bluuebunny/crossref_metadata_2025 huggingface dataset:
Stakeholder perceptions on the role of school inspection standards in demonstrating education quality in China
Authors: Zheng Hong
Published: March 2020

Purpose

The purpose of this study is to identify the factors and issues within the policy context of education and the school inspection system which might affect education quality in China and examine stakeholder perceptions of inspection content and context in one city region in China.

Design/methodology/approach

A mixed-methods design was used. In all, 365 teachers, headteachers and administrative staff from ten schools across the urban and rural area have responded the questionnaires. A total of 13 interviewees including teachers and headteachers from two urban schools and a rural school, city and national inspectors and an educational officer were conducted. The interview instrument was informed by both international and local literature and some of the quantitative findings.

Findings

This paper argues that student non-academic outcomes were perceived by participants to be more important than academic achievements in demonstrating education quality. The prevailing exam-oriented evaluation system still sets barriers for student all-round development. Educational equity in student performance has not drawn sufficient attention from the inspectorates of Shandong province.

Practical implications

School inspection standards remain to be improved to better support student all-round development and equity in educational outcomes within and between schools, and better accommodate policy contexts and local needs.

Originality/value

This study examines the school effectiveness factors which have been rarely tested in Chinese context and collects new empirical evidence to explore participants’ perceptions on the quality of school inspection criteria and education quality in Shandong province.
Implementing PAR in a Thai community development context
Authors: Doungphummes Nuntiya , Vicars Mark
Published: March 2020

Purpose

The purpose of this paper is to present an account of a PAR project in a Thai community and to discuss the methodological implications of implementing a culturally responsive approach.

Design/methodology/approach

The paper draws on the frameworks for PAR conducted as a community development project with rural Thai communities.

Findings

The paper reviews the use of a PAR approach as a culturally responsive approach and presents an experience of culturally situated research practice.

Originality/value

This paper encourages researchers conducting participatory inquiry to engage in deeper critical reflection on the implications of these methods in keeping with PAR's critical ontological, epistemological and axiological orientation.
Home visits by occupational therapists improve adherence to recommendations: Process evaluation of a randomised controlled trial
Authors: Lockwood Kylee J. , Harding Katherine E. , Boyd Jude N. , Taylor Nicholas F.
Published: March 2020

Introduction

As part of hospital discharge planning, occupational therapists often provide recommendations to improve the interaction between a person and their home environment. The aim of this study was to investigate the number and type of recommendations made by occupational therapists during a home assessment visit compared to hospital‐based assessment for patients recovering from hip fracture. A secondary aim was to explore adherence rates to the different types of recommendations.

Methods

Process evaluation of a randomised controlled trial of 65 participants recovering from hip fracture, returning to community living after hospital discharge. All participants received inpatient multidisciplinary rehabilitation and hospital‐based assessment by an occupational therapist (usual care). In addition, the intervention group participated in a single home visit with an occupational therapist prior to hospital discharge. Analysis included the number and type of occupational therapy recommendations, adherence to recommendations at 30 days after discharge, and mediation analysis.

Results

Participants in the home visit group received more recommendations than the usual care group (mean difference [MD] 2.8, 95% CI 1.6 to 3.9) and adhered to a greater proportion of recommendations for assistive technologies (MD 11.4%, 95% CI 2.6 to 20.2) and task modifications (MD 10.0%, 95% CI 0.7 to 19.3). Participants in both groups had lower rates of adherence to recommendations for home modifications compared with other types of recommendations. Adherence to recommendations was a mediator in the relationship between participants' involvement in a pre‐discharge home visit and reduced hospital readmissions.

Conclusion

There was greater adherence to occupational therapy recommendations when patients recovering from hip fracture participated in a home visit compared to hospital‐based assessment, contributing to reduced readmissions to hospital in the first 30 days. Home visits offer additional benefits to hospital‐based assessment through the use of a collaborative approach to decision making in the home environment.
Viscoelastic haemostatic assays and fibrinogen in paediatric acute traumatic coagulopathy: A comprehensive review
Authors: Maconachie Sharon , Jansen Melanie , Cottle Emma , Roy John , Ross Bryony , Winearls James , George Shane
Published: March 2020

Objective

Haemorrhage in paediatric trauma remains a significant cause of morbidity and mortality. Over recent years there has been increasing attention to the role of fibrinogen in traumatic haemorrhage and the association of low fibrinogen levels with poor patient outcomes. In addition, there has been a move towards using viscoelastic haemostatic assays (VHAs) to rapidly assess coagulation status and guide clinicians in the replacement of coagulation factors, including fibrinogen. In the paediatric population, there has been limited uptake of these principles and a paucity of data to support a change in practice. This paper summarises the available evidence in the published literature through a systematic review, presented in narrative format.

Results

There is limited high‐quality prospective data on the use of VHA in the management of acute traumatic coagulopathy in the paediatric population. While the use of fibrinogen early in major haemorrhage is becoming standard practice, there are currently no randomised prospective studies comparing fibrinogen concentrate to cryoprecipitate.

Conclusions

The early identification of hypo‐fibrinogenemia and acute traumatic coagulopathy in paediatric trauma using VHA testing and subsequent early fibrinogen replacement with a concentrated off the shelf product is an attractive treatment option. However, there is currently insufficient high‐level evidence to support the use of fibrinogen concentrate over cryoprecipitate in the paediatric trauma population. Pilot studies currently under way will go some way to addressing this important knowledge gap, and facilitate the design of larger definitive multi‐centre randomised trials.
Institutional anomie and cross‐national differences in incarceration†
Authors: Weiss Douglas B. , Testa Alexander , Rennó Santos Mateus
Published: March 2020

Messner and Rosenfeld's (2007) institutional anomie theory (IAT) has mainly been applied by criminologists to explain crime rates at various aggregate levels. However, Messner and Rosenfeld also suggest that the same social and cultural forces that lead to high crime may explain differences in punishment, although this latter proposition has yet to be subject to empirical testing. Using a variety of data sources for 41 countries measuring various structural and cultural configurations, in this study we assess the extent to which IAT can explain cross‐national differences in incarceration. Our results indicate that the strength of the economic institution and the extent of institutional imbalance reflecting a dominant economic institution are positively associated with incarceration rates when the national culture is characterized by individualism, a competitive achievement orientation, or both. A national culture characterized by both collectivism and a cooperative achievement orientation, however, serves as a buffer against the punitive effects of an institutional imbalance that favors the economy. Our results are discussed in the context of the extant IAT literature and future research on cross‐national incarceration.
Trends in the incidence and survival of patients with esophageal cancer: A SEER database analysis
Authors: He Haiqi , Chen Nanzheng , Hou Yue , Wang Zhe , Zhang Yong , Zhang Guangjian , Fu Junke
Published: March 2020

Background

Recent studies have indicated that the incidence of esophageal cancer has declined in the past decade in the U.S. However, trends in the incidence and survival have not been thoroughly examined.

Methods

Data from 46 063 patients with esophageal cancer between 1973 and 2015 were collected from the Surveillance, Epidemiology, and End Results database. The trends in the age‐adjusted incidence and survival were analyzed using joinpoint regression models.

Results

The age‐adjusted incidence of esophageal cancer increased from 5.55 to 7.44 per 100 000 person‐years between 1973 and 2004. Later, it decreased at an annual percentage change of 1.23%. In the last 40 years, the strong male predominance increased slightly. Importantly, the percentage of patients with localized stage of squamous cell cancer decreased. It was observed that the incidence of esophageal squamous cell carcinoma declined since 1986, while the incidence of esophageal adenocarcinoma sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men. Consistently, the estimated 40‐year limited‐duration prevalence of esophageal adenocarcinoma was higher than that of esophageal squamous cell carcinoma. Additionally, we observed a modest but significant improvement in survival during the study period.

Conclusion

The incidence of esophageal squamous cell carcinoma has decreased significantly over the past four decades in the U.S., while the incidence of adenocarcinoma has increased, particularly among men. Overall, the long‐term survival of patients with esophageal cancer is poor but it has improved over the past decades, especially for the localized disease.

Key points

Significant findings of the study

The incidence of esophageal cancer has decreased at an annual percentage change of 1.23% since 2004. The incidence of esophageal adenocarcinoma has sharply increased since 1973 and surpassed the rate of squamous cell cancer, mainly due to the increase in the incidence among men.

What this study adds

There has been a shift in the prevalence of esophageal cancer histological subtypes over the past decades in the U.S. We found that the incidence of esophageal squamous cell carcinoma has continued to decrease, while the esophageal adenocarcinoma rate has continued to increase.
Clinical importance of VEGFC and PD‐L1 co‐expression in lung adenocarcinoma patients
Authors: Qin Tingting , Xia Junling , Liu Shaochuan , Wang Jing , Liu Hailin , Zhang Yan , Jia Yanan , Li Kai
Published: March 2020

Background

Vascular endothelial growth factor C (VEGFC), an activator of lymphangiogenesis, is newly identified as an immunomodulator which can regulate the immune system so that tumor cells more easily escape immune surveillance. Evidence has shown programmed cell death‐ligand 1 (PD‐L1) can also suppress the immune response. Nevertheless, the clinical significance of co‐expression of VEGFC and PD‐L1 for predicting outcomes in patients with lung adenocarcinoma has not yet been determined.

Methods

A total of 114 patients with lung adenocarcinoma who underwent surgeries at Tianjin Medical University Cancer Institute and Hospital between December 2011 and September 2016 were retrospectively reviewed. Tissue specimens were collected for immunohistochemistry of VEGFC and PD‐L1 which were analyzed with an H‐score system.

Results

In this study, 57 (50.0%) and 47 (41.2%) patients were classified as VEGFC high expression and PD‐L1 high expression. Co‐expression was observed in 33 (28.9%) patients. In addition, a positive correlation was found between VEGFC and PD‐L1 (P = 0.0398, r = 0.1937). In a univariate analysis, both progression‐free survival (PFS) and overall survival (OS) were significantly worse in the VEGFC high expression group and the PD‐L1 high expression group, respectively. Furthermore, VEGFC/PD‐L1 co‐expression showed a worse OS (P = 0.03) and PFS survival (P = 0.01) than the other groups.

Conclusions

Taken together, these results indicate that VEGFC/PD‐L1 co‐expression can forecast both poor OS and PFS in patients with resected lung adenocarcinoma. Co‐expression of VEGFC and PD‐L1 may serve as a significant prognostic factor for patients with lung adenocarcinoma.

Key points

VEGFC/PD‐L1 co‐expression forecasts poor survival in patients with resected lung adenocarcinoma. VEGFC/PD‐L1 co‐expression may be used as a prognostic indicator and provide the theoretical possibility to screen the optimal population with a combination of anti‐VEGFC and anti‐PD‐L1 therapy in the clinical treatment.
Serum selenium in critically ill patients: Profile and supplementation in a depleted region
Authors: Broman Lars Mikael , Bernardson Anna , Bursell Karin , Wernerman Jan , Fläring Urban , Tjäder Inga
Published: March 2020

Background

General selenium supplementation to intensive care unit (ICU) patients in regions with selenium‐rich soil does not improve outcomes. Still selenium supplementation may reduce morbidity and mortality in patients with low‐serum selenium concentration (S‐Se) in selenium‐poor areas who respond to treatment. The primary aim of this observational study was to investigate S‐Se in a selenium‐deficient region at time of intensive care admission, and in addition to monitor S‐Se during high‐dose selenium supplementation for safety.

Methods

We measured S‐Se in 100 consecutive patients admitted to a tertiary general ICU. After initial sampling, high‐dose intravenous (iv) selenium supplementation was administered up to 20 days.

Results

At admission, in 95% of the cases, S‐Se was below the saturation level for selenoenzymes, in 91%, below the Swedish reference level, and in 71%, below the level where selenoenzyme function may be impaired. At day 5 of substitution, all patients still remaining in the ICU (n = 26) were within the range for enzyme function, 12% were below reference, and 24% did not reach full enzymatic saturation. At day 10 and forward, all patients were within target for treatment. No patients were at risk for toxic S‐Se concentration.

Conclusions

S‐Se concentration was substantially lower compared to normal values at ICU admission in this cohort of unselected Swedish critical care patients. Selenium supplementation restituted S‐Se to levels corresponding to enzymatic saturation and the Swedish reference interval for all subjects remaining in the ICU on day 5.
Depression and Functional Outcomes in Patients Presenting to the Emergency Department With Low Back Pain
Authors: Ring Joshua , Peskoe Sarah , Zhao Congwen , Friedman Benjamin W. , George Steven Z. , Eucker Stephanie A.
Published: March 2020

Objectives

Low back pain (LBP) is a common reason for patients to present to emergency departments (EDs). Our objective was to describe the associations between depressive symptoms, pain severity, and functional impairment up to 3 months after initial ED presentation for LBP.

Methods

We performed a secondary analysis on an observational cohort of adult patients from a high‐volume, urban ED. Initial depressive symptoms (Patient Health Questionnaire‐9) and disability (Roland Morris Disability Questionnaire) were collected in person at the time of initial ED visit and by telephone at 1‐week and 3‐month follow‐ups. Pain intensity (Numeric Rating Scale) was collected at 1‐week and 3‐month follow‐ups. Our primary goal was to determine the associations between initial depressive symptoms and pain intensity and disability scores at 3 months. We also investigated the associations of initial and 3‐month change in depressive symptoms with change in disability score from initial presentation to 3 months and change in pain score from 1 week to 3 months.

Results

Of the 674 patients initially enrolled, 362 patients had complete depressive symptom, pain, and disability data and were included in the final analysis. Those with higher levels of intake depressive symptoms had worse pain intensity (B = 0.14, 95% confidence interval [CI] = 0.08 to 0.21) and disability (0.46, 95% CI = 0.30 to 0.62) severity at 3 months, with less improvement in disability over the 3 months (B = 0.22, 95% CI = 0.05 to 0.40). Furthermore, those with worsening depressive symptoms over the 3‐month study period experienced less improvement in pain intensity (B = 0.10, 95% CI = 0.05 to 0.17) and disability (B = 0.84, 95% CI = 0.66 to 1.02) over the same time frame. Except for a slight strengthening of the association between initial depressive symptom severity and 3‐month pain score among patients with no prior LBP episodes, history of prior LBP episodes did not moderate these relationships.

Conclusions

Significant positive temporal associations exist between initial severity and 3‐month progression of depressive symptoms and 3‐month pain intensity and disability outcomes for ED patients with LBP. Future work is needed to investigate whether behavioral interventions initiated from the ED may mitigate the incidence and severity of LBP‐related chronic pain and functional impairments.
Relations Between Acute Effects of Alcohol on Response Inhibition, Impaired Control over Alcohol Use, and Alcohol‐Related Problems
Authors: Corbin William R. , Berey Benjamin L. , Waddell Jack T. , Leeman Robert F.
Published: March 2020

Background

Alcohol consistently impairs response inhibition in the laboratory, and alcohol impairment of response inhibition may lead to excess consumption or increases in intoxicated risk behavior, both of which contribute to risk for alcohol‐related problems. To our knowledge, no prior studies have examined relations between alcohol impairment of response inhibition and either impaired control over alcohol (i.e., inability to adhere to predetermined drinking limits) or real‐world alcohol‐related problems. The current study addressed this gap in the literature.

Methods

Young adult social drinkers (N = 215, 76% male) participated in a between‐subjects, placebo‐controlled alcohol challenge study and completed self‐reports approximately 2 weeks later. Multilevel models were used to examine the hypothesis that alcohol impairment of response inhibition would indirectly lead to alcohol‐related problems through impaired control over alcohol use.

Results

Greater alcohol‐induced impairment of response inhibition and impaired control over alcohol use were both significant predictors of alcohol‐related problems. However, greater alcohol‐induced response inhibition was not a significant predictor of impaired control over alcohol use.

Conclusions

To our knowledge, this is the first study demonstrating relationships between alcohol impairment of response inhibition and real‐world alcohol‐related problems and the first to address relationships between alcohol impairment of response inhibition and impaired control over alcohol use. These results suggest that impaired control over alcohol use may result from deficits in the trait ability to control behavior rather than deficits in alcohol‐induced response inhibition. Regardless, results suggest that alcohol impairment of response inhibition and impaired control over alcohol are both worthwhile intervention targets.
Outcome of endodontic treatment with chlorhexidine gluconate as main irrigant: A case series
Authors: Salas Hair , Vieira Gaya C.S. , Palomino Ivo , Valero Javier , Pacheco‐Yanes Juan , Campello Andrea F. , Pérez Alejandro R.
Published: March 2020

This study evaluated the overall endodontic therapy success using 0.12% or 2% chlorhexidine gluconate as main irrigant. Seventy‐two teeth diagnosed as vital, necrotic or previously treated teeth with apical periodontitis that were consecutively treated by orthograde therapy. All cases were followed clinically and radiographically for at least 1‐year period. Success was established in teeth without signs or adverse clinical symptoms and complete or incomplete radiographic healing. Failure was determined in teeth with any sign or adverse clinical symptoms and a new, unchanged or enlarged radiographic periapical lesion. The data were analysed using chi‐square and Fischer's exact tests. The overall success rate for teeth undergoing vital pulp was 84.6%, 76.2% as for the necrotic teeth and 84% for the retreatment cases. No significant differences were observed between groups (P > 0.05). Cases treated with CHX as main irrigant showed a high overall endodontic therapy success rate.
Understanding high rates of stillbirth and neonatal death in a disadvantaged, high‐migrant district in France: A perinatal audit
Authors: Sauvegrain Priscille , Carayol Marion , Piedvache Aurélie , Guéry Esther , Bréart Gérard , Bucourt Martine , Zeitlin Jennifer ,   the REMIP Investigator Team
Published: March 2020

Introduction

The objective of this study is to investigate factors associated with risks of perinatal death in a disadvantaged, high‐migrant French district with mortality rates above the national average.

Material and methods

The study design is a perinatal audit in 2014 in all 11 maternity units in the Seine‐Saint‐Denis district (25 037 births). The data come from medical chart abstraction, maternal interviews and peer assessor confidential review of deaths. A representative sample of live births in the same district, from the 2010 French Perinatal Survey, was used for comparisons (n = 429). The main outcome measures were stillbirth and neonatal death (0‐27 days) at ≥22 weeks of gestation.

Results

The audit included 218 women and 227 deaths (156 stillbirths, 71 neonatal deaths); 75 women were interviewed. In addition to primiparity and multiple pregnancy, overweight and obesity increased mortality risks (50% of cases, adjusted odds ratios [aOR] 1.7, 95% confidence interval [CI] 1.1‐2.8, and aOR 1.9 [95% CI 1.1‐3.2], respectively) as did the presence of preexisting medical/obstetric conditions (28.6% of cases, aOR 3.2, 95% CI 2.0‐5.3). Problems accessing or complying with care were noted in 25% of medical records and recounted in 50% of interviews. Assessors identified suboptimal factors in 73.2% of deaths and judged 33.9% to be possibly or probably preventable. Care not adapted to risk factors and poor healthcare coordination were frequent suboptimal factors. Possibly preventable deaths were higher (P < .05) for women with gestational diabetes or hypertension (44.6%) than women without (29.0%).

Conclusions

Preventive actions to improve healthcare referral and coordination, especially for overweight and obese women and women with medical and obstetrical risk factors, could reduce perinatal mortality in disadvantaged areas.
A systematic review of economic evaluations of advanced therapy medicinal products
Authors: Lloyd‐Williams Huw , Hughes Dyfrig A.
Published: March 2020

Aims

Advanced therapy medicinal products (ATMPs) represent a new category of medicinal products with a potential for transformative improvements in health outcomes but at exceptionally high prices. Routine adoption of ATMPs requires robust evidence of their cost‐effectiveness.

Methods

A systematic literature review of economic evaluations of ATMPs, including gene therapies, somatic cell therapies and tissue‐engineered products, was conducted. Literature was searched using MedLine, Embase, PubMed, Cochrane Register, the NHS Economic Evaluation Database and the grey literature of health technology assessment organisations with search terms relating to ATMPs and economic evaluations. Titles were screened independently by 2 reviewers. Articles deemed to meet the inclusion criteria were screened independently on abstract, and full texts reviewed. Study findings were appraised critically.

Results

4514 articles were identified, of which 23 met the inclusion criteria. There was some evidence supporting the cost‐effectiveness of: chimeric antigen receptor T‐cell therapy axicabtagene–ciloleucel (Yescarta), embryonic neural stem cells, tumour infiltrating lymphocytes, in vitro expanded myoblast, autologous chondrocyte implantation, ex vivo gene therapy (Strimvelis) and voretigene neparvovec (Luxturna). However, estimates of cost‐effectiveness were associated with significant uncertainty and high likelihood of bias, resulting from largely unknown long‐term outcomes, a paucity of evidence on health state utilities and extensive modelling assumptions.

Conclusion

There are critical limitations to the economic evidence for ATMPs, most notably in relation to evidence on the durability of treatment effect, and the reliability of opinion‐based assumptions necessary when evidence is absent.
Patterns of pregabalin initiation and discontinuation after its subsidy in Australia
Authors: Chiu Tricia , Brett Jonathan , Pearson Sallie‐Anne , Schaffer Andrea L.
Published: March 2020

Following the 2013 public subsidy of pregabalin in Australia for neuropathic pain not responding to other medicines, use and misuse increased substantially. We used pharmaceutical dispensing claims for a 10% sample of Australians to quantify initiation, discontinuation and dispensing of other analgesics before and after initiation. We identified 130 770 people initiating pregabalin between 2013/14 and 2017/18 (median age: 61 years; 56.8% female). Discontinuation rates at 1‐year increased from 77.0% in 2013/14 to 85.9% in 2017/18; 38% only had 1 dispensing. Approximately 1/3 (37.5%) initiated on the lowest strength capsule (25 mg) with only 31.2% later up‐titrating to a higher strength. 47.4% and 53.0% were dispensed opioids within 180 days before and after pregabalin initiation, respectively. Many individuals are using pregabalin for short treatment durations and low dose ranges not consistent with treatment of neuropathic pain, which is generally a chronic condition. This may suggest poorer tolerability than observed in clinical trials, or use for other conditions, some of which may be for indications where the balance of benefits and risk is less clear.
Prejudice against members of a ridiculed working‐class group
Authors: Vázquez Alexandra , Lois David
Published: March 2020

In five experiments, we examined the stereotypes, emotions, and behavioural intentions associated with a Spanish working‐class group, known as chonis. We described a student (Experiments 1–3) or job candidate (Experiments 4–5) and presented participants with a picture showing a woman characterized either as choni or posh (an upper‐class group, Experiments 2–4) or with no picture (Experiments 1, 3–5). Depending on the condition, explicit information about her high social class (Experiment 1), performance (Experiment 3), or category (Experiment 5) was provided. Participants evaluated the candidate more negatively, felt less admiration, and were less willing to interact with her or to recommend her for a job when she was categorized as choni as compared to the other categories. These effects disappeared if the student/candidate had high socioeconomic status or performed excellently in the academic domain, but they were magnified for highly (vs. weakly) materialistic individuals. Class prejudice apparently has harmful effects on disadvantaged individuals, but can be mitigated by explicit information.
P2Y6 receptor inhibition aggravates ischemic brain injury by reducing microglial phagocytosis
Authors: Wen Ruo‐Xue , Shen Hui , Huang Shu‐Xian , Wang Li‐Ping , Li Zong‐Wei , Peng Peng , Mamtilahun Muyassar , Tang Yao‐Hui , Shen Fan‐Xia , Tian Heng‐Li , Yang Guo‐Yuan , Zhang Zhi‐Jun
Published: March 2020

Introduction

Clearance of damaged cells and debris is beneficial for the functional recovery after ischemic brain injury. However, the specific phagocytic receptor that mediates microglial phagocytosis after ischemic stroke is unknown.

Aim

To investigate whether P2Y6 receptor‐mediated microglial phagocytosis is beneficial for the debris clearance and functional recovery after ischemic stroke.

Results

The expression of the P2Y6 receptor in microglia increased within 3 days after transient middle cerebral artery occlusion. Inhibition of microglial phagocytosis by the selective inhibitor MRS2578 enlarged the brain atrophy and edema volume after ischemic stroke, subsequently aggravated neurological function as measured by modified neurological severity scores and Grid walking test. MRS2578 treatment had no effect on the expression of IL‐1α, IL‐1β, IL‐6, IL‐10, TNF‐α, TGF‐β, and MPO after ischemic stroke. Finally, we found that the expression of myosin light chain kinase decreased after microglial phagocytosis inhibition in the ischemic mouse brain, which suggested that myosin light chain kinase was involved in P2Y6 receptor‐mediated phagocytosis.

Conclusion

Our results indicate that P2Y6 receptor‐mediated microglial phagocytosis plays a beneficial role during the acute stage of ischemic stroke, which can be a therapeutic target for ischemic stroke.
Validation of the Finnish severe respiratory insufficiency questionnaire
Authors: Kotanen Petra , Kainu Annette , Brander Pirkko , Bergman Paula , Lehtomäki Anu , Kreivi Hanna‐Riikka
Published: March 2020

Introduction

Chronic respiratory insufficiency impacts patients' lives and reduces quality of life. The Severe Respiratory Insufficiency (SRI) questionnaire examines health‐related quality of life and is designed specifically for patients receiving home mechanical ventilation (HMV) for chronic respiratory failure (CRF).

Objectives

The aim of this study was to validate the Finnish version of the SRI and study its reproducibility in patients with CRF.

Methods

Our 74 patients receiving HMV or long‐term oxygen treatment for CRF or both completed the SRI and St George's Respiratory questionnaires (SGRQ) three times (at baseline, and then one week and one month later). Reliability and validity of the questionnaires was analysed with Cronbach's alpha and intraclass correlation coefficient. Patients were prospectively followed up for 5 years, with data collected on their use of hospital services and mortality.

Results

Cronbach's alpha in the SRI ranged from 0.67 to 0.88 and was >0.7 on all subscales except the “attendant symptoms and sleep”. On four subscales, Cronbach’s alpha was >0.8, and on the summary scale, 0.95. The SRI showed high correlation with SGRQ. Both tests showed good reproducibility. During the 5‐year follow‐up, 27 (36%) patients died.

Conclusions

The Finnish SRI proved valid, reliable and reproducible. Its psychometric properties were good and similar to those of the original questionnaire and of other validation studies.
Contrasting latitudinal clines of nematode diversity in Spartina alterniflora salt marshes between native and introduced ranges
Authors: Zhang Youzheng , Li Bo , Wu Jihua , Pennings Steven C.
Published: March 2020

Aim

Introduced species may display or foster novel latitudinal clines because they are not well adapted to their new habitats. We tested the hypothesis that the latitudinal cline in nematode diversity in salt marshes would differ between the native (United States) and introduced (China) ranges of Spartina alterniflora.

Location

East Coasts of the United States (30.32–43.33°N) and China (30.36–39.14°N).

Methods

We extracted nematodes from soil samples collected at 32 sites along the United States East Coast and 41 sites along the Chinese coast. We compared latitudinal patterns in nematode diversity and composition between the native and introduced ranges.

Results

In the native range of S. alterniflora, nematode richness at lower latitudes was almost twice as high as that at higher latitudes. In contrast, we found no latitudinal pattern in nematode richness or diversity in the introduced range of S. alterniflora. Nematode genus richness at all sites in China was about half that at lower latitudes in the United States. Beta diversity of nematodes increased with geographic distance in the United States, but not China.

Main conclusions

Nematode diversity did not show latitudinal clines in salt marshes dominated by introduced S. alterniflora in China. A likely explanation is that the recently introduced populations are still relatively genetically homogenous, whereas in the native range, genetic variation in plant populations across latitude drives different nematode communities. We suggest that future studies of introduced species will gain additional insights by taking an explicitly geographic perspective.
Attentional abilities constrain language development: A cross‐syndrome infant/toddler study
Authors: D'Souza Dean , D'Souza Hana , Jones Emily J. H. , Karmiloff‐Smith Annette
Published: March 2020

Typically developing (TD) infants adapt to the social world in part by shifting the focus of their processing resources to the relevant aspects of a visual scene. Any impairment in visual orienting may therefore constrain learning and development in domains such as language. However, although something is known about visual orienting in infants at risk of autism, very little is known about it in infants/toddlers with other neurodevelopmental disorders. This is partly because previous studies focused on older children and rarely compared the children tobothchronological age (CA)‐ and mental age (MA)‐matched TD controls. Yet, if visual orienting is important for learning and development, then it is imperative to investigate itearly in developmentand ascertain whether it relates to higher level cognitive functions such as language. We used eye‐tracking technology to directly compare visual orienting in infants/toddlers with one of three neurodevelopmental disorders—Down syndrome (DS), fragile X syndrome (FXS) and Williams syndrome (WS)—matched on CA or MA to TD controls (~15 months). We also measured language ability using the Mullen Scales of Early Learning (MSEL). We found that the ability todisengageattention from a visual stimulus in order to shift it to another visual stimulus is related to language ability in infants/toddlers irrespective of group affiliation. We also found that, contrary to the literature, infants and toddlers with DS (but not WS) are slow at disengaging attention. Our data suggest that orienting attention constrains language development and is impaired in DS.
Participated without consent: Mandatory authorization of government database for secondary use
Authors: Yeh Ming‐Jui
Published: March 2020

Compared with data that is initially collected for research purposes, the mandatory authorization of a government database for secondary use deserves greater scrutiny because it consists of information that is collected initially for administrative purposes. Using the case of Taiwan’s National Health Insurance (NHI) Database as an example, this paper analyzes the ethical issues that emerge when the research participants are “participated” in studies without their consent, according to the current policy. The proponents of secondary use for research purposes maintain that the authorized use of the NHI Database is necessary for public interests, while the opponents argue that the potential lack of democratic accountability and the infringement on people’s rights to privacy and information autonomy is unwarranted. Drawing on the solidarity‐based approach, this paper proposes a temporal solution as a possible reform direction for better ethical justification of the secondary use of the NHI Database.
A new approach to the continuous monitoring of transvenous lead extraction using transesophageal echocardiography—Analysis of 936 procedures
Authors: Nowosielecka Dorota , Polewczyk Anna , Jacheć Wojciech , Tułecki Łukasz , Tomków Konrad , Stefańczyk Paweł , Kleinrok Andrzej , Kutarski Andrzej
Published: March 2020

Aims

The usefulness of transesophageal echocardiographic (TEE) monitoring for transvenous lead extraction (TLE) procedures is still controversial. The purpose of the current study was to present new TEE values in detecting invisible events in fluoroscopy and preventing the development of dangerous complications.

Methods

From 2015 to 2019, a total of 1026 procedures were performed in single TLE center. In total, 1108 leads had been extracted with a mean lead dwell time of 115.8 ± 77.6 months. Continuous TEE was used in 936 patients with a mean age of 67.1 ± 14.4 years.

Results

Preprocedure examination revealed looped leads in 181 (19.3%) patients, dry cardiac perforation in 151 (16.1%), lead‐to‐lead adhesion in 172 (18.4%), lead adhesion to the myocardium in 317 (33.9%), and vegetations in 119 (12.7%) patients. Intra‐procedural TEE demonstrated pulling on the atrial wall, ventricular wall, or tricuspid valve in 380 (40.5%), 235 (25.1%), and 78 (8.3%) patients, respectively. Acute tamponade requiring sternotomy occurred in 11 (1.1%) patients. Migration of vegetation or connective tissue fragments were seen in 69 (7.3%) and 111 (11.8%) patients, respectively. After procedure, TEE was helpful in navigating an implantation, a new lead in 97 (10.3%) patients, and removing the remnants of lead/silicone insulation in 50 (5.3%) patients.

Conclusion

Real time transesophageal echocardiography for the guidance of transvenous lead extraction informs the operator about the danger of manipulations close to delicate cardiac structures and whether immediate modification to the plan of lead removal is necessary in order to prevent the occurrence of unwanted events.
Expression and prognostic significance of the P53‐related DNA damage repair proteins checkpoint kinase 1 (CHK1) and growth arrest and DNA‐damage‐inducible 45 alpha (GADD45A) in human oral squamous cell carcinoma
Authors: Xie Liping , Jia Limin , Qu Jinyue , Chen Dong , Lv Yanhong , Li Haixia , Zheng Jinhua
Published: March 2020

DNA damage repair is a key factor in the maintenance of cell genome stability, plays an important role in the regulation of tumour evolution, and can affect the prognosis of cancer patients. This study aimed to detect the protein expression of the DNA damage repair protein P53 and its upstream and downstream regulators, CHK1, GADD45A, and MDM2, in oral squamous cell carcinoma (OSCC), in order to analyse the association between the expression of these proteins and overall survival, and to assess their prognostic implications for OSCC patients. The expression of the above proteins was detected by immunohistochemistry in 80 human OSCC tissue samples and in non‐cancerous tissue samples. Compared to that in the non‐cancerous tissue, the expression of CHK1, GADD45A, and MDM2 in OSCC tissue was significantly increased. The protein expression of the tumour suppressor gene P53 was also increased. Patients with high CHK1 and MDM2 expression levels had a reduced survival time and a poor prognosis, whereas patients with high GADD45A expression levels had a good prognosis. Our results indicate that high CHK1 expression is an independent risk factor for poor OSCC prognosis, and that CHK1 may be a potential target for OSCC clinical treatment.
Peri‐ictal responsiveness to the social environment is greater in psychogenic nonepileptic than epileptic seizures
Authors: Wardrope Alistair , Wong Siew , McLaughlan Jonathan , Wolfe Maytal , Oto Maria , Reuber Markus
Published: March 2020

Objective

To look for evidence of peri‐ictal social interaction in psychogenic nonepileptic seizures (PNES) and epileptic seizures exploring the notion of PNES as a form of nonverbal communication.

Methods

Video recordings of typical seizures experienced by patients with epilepsy and PNES were obtained in a naturalistic social setting (residential epilepsy monitoring unit). Video analysis by three nonexpert clinicians identified 18 predefined semiological and interactional features indicative of apparent impairment of consciousness or of peri‐ictal responsiveness to the social environment with assessment of interrater reliability using Fleiss κ. Features were compared between epileptic seizures and PNES.

Results

One hundred eighty‐nine seizures from 50 participants (24 epilepsy, 18 PNES, eight combined) were analyzed. At least fair (κ > 0.20) interrater agreement was achieved for 14 features. The PNES and epileptic seizures compared were of similar severity in terms of ictal impairment of consciousness (κ = 0.34, odds ratio [OR] = 1.11, 95% confidence interval [CI] = 0.62‐1.96) and responsiveness (κ = 0.52, OR = 1.01, 95% CI = 0.55‐1.86). PNES were more likely to be preceded by attempts to alert others (κ = 0.52, OR = 12.4, 95% CI = 3.2‐47.7,P < .001), to show intensity affected by the presence of others (κ = 0.44, OR = 199.4, 95% CI = 12.0‐3309.9,P < .001), and to display postictal behavior affected by the presence of others (κ = 0.35, OR = 91.1, 95% CI = 17.2‐482.1,P < .001).

Significance

Nonexpert raters can, with fair to moderate reliability, rate features characterizing ictal impairment of consciousness and responsivity in video recordings of seizures. PNES are associated with greater peri‐ictal responsiveness to the social environment than epileptic seizures. These findings are consistent with a potential communicative function of PNES and could be of differential diagnostic significance.
Testing adaptive significance of host manipulation with a parasitoid wasp
Authors: Pecina Peter , Vidlička Ľubomír , Prokop Pavol
Published: March 2020

According to the extended phenotype hypothesis, certain parasites manipulate the host's behaviour which ultimately enhances the transmission of parasite genes into the next generation. The parasitoid waspAmpulex compressaattacks and stings its cockroachPeriplaneta americanahost and lays an egg on the cockroach's leg. Before the wasp's oviposition, the stung cockroach engages in excessive self‐grooming for about 30 min. The prey location hypothesis posits that self‐grooming may allow the wasp to easily locate its host before transporting it to the nest. To test this hypothesis, we manipulated the mobility of the stung cockroach under different spatial constraints. Latencies to locate stung cockroaches with unlimited movement were similar than latencies to locate stung, but motionless cockroaches irrespectively of spatial constraints. Wasps were less willing to lay eggs and seal an entrance to the burrow in treatments with motionless cockroaches which suggests that if the expected reproductive success is low, then parental investment decreases. Our results provide no support for the location hypothesis and call for further experimental investigation of the extended phenotype hypothesis in parasite–host interactions.
Evolution of tumor cells during AsiDNA treatment results in energy exhaustion, decrease in responsiveness to signal, and higher sensitivity to the drug
Authors: Girard Pierre‐Marie , Berthault Nathalie , Kozlac Maria , Ferreira Sofia , Jdey Wael , Bhaskara Srividya , Alekseev Sergey , Thomas Frederic , Dutreix Marie
Published: March 2020

It is increasingly suggested that ecological and evolutionary sciences could inspire novel therapies against cancer but medical evidence of this remains scarce at the moment. The Achilles heel of conventional and targeted anticancer treatments is intrinsic or acquired resistance following Darwinian selection; that is, treatment toxicity places the surviving cells under intense evolutionary selective pressure to develop resistance. Here, we review a set of data that demonstrate that Darwinian principles derived from the “smoke detector” principle can instead drive the evolution of malignant cells toward a different trajectory. Specifically, long‐term exposure of cancer cells to a strong alarm signal, generated by the DNA repair inhibitor AsiDNA, induces a stable new state characterized by a down‐regulation of the targeted pathways and does not generate resistant clones. This property is due to the original mechanism of action of AsiDNA, which acts by overactivating a “false” signaling of DNA damage through DNA‐PK and PARP enzymes, and is not observed with classical DNA repair inhibitors such as the PARP inhibitors. Long‐term treatment with AsiDNA induces a new “alarm down” state in the tumor cells with decrease in NAD level and reactiveness to it. These results suggest that agonist drugs such as AsiDNA could promote a state‐dependent tumor cell evolution by lowering their ability to respond to high “danger” signal. This analysis provides a compelling argument that evolutionary ecology could help drug design development in overcoming fundamental limitation of novel therapies against cancer due to the modification of the targeted tumor cell population during treatment.
Clinical and ultrasonographic findings of a tear of the gastrocnemius muscle and enthesopathy of the origin of the superficial digital flexor muscle in a reining Quarter Horse mare
Authors: Romero J. M. , Pressanto M. C. , Pepe M. , Di Meo A. , Beccati F.
Published: March 2020

Proximal gastrocnemius and superficial digital flexor (SDF) muscle injuries are reported in the horse but are uncommon. In adult horses, the definitive diagnosis is more commonly based on clinical signs with or without the use of radiographic examination and/or nuclear scintigraphy. This case report describes the clinical and ultrasonographic findings of a tear of the gastrocnemius muscle in a 6‐year‐old reining mare. At standing physical examination, there was a sickled hock appearance, with the point of the hock of the left hindlimb lower (dropped hock) than that of the right hindlimb. At dynamic examination at walk, the mare had instability of the left hock characterised by medial rotation of the hoof and lateral rotation of the point of the hock (twisting motion); at trot, the horse showed mild/moderate left hindlimb lameness characterised by more downward movement of the pelvis during weightbearing of the lame limb compared with that of the sound limb. Ultrasonographic examination of the left thigh and crus showed a large irregular hypoechogenic area and irregularly shaped, retracted muscle stumps on the lateral aspect of the gastrocnemius muscles; the proximal insertion of the SDF muscle on the supracondylar fossa of the femur was irregular in its outline, hypoechogenic and thickened compared with that of the right side. Characteristic muscle fibre pattern was not identified in the left gastrocnemius muscle. On the radiography, a mild irregularity of the bone margin of the lateral supracondylar tuberosity was detected on the caudo 45° medial‐craniolateral oblique view of the distal femur. Clinical and diagnostic imaging findings were consistent with partial failure of the caudal part of the reciprocal apparatus and injury of the gastrocnemius and SDF muscles/origin. The horse was managed conservatively by corrective shoeing, muscle relaxing drugs, controlled exercise and manual stretching.
Exposure to noise pollution across North American passerines supports the noise filter hypothesis
Authors: Cardoso Gonçalo C. , Klingbeil Brian T. , La Sorte Frank A. , Lepczyk Christopher A. , Fink Daniel , Flather Curtis H.
Published: March 2020

The noise filter hypothesis predicts that species using higher sound frequencies should be more tolerant of noise pollution, because anthropogenic noise is more intense at low frequencies. Recent work analysed continental‐scale data on anthropogenic noise across the USA and found that passerine species inhabiting more noise‐polluted areas do not have higher peak song frequency but have more complex songs. However, this metric of song complexity is of ambiguous interpretation, because it can indicate either diverse syllables or a larger frequency bandwidth. In the latter case, the finding would support the noise filter hypothesis, because larger frequency bandwidths mean that more sound energy spreads to frequencies that are less masked by anthropogenic noise. We reanalysed how passerine song predicts exposure to noise using a more thorough dataset of acoustic song measurements, and showed that it is large frequency bandwidths, rather than diverse syllables, that predict the exposure of species to noise pollution. Given that larger bandwidths often encompass higher maximum frequencies, which are less masked by anthropogenic noise, our result suggests that tolerance to noise pollution might depend mostly on having the high‐frequency parts of song little masked by noise, thus preventing acoustic communication from going entirely unnoticed at long distances.