bluuebunny/crossref_metadata_2025 huggingface dataset:
Is pelvic floor muscle contractility an important factor in anal incontinence?
Authors: Mengistu Z. , Gillor M. , Dietz H. P.
Published: September 2020

Objective

Pelvic floor muscle contractility (PFMC) may contribute to anal continence. The aim of this study was to assess the association between clinical and sonographic measures of PFMC and anal incontinence (AI) symptoms, after controlling for anal sphincter and levator ani muscle (LAM) trauma.

Methods

This was a retrospective study of 1383 women assessed at a tertiary center between 2013 and 2016. All patients underwent an interview, including the St Mark's incontinence score (SMIS) in those who reported AI symptoms, a clinical examination, including assessment of PFMC using the modified Oxford scale (MOS), and four‐dimensional translabial ultrasound (TLUS). Sonographic measures of PFMC, i.e. cranioventral shift of the bladder neck (BN) and reduction of anteroposterior (AP) diameter of the levator hiatus, were measured offline using ultrasound volumes obtained at rest and on maximum pelvic floor contraction. The reviewer was blinded to all clinical data.

Results

Of the 1383 patients assessed during the study period, seven were excluded due to missing imaging data, leaving 1376 for analysis. Mean age of the participating women was 55 years and mean body mass index was 29 kg/m2. AI was reported by 221 (16.1%) women, with a mean SMIS of 11.8. Mean MOS grade was 2.3. On TLUS, mean BN cranioventral shift was 5.9 mm and mean AP diameter reduction was 8.1 mm. LAM avulsion and significant external anal sphincter (EAS) defect were diagnosed in 24.8% and 8.7% patients, respectively. On univariate analysis, sonographic measures of PFMC were not associated with AI. Lower MOS grade was associated with symptoms of AI; however, statistical significance was lost on multivariate analysis.

Conclusion

Clinical and sonographic measures of PFMC were not significantly associated with AI symptoms after controlling for EAS and LAM trauma. © 2020 International Society of Ultrasound in Obstetrics and Gynecology
Translational control in aging and neurodegeneration
Authors: Skariah Geena , Todd Peter K.
Published: September 2020

Protein metabolism plays central roles in age‐related decline and neurodegeneration. While a large body of research has explored age‐related changes in protein degradation, alterations in the efficiency and fidelity of protein synthesis with aging are less well understood. Age‐associated changes occur in both the protein synthetic machinery (ribosomal proteins and rRNA) and within regulatory factors controlling translation. At the same time, many of the interventions that prolong lifespan do so in part by pre‐emptively decreasing protein synthesis rates to allow better harmonization to age‐related declines in protein catabolism. Here we review the roles of translation regulation in aging, with a specific focus on factors implicated in age‐related neurodegeneration. We discuss how emerging technologies such as ribosome profiling and superior mass spectrometric approaches are illuminating age‐dependent mRNA‐specific changes in translation rates across tissues to reveal a critical interplay between catabolic and anabolic pathways that likely contribute to functional decline. These new findings point to nodes in posttranscriptional gene regulation that both contribute to aging and offer targets for therapy.

This article is categorized under:

Translation > Translation Regulation

Translation > Ribosome Biogenesis

Translation > Translation Mechanisms
The Classification of Melancholia in Mid-Nineteenth-Century British Medicine
Authors: Jansson Åsa
Published: September 2020

This chapter traces melancholia from the early nineteenth century, when its nosological status as an independent disease category was contested, up until the 1860s. At this time, the view that insanity could be chiefly of the emotional kind, that is, largely without delusion of thought, was rapidly gaining ground among European medical writers. This shift from more traditional views of madness was crucial as it provided the epistemological foundation and conceptual framework necessary for disordered mood to become a possible and plausible medical concept. The chapter charts the nosological trajectory of melancholia through the work mid-century British physicians, who began to appropriate physiological language to speak about disordered mood and melancholia, increasingly abandoning older models.
The soft $$ \mathcal{S} $$-matrix in gravity
Authors: Himwich E. , Narayanan S.A. , Pate M. , Paul N. , Strominger A.
Published: September 2020

Abstract

The gravitational $$ \mathcal{S} $$
S
-matrix defined with an infrared (IR) cutoff factorizes into hard and soft factors. The soft factor is universal and contains all the IR and collinear divergences. Here we show, in a momentum space basis, that the intricate expression for the soft factor is fully reproduced by two boundary currents, which live on the celestial sphere. The first of these is the supertranslation current, which generates spacetime supertranslations. The second is its symplectic partner, the Goldstone current for spontaneously broken supertranslations. The current algebra has an off-diagonal level structure involving the gravitational cusp anomalous dimension and the logarithm of the IR cutoff. It is further shown that the gravitational memory effect is contained as an IR safe observable within the soft $$ \mathcal{S} $$
S
-matrix.
Biological activity versus physiological function of proinsulin C-peptide
Authors: Landreh Michael , Jörnvall Hans
Published: September 2020

Proinsulin C-peptide (C-peptide) has drawn much research attention. Even if the peptide has turned out not to be important in the treatment of diabetes, every phase of C-peptide research has changed our view on insulin and peptide hormone biology. The first phase revealed that peptide hormones can be subject to processing, and that their pro-forms may involve regulatory stages. The second phase revealed the possibility that one prohormone could harbor more than one activity, and that the additional activities should be taken into account in the development of hormone-based therapies. In the third phase, a combined view of the evolutionary patterns in hormone biology allowed an assessment of C-peptide´s role in physiology, and of how biological activities and physiological functions are shaped by evolutionary processes. In addition to this distinction, C-peptide research has produced further advances. For example, C-peptide fragments are successfully administered in immunotherapy of type I diabetes, and plasma C-peptide levels remain a standard for measurement of beta cell activity in patients. Even if the concept of C-peptide as a hormone is presently not supported, some of its bioactivities continue to influence our understanding of evolutionary changes of also other peptides.
Effective balance equations for electrostrictive composites
Authors: Di Stefano Salvatore , Miller Laura , Grillo Alfio , Penta Raimondo
Published: September 2020

This work concerns the study of the effective balance equations governing linear elasticelectrostrictive composites, where mechanical strains can be observed due to the application of a given electric field in the so-calledsmall strain and moderate electric field regime. The formulation is developed in the framework of theactive elastic composites. The latter are defined as composite materials constitutively described by an additive decomposition of the stress tensor into a purely linear elastic contribution and another component, which is assumed to be given and quadratic in the applied electric field when further specialised to electrostrictive composites. We derive the new mathematical model by describing the effective mechanical behaviour of the whole material by means of theasymptotic(periodic)homogenisationtechnique. We assume that there exists a sharp separation between themicro-scale, where the distance among different sub-phases (i.e. inclusions and/or fibres and/or strata) is resolved, and themacro-scale, which is related to the average size of the whole system at hand. This way, we formally decompose spatial variations by assuming that every physical field and material property are depending on both the macro-scale and the micro-scale. The effective governing equations encode the role of the micro-structure, and the effective contributions to the global stress tensor are to be computed by solving appropriate linear-elastic-type cell problems on the periodic cell. We also provide analytic formulae for the electrostrictive tensor when the applied electric field is either microscopically uniform or given by a suitable multiplicative decomposition between purely microscopically and macroscopically varying components. The obtained results are consistently compared with previous works in the field, and can pave the way towards improvement of smart active materials currently utilised for engineering (possibly bio-inspired) purposes.
Kindeswohlgefährdung – Ausweitung des Hellfeldes durch Neukonzeption der klinischen Kinderschutzarbeit
Authors: Schmidt Claudia Maria , Klein Saskia , Stock Philippe , Reinshagen Konrad , Königs Ingo
Published: September 2020

Hintergrund

Das Erkennen von Kindesmisshandlungen und der Umgang damit sind Herausforderungen im ärztlichen Alltag. Die Dunkelziffer bei Misshandlungen und Vernachlässigungen ist hoch.

Ziel der Arbeit

Das Ziel der Arbeit war, die Effektivität des neu strukturierten Kinderschutzprogrammes einer großen deutschen Kinderklinik zu untersuchen und durch die Präsentation der Vorteile der neuen Struktur die Verbesserung von Programmen für Kinder und Mediziner in anderen Kliniken anzuregen.

Methode

Es wurden retrospektiv alle Kinderschutzfälle im Altonaer Kinderkrankenhaus vor und nach Neukonzeption der Kinderschutzarbeit über einen Zeitraum von jeweils 2 Jahren untersucht und miteinander verglichen. Die Kinderschutzgruppe war neu strukturiert worden und wurde nachfolgend von einer hauptamtlichen Kinderschutzkoordinatorin geleitet.

Ergebnis

Die Prävalenz der Verdachtsfälle und der erhärteten Fälle von Kindeswohlgefährdung ist im Untersuchungszeitraum nach Neukonzeption hoch signifikant erhöht. Im Zeitraum vor der Neukonzeption wurden 24 Fälle mit dem Verdacht auf Kindswohlgefährdung untersucht, 23 erhärtet, danach 124 Fälle untersucht, 89 erhärtet. Eine Stigmatisierung der Familien bei der Abklärung wurde trotz des signifikanten Anstiegs falsch-positiver Verdachtsfälle durch sensibles Vorgehen und eine Konfrontation erst bei Erhärtung des Verdachtes vermieden.

Schlussfolgerung

Das vorgestellte Konzept zum medizinischen Kinderschutz in Kinderkliniken scheint das Hellfeld bei Kindeswohlgefährdung effektiv auszuweiten. Sowohl die Reduktion nichtdetektierter Fälle mit der Verhinderung potenzieller Eskalation mit prolongiertem Leidensweg als auch die Verminderung der immensen gesellschaftlichen Folgekosten rechtfertigen die personellen Investitionen.
Does cystoscopy method affect the investigation of bladder pain syndrome/interstitial cystitis?
Authors: Tailor Visha K. , Morris Ellen , Bhide Alka A. , Fernando Ruwan , Digesu Guiseppe A. , Khullar Vik
Published: September 2020

Introduction and hypothesis

Cystoscopic investigation to identify associated histological findings of increased mast cells in the detrusor muscle has been recommended by the European Society for the Study of Bladder Pain Syndrome (ESSIC) in the investigation of bladder pain syndrome/interstitial cystitis (BPS/IC). The aim of this study was to identify if the cystoscopy approach impacts the biopsy results when investigating women presenting with symptoms of BPS/IC.

Methods

We performed a single-centre retrospective analysis of 300 bladder biopsy reports from 2015 to 2018 from women undergoing cystoscopy for BPS/IC. Biopsies obtained using closed cup forceps through a flexible (FC) or rigid cystoscope (RC) were compared.

Results

Fifty-eight FC biopsies were compared with 242 RC biopsies. FC biopsies had a smaller mean diameter (1.6 mm vs 2.9 mm p < 0.01) and volume (4.1 mm3 vs 9.6 mm3p < 0.001) compared with RC biopsies. There was no significant difference in the histological depth of sampling to the muscularis propria. A total of 292 samples had CD117 immunohistochemical staining for mast cell count (MCC) analysis. The MCC/mm2 was significantly lower in FC biopsies (p < 0.01). Sixteen percent of FC samples compared with 60% of RC samples had a high MCC >28/mm2 (p < 0.01). There was no significant difference in positive microbiology culture between FC (21%) and RC (28%) sampling.

Conclusion

Rigid and flexible cystoscopy can be used to investigate BPS/IC as recommended by international societies. However, the biopsy method impacts the mast cell count analysis, which can influence diagnosis and management. Therefore, RC would be the optimal investigation.
Endo-parameters for p-adic classical groups
Authors: Kurinczuk Robert , Skodlerack Daniel , Stevens Shaun
Published: September 2020

For a classical group over a non-archimedean local field of odd residual characteristicp, we prove that two cuspidal types, defined over an algebraically closed field$${\mathbf {C}}$$Cof characteristic different fromp, intertwine if and only if they are conjugate. This completes work of the first and third authors who showed that every irreducible cuspidal$${\mathbf {C}}$$C-representation of a classical group is compactly induced from a cuspidal type. We generalize Bushnell and Henniart’s notion of endo-equivalence to semisimple characters of general linear groups and to self-dual semisimple characters of classical groups, and introduce (self-dual) endo-parameters. We prove that these parametrize intertwining classes of (self-dual) semisimple characters and conjecture that they are in bijection with wild Langlands parameters, compatibly with the local Langlands correspondence.
The impact of acetylsalicylic acid dosed at bedtime on circadian rhythms of blood pressure in the high-risk group of cardiovascular patients—a randomized, controlled trial
Authors: Krasińska Beata , Paluszkiewicz Lech , Miciak-Ławicka Ewa , Krasinski Maciej , Rzymski Piotr , Tykarski Andrzej , Krasiński Zbigniew
Published: September 2020

Purpose

Time of drug administration may significantly influence its effect. The aim of the present study was to investigate the effect of ASA (administrated in the morning or in the evening) on the anti-hypertensive effect and diurnal blood pressure profile in the high-risk group of cardiovascular patients.

Methods

All patients (n = 114) had been diagnosed with coronary heart disease and arterial hypertension prior to the enrolment and had been treated with 75 mg per day of ASA in the morning. The patients were randomly assigned to one of the two study groups receiving 75 mg of ASA per day in a single antiplatelet therapy for 3 months in the morning (n = 58) or in the evening (n = 56). The control group (n = 61) consisted of patients with arterial hypertension but without coronary heart disease, not receiving ASA. In all the patients, during each visit, clinical blood pressure (BP) and ambulatory blood pressure measurements (ABPM) were performed.

Results

There was a significant reduction in 24-h BP and blood pressure at night in the ASA group evening group compared with the ASA morning group and the control group.

Conclusions

The present study demonstrated that compared with the use of ASA in the morning, its administration in the evening may lead to favourable drop in the ABPM and an improvement of the diurnal profile in the high-risk group of cardiovascular patients who are not naïve to ASA.
Switching from mesopredator to apex predator: how do responses vary in amphibians adapted to cave living?
Authors: Manenti Raoul , Melotto Andrea , Guillaume Olivier , Ficetola Gentile Francesco , Lunghi Enrico
Published: September 2020

The effective detection of both prey and predators is pivotal for the survival of mesopredators. However, the condition of being a mesopredator is strongly context dependent. Here we focus on two aquatic caudate species that have colonised caves: the Pyrenean newt (Calotriton asper) and the olm (Proteus anguinus). The former maintains both surface and subterranean populations, while only cave-adapted populations of the latter exist. Both species are apex predators in underground waterbodies, while the Pyrenean newt is a mesopredator in surface waterbodies. Shifting to a higher level of the trophic web through colonising caves may promote the loss of anti-predator response against surface apex predators, and an increase in the ability to detect prey. To test these two non-exclusive hypotheses, we integrated classical behavioural characterisations with a novel approach: the assessment of lateralisation (i.e. preference for one body side exposure). Behavioural experiments were performed using laboratory-reared individuals. We performed 684 trials on 39 Pyrenean newts and eight olms. Under darkness and light conditions, we tested how exposure to different chemical cues (predatory fish, prey and unknown scent) affected individuals’ activity and lateralisation. Both cave and surface Pyrenean newts responded to predator cues, while olms did not. In Pyrenean newts, predator cues reduced the time spent in movement and time spent in lateralisation associated with hunting. Our results show that predator recognition is maintained in a species where recently separated populations inhabit environments lacking of higher predators, while such behaviour tends to be lost in populations with longer history of adaptation.

Significance statement

Predator recognition can be maintained in animals adapted to predator free habitats, but varies with their history of adaptation. Species that are not at the apex of the food web can become top predators if they colonise subterranean environments. We compared the behavioural responses of the olm, a strictly cave species with a long underground evolutionary history, and of the Pyrenean newt, a facultative cave species that also has stream-dwelling populations. Moreover, we integrated a classical behavioural characterisation, such as movement detection, with a novel approach: the assessment of lateralisation. While olms do not respond to external predators scent, cave-dwelling newts still recognise it. This clearly indicates that predator recognition is still maintained in species that have colonised predator-free environments more recently.
Time-dependent solution of the NIMFA equations around the epidemic threshold
Authors: Prasse Bastian , Van Mieghem Piet
Published: September 2020

The majority of epidemic models are described by non-linear differential equations which do not have a closed-form solution. Due to the absence of a closed-form solution, the understanding of the precise dynamics of a virus is rather limited. We solve the differential equations of the N-intertwined mean-field approximation of the susceptible-infected-susceptible epidemic process with heterogeneous spreading parameters around the epidemic threshold for an arbitrary contact network, provided that the initial viral state vector is small or parallel to the steady-state vector. Numerical simulations demonstrate that the solution around the epidemic threshold is accurate, also above the epidemic threshold and for general initial viral states that are below the steady-state.
Clinical and pathological characteristics of ANA/anti-dsDNA positive patients with antineutrophil cytoplasmic autoantibody-associated vasculitis
Authors: Zhao Xiaohong , Wen Qiong , Qiu Yagui , Huang Fengxian
Published: September 2020

Antineutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis (AAV) consists of a group of systemic autoimmune diseases. The roles of serum anti-nuclear antibodies (ANA) and anti-double-stranded DNA (anti-dsDNA) antibodies in AAV patients remain unknown. This study investigated the prevalence of serum ANAs and anti-dsDNA antibodies in AAV patients and characterized the clinical and pathological features of these patients. A total of 218 AAV patients were enrolled. Clinical and pathological data of patients were analyzed retrospectively. Of the 218 AAV patients, 109 (50.0%) were positive for ANA, 45 (20.6%) were positive for anti-dsDNA, and 43 (19.7%) were positive for both. The AAV patients with ANA had severer kidney damage and more chronic renal histopathological changes compared to those who were negative for ANA. Specifically, patients positive for ANA had more hypertension, higher levels of urea nitrogen and serum creatinine, lower estimated glomerular filtration rate (eGFR), more end-stage renal disease (ESRD), severer proteinuria, glomerular sclerosis, tubular interstitial fibrosis and tubular atrophy, and were more likely to receive renal biopsies compared to ANA negative patients. The study found ANA and anti-dsDNA in AVV patients were not rare, ANA-positive AAV patients had severer kidney damage and more chronic renal histopathological changes compared to ANA-negative AAV patients. Renal biopsy is strongly recommended for differential diagnosis in such cases.
Radiation dose management systems—requirements and recommendations for users from the ESR EuroSafe Imaging initiative
Authors: Loose Reinhard W. , Vano Eliseo , Mildenberger Peter , Tsapaki Virginia , Caramella Davide , Sjöberg Johan , Paulo Graciano , Torresin Alberto , Schindera Sebastian , Frija Guy , Damilakis John ,   on behalf of the European Society of Radiology (ESR)
Published: September 2020

The European Directive 2013/59/Euratom requires member states of the European Union to ensure justification and optimisation of radiological procedures and store information on patient exposure for analysis and quality assurance. The EuroSafe Imaging campaign of the European Society of Radiology created a working group (WG) on “Dose Management” with the aim to provide European recommendations on the implementation of dose management systems (DMS) in clinical practice. The WG follows Action 4: “Promote dose management systems to establish local, national, and European diagnostic reference levels (DRL)” of the EuroSafe Imaging Call for Action 2018. DMS are designed for medical practitioners, radiographers, medical physics experts (MPE) and other health professionals involved in imaging to support their tasks and duties of radiation protection in accordance with local and national requirements. The WG analysed requirements and critical points when installing a DMS and classified the individual functions at different performance levels.

Key Points

• DMS are very helpful software tools for monitoring patient exposure, optimisation, compliance with DRLs and quality assurance.

• DMS can help to fulfil dosimetric aspects of the European Directive 2013/59/Euratom.

• The EuroSafe WG analyses DMS requirements and gives recommendations for users.
Laser-guided real-time automatic target identification for endoscopic stone lithotripsy: a two-arm in vivo porcine comparison study
Authors: Schlager Daniel , Schulte Antonia , Schütz Jan , Brandenburg Albrecht , Schell Christoph , Lamrini Samir , Vogel Markus , Teichmann Heinrich-Otto , Miernik Arkadiusz
Published: September 2020

Introduction and objective

Thermal injuries associated with Holmium laser lithotripsy of the urinary tract are an underestimated problem in stone therapy. Surgical precision relies exclusively on visual target identification when applying laser energy for stone disintegration. This study evaluates a laser system that enables target identification automatically during bladder stone lithotripsy, URS, and PCNL in a porcine animal model.

Methods

Holmium laser lithotripsy was performed on two domestic pigs by an experienced endourology surgeon in vivo. Human stone fragments (4–6 mm) were inserted in both ureters, renal pelvises, and bladders. Ho:YAG laser lithotripsy was conducted as a two-arm comparison study, evaluating the target identification system against common lithotripsy. We assessed the ureters’ lesions according to PULS and the other locations descriptively. Post-mortem nephroureterectomy and cystectomy specimens were examined by a pathologist.

Results

The sufficient disintegration of stone samples was achieved in both setups. Endoscopic examination revealed numerous lesions in the urinary tract after the commercial Holmium laser system. The extent of lesions with the feedback system was semi-quantitatively and qualitatively lower. The energy applied was significantly less, with a mean reduction of more than 30% (URS 27.1%, PCNL 52.2%, bladder stone lithotripsy 17.1%). Pathology examination revealed only superficial lesions in both animals. There was no evidence of organ perforation in either study arm.

Conclusions

Our study provides proof-of-concept for a laser system enabling automatic real-time target identification during lithotripsy on human urinary stones. Further studies in humans are necessary, and to objectively quantify this new system’s advantages, investigations involving a large number of cases are mandatory.
Psychosocial emergency care in times of COVID-19: the Essen University Hospital concept for corona-infected patients, their relatives, and medical staff
Authors: Rentrop Vanessa , Schneider Johanna Sophie , Bäuerle Alexander , Junne Florian , Dörrie Nora , Skoda Eva-Maria , Schedlowski Manfred , Mallmann Bernhard , Benecke Anke-Verena , Kohler Hannah , Gerigk Monja , Teigelack Per , Emler Tobias , Scherbaum Norbert , Gradl-Dietsch Gertraud , Scheer Karin , Teufel Martin
Published: September 2020

Due to the SARS CoV-2-virus (COVID-19), anxiety, distress, and insecurity occur more frequently. In particular, infected individuals, their relatives, and medical staff face an increased risk of high psychological distress as a result of the ongoing pandemic. Thus, structured psychosocial emergency concepts are needed. The University hospital of Essen has taken up this challenge by creating the PEC concept to reduce psychosocial long-term consequences for infected patients, relatives, and medical staff at the university hospital. The concept includes professional medical as well as psychological support to convey constructive coping strategies and the provision of adequate tools such as the low-threshold online training program (CoPE It), which is accessible via the webpage www.cope-corona.de.
Association of tumor-infiltrating T lymphocytes with intestinal-type gastric cancer molecular subtypes and outcome
Authors: Mansuri Naziha , Birkman Eva-Maria , Heuser Vanina D. , Lintunen Minnamaija , Ålgars Annika , Sundström Jari , Ristamäki Raija , Lehtinen Laura , Carpén Olli
Published: September 2020

While host immune response is likely to be important for the prognosis of gastric cancer patients, detailed information on the T lymphocyte infiltration in different gastric cancer subtypes is lacking. Here, we studied the presence of CD3, CD8, and FOXP3 (Forkhead box p3) expressing T lymphocytes in a retrospective cohort of 190 intestinal gastric and gastroesophageal adenocarcinomas. The cancers represented four distinct molecular subtypes: Epstein-Barr virus–positive (EBV+), mismatch-repair-deficient (MMR-D), aberrant TP53, and the “other” subtype. The absolute numbers of CD3+, CD8+, and FOXP3+ T lymphocytes were analyzed in relation with these molecular subtypes and selected clinicopathological parameters. Overall, there was a large variation in the amount of infiltrating T lymphocyte in all molecular subtypes. Among the subtypes, EBV+ cancers differed from the other subtypes in increased lymphocyte infiltration and high CD8+/FOXP3+ ratio. While the TP53 aberrant subtype did not differ in the absolute amount of T lymphocyte, the ratio of CD8+/FOXP3+ and CD3+/FOXP3+ cells was highest in this subtype, possibly reflecting immunosuppression associated with genomic instability. Increased CD3+ and CD8+ T lymphocyte infiltrates were associated with better survival, and remained as independent prognostic factors in a multivariate analysis. This study is the first to investigate lymphocytic infiltration within four molecular subtypes of intestinal-type gastric cancer in a European cohort. The results provide an important addition to the current knowledge of T lymphocyte–dependent immune response in gastric cancer and its prognostic significance.
‘I don’t talk about my distress to others; I feel that I have to suffer my problems...’ Voices of Indian women with breast cancer: a qualitative interview study
Authors: Daniel Sunitha , Venkateswaran Chitra , Hutchinson Ann , Johnson Miriam J.
Published: September 2020

Background

Breast cancer is the commonest form of cancer among women globally, including in India. The rising incidence in the developing world is thought to be due to increased life expectancy, urbanisation, and adoption of western lifestyles. A recent systematic review found that Indian women living in India or as immigrants in Canada experienced a range of psychological distresses both ameliorated and exacerbated by cultural issues personally, within the family, within their community, and in the context of faith, and only two of the five qualitative studies explored the experience of women with breast cancer living in India. Distress may also affect treatment compliance.

Aim

The aim of the study was to explore the psychological distresses experienced by Indian women with breast cancer living in Kerala, South India, during and after treatment and to understand better what helped to relieve or increase these distresses.

Methods

In-depth interviews were conducted with 20 consenting women undergoing treatment for breast cancer. Purposive sampling was used to obtain maximum variation in sociodemographic and clinical characteristics. Interviews were verbatim transcribed, translated into English, and back-translated to Malayalam to ensure that the meaning had not been lost. English data were analysed using thematic frame work analysis and synthesised to provide a deeper understanding of the individuals’ experience.

Results

Three major themes emerged from the data. The first major theme was ‘far-reaching psychological distress’. This included anxiety, guilt, anger, and depression in response to the disease and physical side effects of treatment and issues relating to body image, especially hair loss and sexuality. The second major theme was ‘getting on with life’. Women tried to make sense of the disease, by actively seeking information, the role of medical professionals, and their practical adaptations. Many found a new future and a new way to live normal. The third major theme was the ‘support system’ strongly based on family, friends, faith, and the community which affect them positively as well as negatively.

Conclusion

Psychological concerns related to disease and treatment are common in Indian women with particular emphasis on body image issues associated with hair loss. Family and faith were key support systems for almost all the women, although it could also be the causes of distress.
Modeling human thinking about similarities by neuromatrices in the perspective of fuzzy logic
Authors: Grobelny Jerzy , Michalski Rafał , Weber Gerhard-Wilhelm
Published: September 2020

In this work, we propose a new method for modeling human reasoning about objects’ similarities. We assume that similarity depends on perceived intensities of objects’ attributes expressed by natural language expressions such as low, medium, and high. We show how to find the underlying structure of the matrix with intensities of objects’ similarities in the factor-analysis-like manner. The demonstrated approach is based on fuzzy logic and set theory principles, and it uses only maximum and minimum operators. Similarly to classic eigenvector decomposition, we aim at representing the initial linguistic ordinal-scale (LOS) matrix as a max–min product of other LOS matrix and its transpose. We call this reconstructing matrix a neuromatrix because we assume that such a process takes place at the neural level in our brain. We show and discuss on simple, illustrative examples, how the presented way of modeling grasps natural way of reasoning about similarities. The unique characteristics of our approach are treating smaller attribute intensities as less important in making decisions about similarities. This feature is consistent with how the human brain is functioning at a biological level. A neuron fires and passes information further only if input signals are strong enough. The proposal of the heuristic algorithm for finding the decomposition in practice is also introduced and applied to exemplary data from classic psychological studies on perceived similarities between colors and between nations. Finally, we perform a series of simulation experiments showing the effectiveness of the proposed heuristic.
A socio-ecological analysis of risk, protective and promotive factors for the mental health of Burundian refugee children living in refugee camps
Authors: Scharpf Florian , Mkinga Getrude , Masath Faustine Bwire , Hecker Tobias
Published: September 2020

Children and adolescents’ mental health risk and resilience arise from a complex interplay of factors on several socio-ecological levels. However, little is known about the factors that shape the mental health of refugee youth living in refugee camps close to ongoing conflict. We conducted a cross-sectional study with a representative sample of 217 Burundian refugee children aged 7–15 and their mothers residing in refugee camps in Tanzania to investigate associations between risk, protective and promotive factors from various ecological levels (individual, microsystem, exosystem), and children’s post-traumatic stress disorder (PTSD) symptoms, internalizing and externalizing problems, and prosocial behavior. Data were collected using structured clinical interviews and analyzed using multiple regression models. Exposure to violence across all contexts and engagement coping were risk factors for PTSD symptoms and internalizing problems, while only violence by mothers seemed to increase children’s vulnerability for externalizing problems. A differential impact of violence exposures on prosocial behavior was observed. Higher-quality friendships appeared to protect youth from PTSD symptoms and externalizing problems, while they also promoted children’s prosocial behavior, just as mothers’ social support networks. Prevention and intervention approaches should integrate risk, protective and promotive factors for refugee youth’s mental health across multiple ecological contexts and take into account context-specific and adaptive responses to war and displacement.
Local experience, knowledge, and community adaptations to environmental change: the case of a fishing village in central Vietnam
Authors: Leithäuser Henner , Holzhacker Ronald Lindsey
Published: September 2020

Local ecological knowledge (LEK) represents an important link between resource users and their social-ecological system and plays a key role regarding the sustainable planning of environmental resources. This study investigates the nature of LEK in the case of a fishing village at the Tam Giang Lagoon in central Vietnam by applying an ethnographic participant observer approach. The research demonstrates a means to understand a complex, self-organized local network with a multitude of actors with different interests and adaptive behaviors, interfering in diverse and sometimes contradictory ways in the same environmental context. It concludes with two understandings about LEK. (1) It is important to recognize it as a concept that is not fixed in time and space as it is coevolving with broader system changes. (2) Only if approached through careful immersion and participation at the local level can it provide a valuable source of science-based information for improved decision-making.
Implementation of a continuous delivery pipeline for enterprise architecture model evolution
Authors: Sabau Alex R. , Hacks Simon , Steffens Andreas
Published: September 2020

The discipline of enterprise architecture (EA) is an established approach to model and manage the interaction of business processes and IT in an organization. Thereby, the EA model as a central artifact of EA is subject to a continuous evolution caused by multiple sources of changes. The continuous evolution requires a lot of effort in controlling and managing the evolution of the EA model. This is especially true when merging the induced changes from different sources in the EA model. Additionally, the lack of tool and automation support makes this a very time-consuming and error-prone task. The evolutionary character and the automated quality assessment of artifacts is a well-known challenge in the software development domain as well. To meet these challenges, the discipline of continuous delivery (CD) has emerged to be very useful. The evolution of EA model artifacts shows similarities to the evolution of software artifacts. Therefore, we leveraged practices of CD to practices of EA maintenance. Thus, we created a conceptual framework for automated EA model maintenance. The concepts were realized in a first prototype and were evaluated in a fictitious case study against equivalence classes based on EA model metrics and a set of several requirements for automated EA model maintenance from research. Overall, the concepts prove to be a promising basis for further refinement, implementation, and evaluation in research in an industrial context.
Circumventing the Crabtree effect: forcing oxidative phosphorylation (OXPHOS) via galactose medium increases sensitivity of HepG2 cells to the purine derivative kinetin riboside
Authors: Orlicka-Płocka Marta , Gurda-Wozna Dorota , Fedoruk-Wyszomirska Agnieszka , Wyszko Eliza
Published: September 2020

Small-molecule compound-based therapies have provided new insights into cancer treatment against mitochondrial impairment. N6-furfuryladenosine (kinetin riboside, KR) is a purine derivative and an anticancer agent that selectively affects the molecular pathways crucial for cell growth and apoptosis by interfering with mitochondrial functions and thus might be a potential mitotoxicant. Metabolism of cancer cells is predominantly based on the Crabtree effect that relies on glucose-induced inhibition of cell respiration and thus on oxidative phosphorylation (OXPHOS), which supports the survival of cancer cells in metabolic stress conditions. The simplest way to circumvent this phenomenon is to replace glucose with galactose in the culture environment. Consequently, cells become more sensitive to mitochondrial perturbations caused by mitotoxicants. In the present study, we evaluated several cellular parameters and investigated the effect of KR on mitochondrial functions in HepG2 cells forced to rely mainly on OXPHOS. We showed that KR in the galactose environment is a more potent apoptosis-inducing agent. KR decreases the mitochondrial membrane potential, reduces glutathione level, depletes cellular ATP, and induces reactive oxygen species (ROS) production in the OXPHOS state, leading to the loss of cell viability. Taken together, these results demonstrate that KR directly acts on the mitochondria to limit their function and that the sensitivity of cells is dependent on their ability to cope with energetic stress.
The Role of the Family’s Emotional Climate in the Links between Parent-Adolescent Communication and Adolescent Psychosocial Functioning
Authors: Kapetanovic Sabina , Skoog Therése
Published: September 2020

The current study was designed to extend the parenting literature by testing the moderating role of the family’s emotional climate, operationalized with parent-adolescent emotional closeness and adolescent feelings of being overly controlled by parents on the longitudinal associations between parent-driven communication efforts (i.e. parental behavioral control and solicitation of information from their adolescent), adolescent-driven communication efforts (i.e. adolescent disclosure and secrecy) and adolescent psychosocial functioning (i.e. emotional problems, conduct problems, delinquency, and wellbeing). We conducted a series of cross-lagged models controlling for adolescent gender and ethnicity using a two-wave Swedish longitudinal set of self-report data (N = 1515, 51% girls, M age = 13.0 and 14.3 years at T1 and T2, respectively). Multi-group analyses revealed that the negative links between T1 parental control and T2 adolescent delinquency, T1 parental solicitation and T2 adolescent conduct problems and delinquency, and T1 emotional problems and T2 adolescent disclosure were moderated by the family’s emotional climate. When the family’s emotional climate was positive, the parenting strategies had a more positive effect on adolescent psychosocial functioning, and adolescents with emotional problems communicated more openly with their parents. These findings suggest that the relational context in the family is an important protective factor and add specificity to the previously established role of parent-adolescent communication in adolescent psychosocial development. In terms of preventive interventions, strategies to enhance the family’s emotional climate should be considered prior to teaching specific parenting strategies.
Mechanical loading of tissue engineered skeletal muscle prevents dexamethasone induced myotube atrophy
Authors: Aguilar-Agon Kathryn W. , Capel Andrew J. , Fleming Jacob W. , Player Darren J. , Martin Neil R. W. , Lewis Mark P.
Published: September 2020

Skeletal muscle atrophy as a consequence of acute and chronic illness, immobilisation, muscular dystrophies and aging, leads to severe muscle weakness, inactivity and increased mortality. Mechanical loading is thought to be the primary driver for skeletal muscle hypertrophy, however the extent to which mechanical loading can offset muscle catabolism has not been thoroughly explored. In vitro 3D-models of skeletal muscle provide a controllable, high throughput environment and mitigating many of the ethical and methodological constraints present during in vivo experimentation. This work aimed to determine if mechanical loading would offset dexamethasone (DEX) induced skeletal muscle atrophy, in muscle engineered using the C2C12 murine cell line. Mechanical loading successfully offset myotube atrophy and functional degeneration associated with DEX regardless of whether the loading occurred before or after 24 h of DEX treatment. Furthermore, mechanical load prevented increases in MuRF-1 and MAFbx mRNA expression, critical regulators of muscle atrophy. Overall, we demonstrate the application of tissue engineered muscle to study skeletal muscle health and disease, offering great potential for future use to better understand treatment modalities for skeletal muscle atrophy.
Health-related stakeholders’ perceptions of clinical pharmacy services in Qatar
Authors: Jebara Tesnime , Cunningham Scott , MacLure Katie , Awaisu Ahmed , Pallivalapila Abdulrouf , Al Hail Moza , Stewart Derek
Published: September 2020

Background In Qatar, the National Vision 2030 and the National Health Strategy 2018–2022 articulate the need to improve healthcare delivery by better utilisation of the skilled workforce. In this regard, pharmacy practice is rapidly advancing and several extended pharmacy services are now available in institutionalised settings. Objective This study aimed to determine health-related stakeholders’ perceptions of current clinical pharmacy services in Qatar, and the potential development and implementation of further patient-centred roles. Setting All major organisations and institutions relating to the practice, education, regulation, and governance of pharmacy in Qatar. Method Qualitative, face-to-face semi-structured interviews were conducted with individuals in key strategic positions of policy development and influence (i.e. health-related academic leaders, healthcare policy developers, directors of medicine/pharmacy/nursing, and patient safety leaders). Participants were recruited via a combination of purposeful and snowball sampling, until the point of data saturation was reached. The interview guide was grounded in the Consolidated Framework for Implementation Research domains of innovation characteristics, outer and inner setting, characteristics of individuals, and implementation process. The interviews were digitally recorded, transcribed and independently analysed by two researchers using the Framework approach. Main outcome measure Perceptions of stakeholders regarding current and potential for future clinical pharmacy services in Qatar. Results Thirty-seven interviews were conducted with stakeholders of policy influence in healthcare. The interviewees reported a variety of clinical pharmacy services available in Qatar, which they perceived as positively impacting patient care outcomes, pharmacists’ professional autonomy, and the healthcare system in general (innovation characteristics). However, they perceived that these services were mainly performed in hospitals and less in community pharmacy setting (inner setting) and were undervalued by patients and the public (outer setting). Expansion of pharmacists’ clinical activities was supported, with recognition of facilitators such as the skillset and training of pharmacists, potential time release due to automation and well-considered implementation processes (characteristics of individuals, inner setting, process). Conclusion Health-related stakeholders in Qatar have positive perceptions of current clinical pharmacy services and support the expansion of pharmacist’s roles. However, service development needs to consider the issues of patient and public awareness and initially target institutionalised healthcare settings.
Understanding phase-transfer catalytic synthesis of fullerenol and its interference from carbon dioxide and ozone
Authors: Chokaouychai Sirikanya , Zhang Qi
Published: September 2020

Phase-transfer catalytic reaction involving the use of tetrabutylammonium hydroxide (TBAH) as catalyst and sodium hydroxide (NaOH) solution as the source of hydroxide ions is among the popular choices for synthesis of fullerenol, the polyhydroxylated fullerene. To further understand the process, two experiments were conducted to preliminarily explore the influences of the amount of TBAH and NaOH, respectively, in terms of the achieved level of hydroxylation (i.e. number of hydroxyl groups per fullerenol molecule). The process responded to the variation of the amount of TBAH (over a twofold series of 3–192 drops, average volume 0.0223 ± 0.0004 ml per drop) in a nonlinear manner with a local maximum achieved from 24 drops TBAH (giving 13 OH groups) and a local minimum from 48 drops (giving 8 groups). To the variation of the amount of NaOH (over the range of 0.5–8.0 ml NaOH), the fitted function of the process response resembled Freundlich adsorption isotherm, with an initially increasing trend before levelling off at 4.0 ml NaOH (giving 15 OH groups). It is therefore suggested that fullerene hydroxylation could be explained by liquid–solid adsorption. In addition, it was found that ambient carbon dioxide led to the existence of sodium carbonate in the bulk of the collected product (although not chemically bound). It was also discovered that ambient ozone adversely affected fullerenol synthesis by converting C60 fullerene into fullerene epoxide (C60O). The affected syntheses thus produced epoxide-containing fullerenol instead.