereotypes of warmth—but not of competence—can buffer condemning emotions and retaliatory intent toward an offending company. They further (2) reveal the psychological mechanism of greed attributions that underlies this bias and (3) identify the type of crisis as a crucial contingency factor that facilitates (corporate ability crisis) or suppresses (corporate value crisis) the buffering effect of country warmth.
Trends in Abusive and Nonabusive Injury Hospitalizations in Young Children in Texas, 2004–2018
Authors: Cain Cary M. , Mandell Dorothy J. , Thompson Ralph R. , Cummings Angela L. , Van Horne Bethanie S. , Greeley Christopher S.
Published: December 2020

Hospitalization data provide context to understanding abusive and non-abusive injuries and how these hospitalizations change over time. The purpose of this study was to utilize Texas inpatient hospitalization data to assess age-related differences among infants (<12 months of age) and toddlers (12–59 months of age) in injury trends and patterns of injury among abusive and non-abusive hospitalization encounters over a 15-year time period. For both age groups, pediatric hospitalizations for non-abusive injuries decreased significantly over time; however, hospitalizations for abusive injuries did not. Compared to non-abusive injury hospitalizations, abusive injury hospitalizations were statistically more likely to involve more body regions and were associated with fractures, internal organ injuries, and superficial wounds. Abusive injury hospitalizations had longer lengths of stay and resulted in higher illness severity scores. Toddler injury hospitalizations were associated with most of the body regions, with the exception of traumatic brain injury for which the odds of hospitalization were higher for infants. This study confirms the persistence of abusive injury hospitalizations and the age-related susceptibility to certain injuries comparing infants and toddlers. The findings reflect the clinical documentation and decision making of pediatric practitioners in a large state over 15 years and inform the trends in identification of injuries which are most common and consistent by age and intent.
Human–Equine Tourism and Nature-Based Solutions: Exploring Psychological Well-Being Through Transformational Experiences
Authors: Danby Paula , Grajfoner Dasha
Published: December 2020

This article critically explores insights into human–equine touristic experiences and acknowledges how such interconnectivity underline nature-based solutions (NBS) to mutually enhance psychological well-being. Despite the growing interest in NBS limited accounts have explored human–animal relations within the realm of touristic encounters. Drawing upon multispecies ethnographic accounts, participant observations, diaries, and in-depth interviews were held with 21 participants, with topics themed around human–equine experiences, relational encounters, and well-being. The sample was taken from participants located in the North East of England who engaged in equestrian tourism. Findings revealed life-changing transformations as a result of multispecies encounters. Deep emotional elements were experienced through intersubjectivity where participants spoke of the psychological benefits of being immersed in natural landscapes with their equine companions. This article demonstrates human–equine experiences as a positive NBS and illustrates that for the two species to effectively interact in equine-assisted psychological interventions requires mutual trust, empathy, and effective communication.
Association of BglII Polymorphism in ITGA2 and (894G/T and −786T/C) Polymorphisms in eNOS Gene With Stroke Susceptibility in Tunisian Patients α2 Gene Polymorphism in α2β1 Integrin and eNOS Gene Variants and Stroke
Authors: Jalel Akrem , Midani Fatma , Fredj Sondess Hadj , Messaoud Taieb , Hentati Fayçal , Soualmia Hayet
Published: December 2020

Background:

This study investigated the association of BglII polymorphism in α2β1 integrin gene ( ITGA2) and eNOS (894G/T and –786T/C) polymorphisms with ischemic stroke (IS) in Tunisian patients.

Methods:

The study comprised 210 patients with IS and 208 controls. The genotypes of the BglII polymorphism in ITGA2 and eNOS (894G/T and –786T/C) polymorphisms were determined using the PCR-RFLP. The χ2 test was used and the genotype data comparison included heterozygous groups. Haplotype estimation and multiple logistic regression analysis were performed to analyze the significance of polymorphisms.

Results:

The genotype distribution of the BglII polymorphism was significantly different between cases and controls ( p < 0.004). This polymorphism was associated with the risk of IS ( OR = 3.38, p < 0.001) for the BglII(+/+) genotype. Likewise, the genotype distributions of eNOS (894G/T and –786T/C) polymorphisms were significantly different between the two groups ( p < 0.005 and p < 0.01, respectively). The 894G/T polymorphism increased the risk of IS for the TT genotype ( OR = 2.23, p < 0.008) and the GT genotype ( OR = 1.74, p < 0.009). In addition, the –786T/C variant in the eNOS gene was a risk factor for IS for CC homozygous ( OR = 2.52, p < 0.005). T-C Haplotype ( OR = 3.06) from combination of the eNOS (894G/T and –786T/C) and T-C- BglII(+) haplotype ( OR = 2.76) from combination of eNOS and ITGA2 polymorphisms represented high risks for IS.

Conclusions:

This study suggests that the BglII variant in ITGA2 is associated with IS susceptibility. Furthermore, the 894G/T and –786T/C polymorphisms in the eNOS gene may be considered as genetic risk factors for IS in the Tunisian population.
Topographic properties of the cornea in welders
Authors: Asharlous Amir , Hashemi Hassan , Yekta Abbasali , Aghamirsalim Mohamadreza , Ostadimoghaddam Hadi , Gharaee Hamid , Sardari Sara , Khabazkhoob Mehdi
Published: December 2020

Purpose:

The aim of the present study was to evaluate the topographic status of the welders’ corneas.

Methods:

In this historical cohort, a group of welders (with at least 5 years’ experience in welding) and a control group were assessed and compared. Lack of exposure to welding for 3 months or more was considered an exclusion criterion. In all participants, after taking a complete history of visual and ocular problems, both eyes underwent Pentacam imaging. Then, all subjects received slit lamp biomicroscopy for evaluation of ocular surface diseases.

Results:

The data of 140 welders (mean age: 46.66 ± 13.01 years) and 172 controls (mean age: 45.05 ± 12.61 years) were analyzed. The welders’ corneas had significantly higher eccentricity ( p < 0.0001), keratometry readings ( p < 0.0001), and cylinder power ( p < 0.0001). The central, inferior, and nasal cornea were significantly thinner in the welders than in controls ( p < 0.0001) while the difference was not significant in the superior and temporal cornea. All indices of corneal irregularity except for the central keratoconus index (CKI) and index of height asymmetry (IHA) were higher in welders compared to the control group ( p < 0.0001).

Conclusion:

According to the results of this study, the welders’ corneas are topographically irregular. Welders exhibit characteristics like steeper keratometry readings; higher eccentricity indexes; thinner central, inferior, and nasal corneas; and higher indices of corneal irregularity, especially the CK index. Long-term ultraviolet exposure may be a possible reason for these corneal changes.
Refractive outcomes of high-magnitude astigmatism correction using femtosecond LASIK versus transepithelial PRK
Authors: Reitblat Olga , Gershoni Assaf , Mimouni Michael , Vainer Igor , Livny Eitan , Nahum Yoav , Segev Fani , Bahar Irit
Published: December 2020

Purpose:

To compare the outcomes of femtosecond laser assisted in situ keratomileusis (FS-LASIK) with transepithelial photorefractive keratectomy (T-PRK) for the correction of high-grade astigmatism.

Methods:

Medical records of patients with astigmatism of 2 diopters (D) or higher, who were treated with FS-LASIK or T-PRK in 2013 through 2014 at a private practice laser clinic, were retrospectively analyzed. Efficacy, safety, predictability and vector analysis of astigmatism correction were compared between the treatment groups.

Results:

The study included 93 eyes treated with FS-LASIK and 186 eyes treated with T-PRK. No significant differences in postoperative spherical equivalent (−0.10 ± 0.7 D and −0.11 ± 0.7 D, respectively, p = 0.958) and postoperative refractive astigmatism (0.79 ± 0.54 D and 0.82 ± 0.63 D, respectively, p = 0.685) were demonstrated. A significant advantage of FS-LASIK over T-PRK was seen for the efficacy (1.00 ± 0.18 and 0.86 ± 0.22, respectively, p < 0.001) and safety (1.03 ± 0.17 and 0.89 ± 0.21, respectively, p < 0.001) indices. Results remain statistically significant in a multivariate analysis model. Vector analysis for the astigmatism correction showed no significant difference between the surgery methods in the surgically induced astigmatism, difference vector, correction index and index of success.

Conclusion:

Both procedures demonstrated desirable post-operative SE outcomes for high-grade astigmatism correction. However, FS-LASIK achieved better results than T-PRK in the efficacy and safety parameters.
Distal transradial artery access for vascular access intervention
Authors: Watanabe Shingo , Usui Michio
Published: December 2020

Background:

Vascular access intervention is a useful treatment method for maintaining arteriovenous fistula (AVF) in dialysis patients. The outflow vein is commonly used as the access site for vascular access intervention. In cases where it is difficult to puncture veins due to multiple lesions or poor AVF development, vascular access intervention is performed using the radial artery. However, it is difficult to perform a vascular access intervention with radial artery access to the AVF in the distal forearm. We reported the efficacy and safety of vascular access intervention with distal transradial artery access (dTRA).

Case series:

We have been conducting vascular access intervention with dTRA access since January 2019. We evaluated complications and procedure time for 12 cases of vascular access intervention with dTRA access performed from January to December 2019. The success rate of the procedure was 100% and no puncture hemorrhagic complication was observed in 12 cases performed at our institution. No radial artery occlusion was observed in 12 cases. The average fluoroscopy time was 11.5 min and the average contrast volume was 41 ml.

Conclusion:

dTRA for vascular access intervention has advantages over conventional radial artery access in terms of safety of the procedure and ease of hemostasis.
Correlates of Indoor Concentration of Carbon Monoxide in Residential Buildings in Gondar Town, Northwest Ethiopia
Authors: Gizaw Zemichael , Teka Zinabu
Published: December 2020

This community-based cross-sectional study was conducted to investigate the indoor concentration of carbon monoxide (CO) and associated factors in residential buildings of Gondar town, northwest Ethiopia. Data were collected from 384 occupied buildings and occupants using CO meter, interviewers administered questionnaire, and observation checklists. Multivariable binary logistic regression analysis was used for controlling the possible effect of confounders and to identify factors associated with indoor concentration of CO on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and P < .05. The current study revealed that 224(58.3%) occupied buildings had the concentration of CO above the permissible value for 15 minute exposure for living rooms (100 mg/m3). Indoor concentration of CO was significantly associated with access to health information [AOR = 0.081, 95%CI = (0.008, 0.803)], number of rooms [AOR = 0.016, 95% CI = (0.001, 0.279)], area of occupied room [AOR = 0.019, 95% CI = (0.001, 0.237)], buildings located away from main roads/garages [AOR = 0.045, 95% CI = (0.005, 0.415)], clean energy sources [AOR = 0.010, 95% CI = (0.001, 0.123)], presence of separate kitchen [AOR = 0.030, 95% CI = (0.004, 0.221)], no incensing in the room [AOR = 0.055, 95% CI = (0.006,0.499)] and measurements in the afternoon [AOR = 0.114, 95% CI = (0.013, 0.965)]. Residents, therefore, need to use clean energy sources, construct a kitchen with a properly constructed chimneys away from the main building, and avoid incensing inside the indoor environment.
Quantification of Plasma Kynurenine Metabolites Following One Bout of Sprint Interval Exercise
Authors: Trepci Ada , Imbeault Sophie , Wyckelsma Victoria L , Westerblad Håkan , Hermansson Sigurd , Andersson Daniel C , Piehl Fredrik , Venckunas Tomas , Brazaitis Marius , Kamandulis Sigitas , Brundin Lena , Erhardt Sophie , Schwieler Lilly
Published: December 2020

The kynurenine pathway of tryptophan degradation produces several neuroactive metabolites suggested to be involved in a wide variety of diseases and disorders, however, technical challenges in reliably detecting these metabolites hampers cross-comparisons. The main objective of this study was to develop an accurate, robust and precise bioanalytical method for simultaneous quantification of ten plasma kynurenine metabolites. As a secondary aim, we applied this method on blood samples taken from healthy subjects conducting 1 session of sprint interval exercise (SIE). It is well accepted that physical exercise is associated with health benefits and reduces risks of psychiatric illness, diabetes, cancer and cardiovascular disease, but also influences the peripheral and central concentrations of kynurenines. In line with this, we found that in healthy old adults ( n = 10; mean age 64 years), levels of kynurenine increased 1 hour ( P = .03) after SIE, while kynurenic acid (KYNA) concentrations were elevated after 24 hours ( P = .02). In contrast, no significant changes after exercise were seen in young adults ( n = 10; mean age 24 years). In conclusion, the described method performs well in reliably detecting all the analyzed metabolites in plasma samples. Furthermore, we also detected an age-dependent effect on the degree by which a single intense training session affects kynurenine metabolite levels.
Effects of Bisphosphonate Therapy on Bone Mineral Density in Boys with Duchenne Muscular Dystrophy
Authors: Ronsley Rebecca , Islam Nazrul , Kang Mehima , Nadel Helen , Reilly Christopher , Metzger Daniel , Selby Kathryn , Panagiotopoulos Constadina
Published: December 2020

The objective of this study was to estimate the comparative effectiveness of bisphosphonate therapy on bone mineral density (BMD) in patients with corticosteroid-treated Duchenne muscular dystrophy (DMD). A retrospective, comparative effectiveness study evaluating changes in BMD and fragility fractures in patients with DMD presenting to British Columbia Children’s Hospital from 1989 to 2017 was conducted. Marginal structural generalized estimating equation models weighted by stabilized inverse-probability of treatment weights were used to estimate the comparative effectiveness of therapy on BMD. Of those treated with bisphosphonates (N = 38), 7 (18.4%), 17 (44.7%), and 14 (36.8%) cases were treated with pamidronate, zoledronic acid, or a combination of both, respectively, while 36 cases of DMD were untreated. Mean age of bisphosphonate initiation was 9.2 (SD 2.7) years. Mean fragility fractures declined from 3.5 to 1.0 following bisphosphonate therapy. Compared to the treated group, the untreated group had an additional 0.63-SD decrease (95% confidence interval [CI]: −1.18, −0.08, P = .026) in total BMD and an additional 1.04-SD decrease (95% CI: −1.74, −0.34; P = .004) in the left hip BMD, but the change in lumbar spine BMD (0.15, 95% CI: −0.36, 0.66; P = .57) was not significant. Bisphosphonate therapy may slow the decline in BMD in boys with corticosteroid-treated DMD compared to untreated counterparts. Total number of fragility fractures decreased following bisphosphonate therapy.
Cross-Match as an Immuno-Oncological Risk Factor for Hepatocellular Carcinoma Recurrence and Inferior Survival After Living Donor Liver Transplantation: A Call for Further Investigation
Authors: Ho Cheng-Maw , Hu Rey-Heng , Wu Yao-Ming , Ho Ming-Chih , Lee Po-Huang
Published: December 2020

Background:

The success of immunotherapy for patients with hepatocellular carcinoma (HCC) suggests that immune dysregulation occurs in HCC patients. This warrants an immuno-oncological risk assessment in the platform of liver transplantation.

Methods:

This retrospective single-center study analyzed risk factors for—particularly cross-matching performed through conventional complement-dependent cytotoxicity cross-match tests—and the outcomes of HCC recurrence following living donor liver transplant.

Results:

A total of 71 patients were included. The median follow-up period was 29.1 months; 17 (23.9%) patients had posttransplant HCC recurrence, and their 1-, 3-, and 5-year-survival rates were 70.6%, 25.7%, and 17.1%, respectively, which were inferior to those of patients without HCC recurrence (87.0%, 80.7%, and 77.2%, respectively; P < .001). In addition to microvascular invasion, positive cross-match results for B cells at 37°C (B- 37°C) or T cells at 4°C (T- 4°C) were associated with inferior overall survival in multivariable analysis after adjustment for tumor status beyond Milan criteria and elevated alpha-fetoprotein levels. Rejection alone cannot be the mechanism underlying the effects of positive cross-match results on patient outcomes. Adjusted survival curves suggested that positive cross-match B- 37°C or T- 4°C was associated with inferior recurrence-free and patient survival, but the robustness of the finding was limited by insufficient power.

Conclusions:

Additional large-scale studies are required to validate positive cross-match as an immuno-oncological factor associated with HCC recurrence and inferior patient survival.
On lower-dimensional models in lubrication, Part B: Derivation of a Reynolds type of equation for incompressible piezo-viscous fluids
Authors: Almqvist Andreas , Burtseva Evgeniya , Rajagopal Kumbakonam , Wall Peter
Published: December 2020

The Reynolds equation is a lower-dimensional model for the pressure in a fluid confined between two adjacent surfaces that move relative to each other. It was originally derived under the assumption that the fluid is incompressible and has constant viscosity. In the existing literature, the lower-dimensional Reynolds equation is often employed as a model for the thin films, which lubricates interfaces in various machine components. For example, in the modelling of elastohydrodynamic lubrication (EHL) in gears and bearings, the pressure dependence of the viscosity is often considered by just replacing the constant viscosity in the Reynolds equation with a given viscosity-pressure relation. The arguments to justify this are heuristic, and in many cases, it is taken for granted that you can do so. This motivated us to make an attempt to formulate and present a rigorous derivation of a lower-dimensional model for the pressure when the fluid has pressure-dependent viscosity. The results of our study are presented in two parts. In Part A, we showed that for incompressible and piezo-viscous fluids it is not possible to obtain a lower-dimensional model for the pressure by just assuming that the film thickness is thin, as it is for incompressible fluids with constant viscosity. Here, in Part B, we present a method for deriving lower-dimensional models of thin-film flow, where the fluid has a pressure-dependent viscosity. The main idea is to rescale the generalised Navier-Stokes equation, which we obtained in Part A based on theory for implicit constitutive relations, so that we can pass to the limit as the film thickness goes to zero. If the scaling is correct, then the limit problem can be used as the dimensionally reduced model for the flow and it is possible to derive a type of Reynolds equation for the pressure.
Structural constraints of functional connectivity drive cognitive impairment in the early stages of multiple sclerosis
Authors: Koubiyr Ismail , Deloire Mathilde , Brochet Bruno , Besson Pierre , Charré-Morin Julie , Saubusse Aurore , Tourdias Thomas , Ruet Aurélie
Published: December 2020

Background:

The relationship between structural and functional deficits in multiple sclerosis (MS) is unclear.

Objective:

This study explored structure-function relationships during the 5 years following a clinically isolated syndrome and their role in cognitive performance.

Methods:

Thirty-two patients were enrolled after their first neurological episode suggestive of MS and followed for 5 years, along with 10 matched healthy controls. We assessed structural (using diffusion tensor imaging) and functional (using resting-state functional magnetic resonance imaging (fMRI)) brain network metrics, clinical and cognitive scores at each follow-up visit. Structural–functional coupling, calculated as the correlation coefficient between strengths of structural and functional networks, was used to assess structure–function relationships.

Results:

Structural clustering coefficient was significantly increased after 5 years, whereas characteristic path length decreased. Structural connections decreased after 1 year and increased after 5 years. Functional connections and related path lengths were decreased after 5 years. Structural–functional coupling had increased significantly after 5 years. This structural–functional coupling was associated with cognitive and clinical evolution, with stronger coupling associated with a decline in both domains.

Conclusion:

Our findings provide novel biological evidence that MS leads to a more constrained anatomical-dependant functional connectivity. The collapse of this network seems to lead to both cognitive worsening and clinical disability.
Clinical significance of a single cerebrospinal fluid immunoglobulin band: A retrospective study
Authors: Tusseau Maud , Cheli Estelle , Marignier Romain , Poitevin Françoise , Malcus Christophe , Gossez Morgane , Bancel Julien , Monneret Guillaume , Vukusic Sandra
Published: December 2020

Background:

To demonstrate an inflammatory process in the central nervous system, the presence of at least two immunoglobulin (Ig) bands in the cerebrospinal fluid (CSF) is required. So far, the presence of a single abnormal Ig band is considered as negative.

Objective:

The objective was to assess retrospectively the significance of a single CSF Ig band in clinical practice.

Methods and results:

Out of 10,286 CSF analyses, we retained 214 results with single Ig. An inflammatory neurological disorder was diagnosed in 41% of patients.

Conclusion:

Despite a modest sensitivity, the presence of a single CSF Ig band may be a biomarker of an inflammatory mechanism and, as such, may prompt the clinician to repeat the analysis when the clinical context remains suggestive.
High rejection, low selection: How ‘punitive parties’ shape ethnic minority representation
Authors: English Patrick
Published: December 2020

Evidence suggests that as public opinion towards immigration becomes more negative, so the descriptive representation of ethnic minority groups is increasingly restricted. Recently, some initial research into the causal mechanism hinted that this effect is driven by patterns of candidacy. This suggests that political parties are creating an ‘ethnic penalty’ of their own in the selection stage. This paper investigates the relationship between patterns of candidacy, party strategy, and public opinion in Great Britain from 1997 to 2019, and proposes that ‘punitive parties’ are strongly responsible for shaping the representational outcomes of minority groups. I find support for earlier suggestions that parties are increasingly likely to place ethnic minority candidates away from ‘winnable’ contests as anti-immigrant hostility rises. These findings are important for our conceptions of ethnic penalties, of party behaviour in selection processes, and for the study and cause of improving political representation.
Following the coalition? Testing the impact of coalitions on policy preferences in Germany
Authors: Guntermann Eric , Quinlan Stephen
Published: December 2020

Ultimately, electoral democracy is about governments doing what citizens want. However, considerable evidence shows that parties influence citizens’ preferences. Most studies on party influence rely on experimental designs that present participants with parties’ positions. The disadvantage of experiments is that many citizens are already aware of those positions, thus underestimating party influence. Very few studies assess reactions to real changes in party positions, which avoids this limitation. We break new ground by assessing the impact of changes in coalition governments, which lead parties to express different positions for reasons that are partly exogenous to elite and mass preferences, on partisans’ attitudes. Using panel data from the German Longitudinal Election Study (GLES), we leverage a major coalition change by Angela Merkel in Germany in 2013. We find that this change influenced the preferences of partisans of the coalition parties. Our findings have significant implications for how we think about democratic representation in multi-party contexts.
International tourism demand forecasting with machine learning models: The power of the number of lagged inputs
Authors: Bi Jian-Wu , Han Tian-Yu , Li Hui
Published: December 2020

This study explores how to select the optimal number of lagged inputs (NLIs) in international tourism demand forecasting. With international tourist arrivals at 10 European countries, the performances of eight machine learning models are evaluated using different NLIs. The results show that: (1) as NLIs increases, the error of most machine learning models first decreases rapidly and then tends to be stable (or fluctuates around a certain value) when NLIs reaches a certain cutoff point. The cutoff point is related to 12 and its multiples. This trend is not affected by the size of the test set; (2) for nonlinear and ensemble models, it is better to select one cycle of the data as the NLIs, while for linear models, multiple cycles are a better choice; (3) significantly different prediction results are obtained by different categories of models when the optimal NLIs are used.
Perceived teachers’ autonomy support, positive behaviour, and misbehaviour in physical education: The roles of advantageous comparison and non-responsibility
Authors: Hsu Wei-Ting , Shang I-Wei , Hsiao Chia-Huei
Published: December 2020

To better investigate why positive behaviour and misbehaviour occur, the study aimed to examine the relationships among teachers’ autonomy support and students’ advantageous comparison, non-responsibility, positive behaviour, and misbehaviour. We also examined the mediating roles of advantageous comparison and non-responsibility in these relations. The participants were 478 students with an average age of 14.6 ± 1.49 years, and the students included 259 males and 219 females. Structural equation modelling indicated that teachers’ autonomy support had direct negative effects on advantageous comparison and non-responsibility. Furthermore, advantageous comparison and non-responsibility had direct positive effects on students’ misbehaviour and had direct negative effects on positive behaviour. The relationships between teachers’ autonomy support and students’ misbehaviour and positive behaviour were mediated by advantageous comparison and non-responsibility. In line with previous work, teacher autonomy support might be critical to enhancing students’ positive behaviour as well as reducing their misbehaviour. Since the mediating roles of advantageous comparison and non-responsibility were confirmed, we also suggest that strategies should be applied to eliminate students’ moral disengagement.
Sexual jokes at school and psychological complaints: Student- and class-level associations
Authors: Låftman Sara Brolin , Bjereld Ylva , Modin Bitte , Löfstedt Petra
Published: December 2020

Background: Students who are subjected to sexual harassment at school report lower psychological well-being than those who are not exposed. Yet, it is possible that the occurrence of sexual harassment in the school class is also stressful for those who are not directly targeted, with potential negative effects on well-being for all students. Aim: The aim was to examine whether exposure to sexual jokes at the student level and at the class level was associated with students’ psychological complaints, and if these associations differed by gender. Method: Data from the Swedish Health Behaviour in School-aged Children (HBSC) of 2017/18 was used, with information from students aged 11, 13 and 15 years ( N=3720 distributed across 209 classes). Psychological health complaints were constructed as an index based on four items. Exposure to sexual jokes at the student level was measured by one item, and at the class level as the class proportion of students exposed to sexual jokes, in per cent. Two-level linear regression analyses were performed. Results: Students who had been exposed to sexual jokes at school reported higher levels of psychological complaints, especially boys. Furthermore, the class proportion of students who had been exposed to sexual jokes was also associated with psychological complaints, even when adjusting for student-level exposure to sexual jokes, gender, grade and class size. Conclusions: Sexual jokes seem to be harmful for those who are directly exposed, but may also affect indirectly exposed students negatively. Thus, a school climate free from sexual jokes may profit all students.
Reversal of warfarin and direct-acting oral anticoagulants in traumatic intracranial hemorrhage: Four factor prothrombin complex concentrates for all?
Authors: Moore Kerry K , Barton Cassie A , Levins Elizabeth S , Oetken Heath , Dewey Elizabeth N , Fleming Michael , Schreiber Martin
Published: December 2020

Background

Patients receiving oral anticoagulation who experience a traumatic intracranial hemorrhage (ICH) should receive anticoagulation reversal. Four factor prothrombin complex concentrate (4FPCC) is indicated for reversal of warfarin, and is frequently used for reversal of direct-acting oral anticoagulants (DOACs). The purpose of this study is to compare the safety and efficacy of 4FPCC reversal for traumatic ICH in DOAC- and warfarin-anticoagulated patients.

Methods

This was a single-center, retrospective review of adult patients with traumatic ICH who received 4FPCC for reversal of anticoagulation between April 2013 and August 2018. The ICH volume on the pre- and post-reversal head CT scans was measured. The primary endpoint was the incidence of expansion of ICH volume of blood using pre-and post-4FPCC imaging.

Results

A total of 102 patients meeting inclusion criteria were identified with 75 patients in the warfarin group and 27 patients in the DOAC group. There were no significant differences in baseline characteristics between the groups except DOAC patients had larger ICH volumes at baseline as compared to warfarin patients (23.4 mm3 vs 3.7 mm3, p = 0.0001). There was neither a statistical difference in change in ICH volume pre-and post-4FPCC administration, nor in the rate of >20% ICH expansion between the warfarin and DOAC groups. There was no difference in the rate of adverse events compared between groups.

Conclusion

There was no difference in the either the change in ICH volume or the rate of >20% ICH expansion in patients receiving 4FPCC for reversal DOAC versus warfarin anticoagulation. Rates of complications were low in both groups.