bluuebunny/crossref_metadata_2025 huggingface dataset:
History of Mindfulness and Psychology
Authors: Shapiro Shauna , Weisbaum Elli
Published: February 2020

Mindfulness practice and protocols—often referred to as mindfulness-based interventions (MBIs)—have become increasingly popular in every sector of society, including healthcare, education, business, and government. Due to this exponential growth, thoughtful reflection is needed to understand the implications of, and interactions between, the historical context of mindfulness (insights and traditions that have been cultivated over the past 25 centuries) and its recent history (the adaptation and applications within healthcare, therapeutic and modern culture, primarily since the 1980s).

Research has shown that MBIs have significant health benefits including decreased stress, insomnia, anxiety, and panic, along with enhancing personal well-being, perceptual sensitivity, processing speed, empathy, concentration, reaction time, motor skills, and cognitive performance including short- and long-term memory recall and academic performance. As with any adaptation, skillful decisions have to be made about what is included and excluded. Concerns and critiques have been raised by clinicians, researchers, and Buddhist scholars about the potential impact that the decontextualization of mindfulness from its original roots may have on the efficacy, content, focus, and delivery of MBIs. By honoring and reflecting on the insights, intentions, and work from both historical and contemporary perspectives of mindfulness, the field can support the continued development of effective, applicable, and accessible interventions and programs.
Inter-Agency Guidelines for Psychosocial Intervention in Emergencies
Authors: Bragin Martha S.
Published: February 2020

The Inter-Agency Standing Committee (IASC) is the arm of the international community that provides guidelines for practice in humanitarian emergencies and coordinates among the three parts of the humanitarian system: the United Nations and its agencies; the Red Cross and Red Crescent Societies and the International Committee for the Red Cross; and the consortia of International non-governmental organizations (NGOs). This article describes the IASC Guidelines for Mental Health and Psychosocial Support in Emergency Settings, their role and history, and the role of social work in their development. The article notes the concurrence of various aspects of the Guidelines with social work practice, and provides case examples of social work interventions in the context of the Guidelines. Practical tools that social workers can use when confronting emergencies at home or abroad are included in the reference list.
Contemporary reconstruction after complex facial trauma
Authors: Zeiderman Matthew R , Pu Lee L Q
Published: February 2020

Complex facial trauma requires complex repair and solutions. This process is challenging for the surgeon who seeks to manage the expectations of the patient and family while achieving the best possible result. Historically, the use of pedicled flaps, and then free tissue transfer, were the primary techniques utilized. Advancements in soft-tissue reconstruction, such as perforator flaps and pre-expanded and prefabricated flaps, allow refinement of the soft-tissue reconstruction process to create the best initial soft-tissue coverage. The advent of contemporary technologies, such as virtual surgical planning, stereolithography and customized implants and plates, facilitates a tailored approach to the patient’s reconstructive needs for precise bony reconstruction. When surgical and technological techniques are combined in complementary multistage reconstructions, better reconstructive and aesthetic outcomes are achievable than ever before. In this review, the authors present a summary of the management of complex facial trauma based on the senior author’s broad experience. Initial management and contemporary reconstructive techniques and technology to provide optimal outcomes are reviewed. A case series of complex facial traumas and their reconstructive process is also presented to demonstrate how complementary staged procedures can yield an optimal result. We believe the reconstructive surgeon managing complex facial trauma should strive to incorporate contemporary technologies and techniques into their armamentarium to provide the best patient care.
Evolution of renal function in patients with severe intestinal failure on home parenteral nutrition
Authors: Chalencon Elodie , Koppe Laetitia , Lauverjat Madeleine , Barnoud Didier , Fouque Denis , Chambrier Cécile
Published: February 2020

Background

Kidney disease is a frequent but underestimated complication in patients suffering from intestinal failure (IF) treated by long-term home parenteral nutrition (HPN). The evolution in glomerular filtration rate (GFR) over time is poorly characterized. The current equations for estimating GFR have limited precision. No study has specifically investigated the reliability of recent creatinine-based estimated GFR (eGFR) equations in this population. The aim of this study was to evaluate the renal function decline under home parenteral nutrition (HPN) with a gold standard method and compare the performances of routinely used eGFR equations.

Methods

Forty patients with HPN and two or more GFR measurements were retrospectively studied. The renal function decline was calculated by the slope drawn between the successive measured GFRs (mGFRs). The performances of the Modification of Diet in Renal Disease, Chronic Kidney Disease Epidemiology Collaboration, full age spectrum and revised Lund–Malmö equations were compared with reference methods (inulin or iohexol clearance).

Results

The mean mGFR was 78 ± 28 mL/min/1.73 m2. The annual decline of mGFR was −1.9 mL/min/1.73 m2/year. No predisposing factor was identified to predict impairment in renal function. eGFR formulas grossly overestimated mGFR and had a low level of accuracy.

Conclusions

Patients with IF are at significant risk for impaired renal function. In this population, the tested eGFR equations were inaccurate. However, monitoring kidney function with mGFR remains important in these patients, as their GFR regularly declines and no specific risk factor has yet been identified.
Data presentation in security operations centres: exploring the potential for sonification to enhance existing practice
Authors: Axon Louise , AlAhmadi Bushra A , Nurse Jason R C , Goldsmith Michael , Creese Sadie
Published: February 2020

Security practitioners working in Security Operations Centres (SOCs) are responsible for detecting and mitigating malicious computer network activity. This work requires both automated tools that detect and prevent attacks, and data presentation tools that can present pertinent network security monitoring information to practitioners in an efficient and comprehensible manner. In recent years, advances have been made in the development of visual approaches to data presentation, with some uptake of advanced security visualization tools in SOCs. Sonification in which data are represented as sound, is said to have potential as an approach that could work alongside existing visual data presentation approaches to address some of the unique challenges faced by SOCs. For example, sonification has been shown to enable peripheral monitoring of processes, which could aid practitioners multitasking in busy SOCs. The perspectives of security practitioners on incorporating sonification into their actual working environments have not yet been examined, however. The aim of this article, therefore, is to address this gap by exploring attitudes to using sonification in SOCs and by identifying the data presentation approaches currently used. We report on the results of a study consisting of an online survey (N = 20) and interviews (N = 21) with security practitioners working in a range of different SOCs. Our contributions are (i) a refined appreciation of the contexts in which sonification could aid in SOC working practice, (ii) an understanding of the areas in which sonification may not be beneficial or may even be problematic, (iii) an analysis of the critical requirements for the design of sonification systems and their integration into the SOC setting and (iv) evidence of the visual data presentation techniques currently used and identification of how sonification might work alongside and address challenges to using them. Our findings clarify insights into the potential benefits and challenges of introducing sonification to support work in this vital security monitoring environment. Participants saw potential value in using sonification systems to aid in anomaly detection tasks in SOCs (such as retrospective hunting), as well as in situations in which peripheral monitoring is desirable: while multitasking with multiple work tasks, or while outside of the SOC.
Marginalized Memories and Multi-Layered Narratives of the Great War in Kamila Shamsie’s A God In Every Stone (2014)
Authors: Windsor Tara Talwar
Published: February 2020

Taking Kamila Shamsie’s 2014 war novel A God in Every Stone as its core case study, this article examines the development of increasingly complex, heterogeneous and inclusive understandings and memories of the Great War in the twenty-first century. It demonstrates how the novel’s complex and intricate narrative, as well as its paratextual framing and much of its reception, offer a timely engagement with a range of hitherto hidden or marginalized histories, particularly in relation to the role of women and experiences of South Asian soldiers, as well as with colonial violence and anti-colonial resistance in the war’s aftermath. At the same time, the novel underscores the ambivalences contained in those stories. Through this analysis, the article considers the extent to which A God in Every Stone can be seen as a ‘more expansive form of commemoration [...] with the scope for multiple narratives’.1 The novel is also ‘historically and ethically responsible’, not least in its critical reflection on the purposes, practices and power structures behind longer-standing historical narratives and cultural memories of the war itself and the (imperial) past in a post-colonial global context.
Implementation of a Transitional Care Model for Stroke: Perspectives From Frontline Clinicians, Administrators, and COMPASS-TC Implementation Staff
Authors: Lutz Barbara J , Reimold Alexandria E , Coleman Sylvia W , Guzik Amy K , Russell Laurie P , Radman Meghan D , Johnson Anna M , Duncan Pamela W , Bushnell Cheryl D , Rosamond Wayne D , Gesell Sabina B
Published: February 2020

Background and Objectives

Stroke is a chronic, complex condition that disproportionally affects older adults. Health systems are evaluating innovative transitional care (TC) models to improve outcomes in these patients. The Comprehensive Post-Acute Stroke Services (COMPASS) Study, a large cluster-randomized pragmatic trial, tested a TC model for patients with stroke or transient ischemic attack discharged home from the hospital. The implementation of COMPASS-TC in complex real-world settings was evaluated to identify successes and challenges with integration into the clinical workflow.

Research Design and Methods

We conducted a concurrent process evaluation of COMPASS-TC implementation during the first year of the trial. Qualitative data were collected from 4 sources across 19 intervention hospitals. We analyzed transcripts from 43 conference calls with hospital clinicians, individual and group interviews with leaders and clinicians from 9 hospitals, and 2 interviews with the COMPASS-TC Director of Implementation using iterative thematic analysis. Themes were compared to the domains of the RE-AIM framework.

Results

Organizational, individual, and community factors related to Reach, Adoption, and Implementation were identified. Organizational readiness was an additional key factor to successful implementation, in that hospitals that were not “organizationally ready” had more difficulty addressing implementation challenges.

Discussion and Implications

Multifaceted TC models are challenging to implement. Facilitators of implementation were organizational commitment and capacity, prioritizing implementation of innovative delivery models to provide comprehensive care, being able to address challenges quickly, implementing systems for tracking patients throughout the intervention, providing clinicians with autonomy and support to address challenges, and adequately resourcing the intervention.

Clinical Trial Registration

NCT02588664
Resurrecting positive action
Authors: McCrudden Christopher
Published: February 2020

The idea of “positive action” has long been regarded as a key element in a gender equality strategy and has been extensively promoted by the European Union (EU) as such. This brief comment considers: (i) how far positive action has been adopted in the EU and the European Economic Area (EEA); (ii) the reasons why the practice of positive action has fallen short of the ambitions that the EU has had for it; and (iii) how it might best be resurrected. I emphasize in particular the need for a radically revised regulatory approach to be adopted, one more in keeping with the insights of regulatory theory in other contexts.
An iterative method for classification of binary data
Authors: Molitor Denali , Needell Deanna
Published: February 2020

In today’s data-driven world, storing, processing and gleaning insights from large-scale data are major challenges. Data compression is often required in order to store large amounts of high-dimensional data, and thus, efficient inference methods for analyzing compressed data are necessary. Building on a recently designed simple framework for classification using binary data, we demonstrate that one can improve classification accuracy of this approach through iterative applications whose output serves as input to the next application. As a side consequence, we show that the original framework can be used as a data preprocessing step to improve the performance of other methods, such as support vector machines. For several simple settings, we showcase the ability to obtain theoretical guarantees for the accuracy of the iterative classification method. The simplicity of the underlying classification framework makes it amenable to theoretical analysis.
Gene regulatory networks associated with lateral root and nodule development in soybean
Authors: Smita Shuchi , Kiehne Jason , Adhikari Sajag , Zeng Erliang , Ma Qin , Subramanian Senthil
Published: February 2020

Legume plants such as soybean produce two major types of root lateral organs, lateral roots and root nodules. A robust computational framework was developed to predict potential gene regulatory networks (GRNs) associated with root lateral organ development in soybean. A genome-scale expression data set was obtained from soybean root nodules and lateral roots and subjected to biclustering using QUBIC (QUalitative BIClustering algorithm). Biclusters and transcription factor (TF) genes with enriched expression in lateral root tissues were converged using different network inference algorithms to predict high-confidence regulatory modules that were repeatedly retrieved in different methods. The ranked combination of results from all different network inference algorithms into one ensemble solution identified 21 GRN modules of 182 co-regulated genes networks, potentially involved in root lateral organ development stages in soybean. The workflow correctly predicted previously known nodule- and lateral root-associated TFs including the expected hierarchical relationships. The results revealed distinct high-confidence GRN modules associated with early nodule development involving AP2, GRF5 and C3H family TFs, and those associated with nodule maturation involving GRAS, LBD41 and ARR18 family TFs. Knowledge from this work supported by experimental validation in the future is expected to help determine key gene targets for biotechnological strategies to optimize nodule formation and enhance nitrogen fixation.
Adult dogs of different breed sizes have similar threonine requirements as determined by the indicator amino acid oxidation technique
Authors: Mansilla Wilfredo D , Fortener Lisa , Templeman James R , Shoveller Anna K
Published: February 2020

Threonine (Thr) requirements for immature (growing) Beagles have been determined, but little knowledge is available on Thr requirements for maintenance in mature dogs. Moreover, differences of Thr requirements among different breeds or sizes of adult dogs have not been investigated. The objective of the present study was to determine Thr requirements in adult dogs of three different breeds using the indicator amino acid oxidation (IAAO) technique. In total, 13 adult dogs were used, 4 Miniature Dachshunds (5.8 ± 0.4 kg body weight [BW]; 3 spayed and 1 neutered), 4 spayed Beagles (9.3 ± 0.6 kg BW), and 5 neutered Labrador Retrievers (30.5 ± 1.7 kg BW). Dogs were fed a Thr-deficient diet (Thr = 0.23%) and randomly allocated to receiving one of seven concentrations of Thr supplementation (final Thr concentration in experimental diets was 0.23%, 0.33%, 0.43%, 0.53%, 0.63%, 0.73%, and 0.83%; as fed basis) for 2 d. After 2 d of adaptation to the experimental diets, dogs underwent individual IAAO studies. During the IAAO studies, total daily feed was divided into 13 equal meals; at the sixth meal, dogs were fed a bolus of l-[1-13C]-Phenylalanine (Phe) (9.40 mg/kg BW), and thereafter, l-[1-13C]-Phe (2.4 mg/kg BW) was supplied with every meal. Before feeding the next experimental diet, dogs were fed a Thr-adequate basal diet for 4 d (Thr = 0.80% as fed basis) in known amounts that maintained individual dog BW. Total production of 13CO2 during isotopic steady state was determined by enrichment of 13CO2 in breath samples and total production of CO2 measured using indirect calorimetry. The mean requirements for Thr, defined as the breakpoint, and the 95% confidence interval (CI) were determined using a two-phase linear regression model. For Miniature Dachshunds, the two-phase model was not significant, and Thr requirements could not be determined. Mean Thr requirements for Beagles and Labradors were 72.2 and 64.1 mg/kg BW on an as-fed basis, respectively. The requirement for Thr between these two dog breeds was not different (P > 0.10). Thus, the data for Beagles and Labradors were pooled and a mean requirement for Thr was determined at 66.9 mg/kg BW, and the 95% CI was estimated at 84.3 mg/kg BW. In conclusion, estimated Thr requirements for Beagles and Labradors did not differ, and these recommendations are higher than those suggested by NRC (2006) and AAFCO (2014) for adult dogs at maintenance.
Stirring rate affects thermodynamics and unfolding kinetics in isothermal titration calorimetry
Authors: Maruno Takahiro , Ohkubo Tadayasu , Uchiyama Susumu
Published: February 2020

Isothermal titration calorimetry (ITC) directly provides thermodynamic parameters depicting the energetics of intermolecular interactions in solution. During ITC experiments, a titration syringe with a paddle is continuously rotating to promote a homogeneous mixing. Here, we clarified that the shape of the paddles (flat, corkscrew and small-pitched corkscrew) and the stirring rates influence on the thermodynamic parameters of protein–ligand interaction. Stirring with the flat paddle at lower and higher rate both yielded a lower exothermic heat due to different reasons. The complete reaction with no incompetent fractions was achieved only when the stirring was performed at 500 or 750 rpm using the small-pitched corkscrew paddle. The evaluation of the protein solution after 1,500 rpm stirring indicated that proteins in the soluble fraction decreased to 94% of the initial amount, among which 6% was at an unfolded state. In addition, a significant increase of micron aggregates was confirmed. Furthermore, a new approach for the determination of the unfolding kinetics based on the time dependence of the total reaction heat was developed. This study demonstrates that a proper stirring rate and paddle shape are essential for the reliable estimation of thermodynamic parameters in ITC experiments.
Tales of the city: what do agglomeration cases tell us about agglomeration in general?
Authors: Faggio Giulia , Silva Olmo , Strange William C
Published: February 2020

This article considers the heterogeneous microfoundations of agglomeration economies. It studies the co-location of industries to look for evidence of labour pooling, input sharing and knowledge spillovers. The novel contribution of the article is that it estimates single-industry models using a common empirical framework that exploits the cross-sectional variation in how one industry co-locates with the other industries in the economy. This unified approach yields evidence on the relative importance of the Marshallian microfoundations at the single-industry level, allowing for like-for-like cross-industry comparisons on the determinants of agglomeration. Using UK data, we estimate such microfoundation models for 97 manufacturing sectors, including the classic agglomeration cases of automobiles, computers, cutlery and textiles. These four cases—as with all of the individual industry models we estimate—clearly show the importance of the Marshallian forces. However, they also highlight how the importance of these forces varies across industries—implying that extrapolation from cases should be viewed with caution. The article concludes with an investigation of the pattern of heterogeneity. The degree of an industry’s clustering (localisation), entrepreneurship, incumbent firm size and worker education are shown to contribute to the pattern of heterogeneous microfoundations.
Genetic Counseling and Germline Testing in the Era of Tumor Sequencing: A Cohort Study
Authors: Klek Stefan , Heald Brandie , Milinovich Alex , Ni Ying , Abraham Jame , Mahdi Haider , Estfan Bassam , Khorana Alok A , Bolwell Brian J , Grivas Petros , Sohal Davendra P S , Funchain Pauline
Published: February 2020

Background

The clinical impact of addressing potential germline alterations from tumor-only next-generation sequencing (NGS) is not well characterized. Current guidelines for cancer genetic testing may miss clinically actionable germline changes, which may have important implications for cancer screening, treatment, and prevention. We examined whether increasing involvement of the clinical genetics service during somatic tumor-only NGS review at Molecular Tumor Board (MTB) increases the detection of germline findings.

Methods

In a retrospective evaluation of patients who underwent tumor-only NGS and were reviewed at MTB, we quantified genetic counseling (GC) referrals as well as germline testing uptake and results across three cohorts: before (C1) and after (C2) the addition of tumor-only NGS review and after (C3) instituting a formal process to coordinate NGS-based genetics referrals to preexisting oncology appointments. All statistical tests were two-sided.

Results

From 2013 to 2017, 907 tumor-only NGS reports were reviewed at MTB (nC1 = 281, nC2 = 493, nC3 = 133); gastrointestinal (22.5%), lung (19.7%), genitourinary (14.8%), and breast (14.1%) were the most common index cancers. GC visits due to MTB increased with each successive cohort (C1 = 1.1%, C2 = 6.9%, C3 = 13.5%; P for trend [Ptrend] < .001), as did germline testing (C1 = 0.7%, C2 = 3.2%, C3 = 11.3%; Ptrend < .001). Diagnosis of germline pathogenic variants increased with each successive cohort (C1 = 1.4%, C2 = 2.0%, C3 = 7.5%; Ptrend = .003) and with germline pathogenic variants found by MTB review (C1 = 0.4%, C2 = 0.4%, C3 = 2.3%; Ptrend = .12).

Conclusions

Both review of tumor-only NGS by genetics and the institution of a process coordinating GC with oncology appointments increased the discovery of germline pathogenic variants from tumor-only NGS testing. Furthermore, this process identified germline pathogenic variant carriers who would not have otherwise met standard criteria for germline testing.
Family-specific analysis of variant pathogenicity prediction tools
Authors: Zaucha Jan , Heinzinger Michael , Tarnovskaya Svetlana , Rost Burkhard , Frishman Dmitrij
Published: February 2020

Using the presently available datasets of annotated missense variants, we ran a protein family-specific benchmarking of tools for predicting the pathogenicity of single amino acid variants. We find that despite the high overall accuracy of all tested methods, each tool has its Achilles heel, i.e. protein families in which its predictions prove unreliable (expected accuracy does not exceed 51% in any method). As a proof of principle, we show that choosing the optimal tool and pathogenicity threshold at a protein family-individual level allows obtaining reliable predictions in all Pfam domains (accuracy no less than 68%). A functional analysis of the sets of protein domains annotated exclusively by neutral or pathogenic mutations indicates that specific protein functions can be associated with a high or low sensitivity to mutations, respectively. The highly sensitive sets of protein domains are involved in the regulation of transcription and DNA sequence-specific transcription factor binding, while the domains that do not result in disease when mutated are responsible for mediating immune and stress responses. These results suggest that future predictors of pathogenicity and especially variant prioritization tools may benefit from considering functional annotation.
Phase I study of intraventricular infusions of autologous ex vivo expanded NK cells in children with recurrent medulloblastoma and ependymoma
Authors: Khatua Soumen , Cooper Laurence J N , Sandberg David I , Ketonen Leena , Johnson Jason M , Rytting Michael E , Liu Diane D , Meador Heather , Trikha Prashant , Nakkula Robin J , Behbehani Gregory K , Ragoonanan Dristhi , Gupta Sumit , Kotrotsou Aikaterini , Idris Tagwa , Shpall Elizabeth J , Rezvani Katy , Colen Rivka , Zaky Wafik , Lee Dean A , Gopalakrishnan Vidya
Published: February 2020

Background

Recurrent pediatric medulloblastoma and ependymoma have a grim prognosis. We report a first-in-human, phase I study of intraventricular infusions of ex vivo expanded autologous natural killer (NK) cells in these tumors, with correlative studies.

Methods

Twelve patients were enrolled, 9 received protocol therapy up to 3 infusions weekly, in escalating doses from 3 × 106 to 3 × 108 NK cells/m2/infusion, for up to 3 cycles. Cerebrospinal fluid (CSF) was obtained for cellular profile, persistence, and phenotypic analysis of NK cells. Radiomic characterization on pretreatment MRI scans was performed in 7 patients, to develop a non-invasive imaging-based signature.

Results

Primary objectives of NK cell harvest, expansion, release, and safety of 112 intraventricular infusions of NK cells were achieved in all 9 patients. There were no dose-limiting toxicities. All patients showed progressive disease (PD), except 1 patient showed stable disease for one month at end of study follow-up. Another patient had transient radiographic response of the intraventricular tumor after 5 infusions of NK cell before progressing to PD. At higher dose levels, NK cells increased in the CSF during treatment with repetitive infusions (mean 11.6-fold). Frequent infusions of NK cells resulted in CSF pleocytosis. Radiomic signatures were profiled in 7 patients, evaluating ability to predict upfront radiographic changes, although they did not attain statistical significance.

Conclusions

This study demonstrated feasibility of production and safety of intraventricular infusions of autologous NK cells. These findings support further investigation of locoregional NK cell infusions in children with brain malignancies.
Responses in the diffusivity and vascular function of the irradiated normal brain are seen up until 18 months following SRS of brain metastases
Authors: Nilsen Line Brennhaug , Digernes Ingrid , Grøvik Endre , Saxhaug Cathrine , Latysheva Anna , Geier Oliver , Breivik Birger , Sætre Dag Ottar , Jacobsen Kari Dolven , Helland Åslaug , Emblem Kyrre Eeg
Published: February 2020

Background

MRI may provide insights into longitudinal responses in the diffusivity and vascular function of the irradiated normal-appearing brain following stereotactic radiosurgery (SRS) of brain metastases.

Methods

Forty patients with brain metastases from non-small cell lung cancer (N = 26) and malignant melanoma (N = 14) received SRS (15–25 Gy). Longitudinal MRI was performed pre-SRS and at 3, 6, 9, 12, and 18 months post-SRS. Measures of tissue diffusivity and vascularity were assessed by diffusion-weighted and perfusion MRI, respectively. All maps were normalized to white matter receiving less than 1 Gy. Longitudinal responses were assessed in normal-appearing brain, excluding tumor and edema, in the LowDose (1–10 Gy) and HighDose (>10 Gy) regions. The Eastern Cooperative Oncology Group (ECOG) performance status was recorded pre-SRS.

Results

Following SRS, the diffusivity in the LowDose region increased continuously for 1 year (105.1% ± 6.2%; P < .001), before reversing toward pre-SRS levels at 18 months. Transient reductions in microvascular cerebral blood volume (P < .05), blood flow (P < .05), and vessel densities (P < .05) were observed in LowDose at 6–9 months post-SRS. Correspondingly, vessel calibers in LowDose transiently increased at 3–9 months (P < .01). The responses in HighDose displayed similar trends as in LowDose, but with larger interpatient variations. Vascular responses followed pre-SRS ECOG status.

Conclusions

Our results imply that even low doses of radiation to normal-appearing brain following cerebral SRS induce increased diffusivity and reduced vascular function for up until 18 months. In particular, the vascular responses indicate the reduced ability of the normal-appearing brain tissue to form new capillaries. Assessing the potential long-term neurologic effects of SRS on the normal-appearing brain is warranted.
The Effect of Women’s Descriptive Representation on Premature Mortality
Authors: Patton Dana , Fording Richard C
Published: February 2020

Although many studies have found that women legislators pursue policies important to women, we know relatively little concerning the effect of women’s descriptive representation (WDR) on women’s quality of life. We address this question by examining the relationship between the election of women state legislators and public health. Specifically, we estimate the effect of WDR on premature death rates from 1982 to 2010. We find that WDR serves to improve the well-being of both women and men. However, the effect of WDR on women’s health is contingent on several important factors. First, the health-improving effects of WDR are most strongly related to the descriptive representation of Democratic women. Second, the effect of Democratic WDR on women’s health, relative to men’s health, increases with the scale of the state’s Medicaid program. Finally, we estimate the mediating role of nine specific policies, finding that four policies mediate the effect of Democratic WDR on premature mortality. Overall, our results suggest that policy remedies aimed at improving the severe underrepresentation of women in government may help to improve the relatively low ranking of the United States on indicators of public health.
In-vitro and in-vivo models for hepatitis B cure research
Authors: Allweiss Lena , Strick-Marchand Helene
Published: February 2020

Purpose of review

Antiviral therapy for chronic hepatitis B infection is rarely curative, thus research in HBV cure strategies is a priority. Drug development and testing has been hampered by the lack of robust cell culture systems and small animal models. This review summarizes existing models for HBV cure research and focuses on recent developments since 2017 until today.

Recent findings

The field has progressed in the development of cell culture and animal models to study HBV. Although early cell culture systems relied on transfection of HBV genomes in hepatoma cell lines, novel models expressing the entry receptor for HBV are susceptible to infection. Improved culture conditions for primary human hepatocytes, the primary target of HBV, have enabled the screening and validation of novel antivirals. Mouse models grafted with partially humanized livers are suitable for testing viral entry inhibitors or direct acting antivirals, and can be reconstituted with human immune cells to analyze immunotherapies. Other immunocompetent models include mice transduced with HBV genomes or woodchucks infected with their native hepatitis virus.

Model systems for HBV research have helped lay the groundwork for the development and optimization of antiviral and immune-based therapeutic approaches that are now moving to clinical trials.
The Discrepancy Between Cognitive Complaints and Neuropsychological Test Findings in Persons With Traumatic Brain Injury
Authors: Vos Leia , Williams Michael W. , Poritz Julia M. P. , Ngan Esther , Leon-Novelo Luis , Sherer Mark
Published: February 2020

Objective:

To better identify variables related to discrepancies between subjective cognitive complaints and objective neuropsychological findings in persons with traumatic brain injury (TBI).

Setting:

Three rehabilitation centers in the United States.

Participants:

In total, 504 community-dwelling adult survivors of TBI following discharge from inpatient rehabilitation.

Design:

Prospective cohort observation study.

Main Measures:

Wechsler Adult Intelligence Scale, Fourth Edition, Digit Span; Rey Auditory Verbal Learning Test; Trail Making Test, Part B; Word Memory Test; Patient Health Questionnaire-9; Neurobehavioral Symptom Inventory; TBI-Quality of Life item bank.

Results:

Statistical analyses revealed multiple factors associated with subjective-objective discrepancies in attention, memory, and executive functions. Depression was consistently associated with underestimation of cognitive abilities. However, subjective-objective discrepancies varied by cognitive domains in regard to other factors related to underestimation and overestimation of abilities.

Conclusions:

Reconciling and interpreting subjective-objective discrepancies regarding cognitive functions following TBI are important tasks for case conceptualization and treatment planning. Depression is an important patient characteristic to consider when discrepancy patterns indicate underestimation of cognitive abilities. This study highlights the importance of assessing mood, a modifiable patient characteristic, with self-report symptom inventories. Future studies are needed to connect these findings with TBI outcomes.
Receipt of Treatment for Depression Following Traumatic Brain Injury
Authors: Albrecht Jennifer S. , Abariga Samuel A. , dosReis Susan , Perfetto Eleanor M. , Mullins C. Daniel , Rao Vani
Published: February 2020

Objective:

Lack of evidence for efficacy and safety of treatment and limited clinical guidance have increased potential for undertreatment of depression following traumatic brain injury (TBI).

Methods:

We conducted a retrospective cohort study among individuals newly diagnosed with depression from 2008 to 2014 to assess the impact of TBI on receipt of treatment for incident depression using administrative claims data. We created inverse probability of treatment-weighted populations to evaluate the impact of TBI on time to receipt of antidepressants or psychotherapy following new depression diagnosis during 24 months post-TBI or matched index date (non-TBI cohort).

Results:

Of 10 428 individuals with incident depression in the TBI cohort, 44.7% received 1 or more antidepressants and 20.0% received 1 or more psychotherapy visits. Of 10 463 in the non-TBI cohort, 41.2% received 1 or more antidepressants and 17.6% received 1 or more psychotherapy visits. TBI was associated with longer time to receipt of antidepressants compared with the non-TBI cohort (average 39.6 days longer than the average 126.2 days in the non-TBI cohort; 95% confidence interval [CI], 24.6-54.7). Longer time to psychotherapy was also observed among individuals with TBI at 6 months post-TBI (average 17.1 days longer than the average 47.9 days in the non-TBI cohort; 95% CI, 4.2-30.0), although this association was not significant at 12 and 24 months post-TBI.

Conclusions:

This study raises concerns about the management of depression following TBI.
Effects of resveratrol on coagulative, fibrinolytic, and inflammatory marker expression and secretion by endothelial cells (human umbilical vein endothelial cells)
Authors: Shahidi Minoo , Parhizkary Freshteh , Sharifi Roya , Ghotaslou Abbas , Barati Mahmood
Published: February 2020

Increasing the prevalence of cardiovascular disease (CVD) has led to an investigation into components that might influence CVD. Accordingly, many recent studies have reported the benefits of resveratrol (RSV). Therefore, this study aimed to scrutinize the direct effect of RSV on human umbilical vein endothelial cells (HUVECs) by detecting coagulative, fibrinolytic, and inflammatory markers. HUVECs were cultured and treated with different concentrations of RSV. The effects of RSV were identified by representative markers of coagulation, fibrinolysis pathway, and inflammation, including von Willebrand factor (VWF), factor VIII, tissue plasminogen activator-1 (t-PA-1), and interleukin-8 (IL-8). The detection process was carried out using real-time PCR (qPCR), flow cytometry, ELISA, and immunocytochemistry (ICC) methods. The present findings demonstrated a significant decrease in VWF, t-PA-1, and IL-8 secretion levels. Furthermore, RSV diminished the activity of factor VIII and mRNA expression levels of VWF and t-PA-1. The ICC results also showed a decrease in the level of intracellular t-PA. Our data revealed the anti-inflammatory, anticoagulation, and antifibrinolytic effect of RSV in cell culture.
Plasma viscosity pattern and erythrocyte aggregation in two patients with congenital afibrinogenemia
Authors: Caimi Gregorio , Raso Simona , Napolitano Mariasanta , Siragusa Sergio , Lo Presti Rosalia
Published: February 2020

In this case report, we examine the behavior of plasma viscosity, explored at high and low shear rates, and erythrocyte aggregation in two patients with congenital afibrinogenemia, a clinical disorder firstly described in 1920 and that has an estimated incidence of 1 : 1–200 0000. The two hemorheological parameters examined by us showed a marked decrease in both patients, in one of whom erythrocyte aggregation was even undetectable. Keeping in mind that spontaneous thrombosis (venous and arterial) has been often described in congenital afibrinogenemia, it can be hypothesized that the decrease in plasma viscosity and erythrocyte aggregation might cause a reduction of the endothelial synthesis and release of nitric oxide through the fall of the wall shear stress.
Pervasive Discrimination and Allostatic Load in African American and White Adults
Authors: Van Dyke Miriam E. , Baumhofer Nicole Kau’i , Slopen Natalie , Mujahid Mahasin S. , Clark Cheryl R. , Williams David R. , Lewis Tené T.
Published: February 2020

Objective

This study aimed to examine associations among race, the accumulation of multiple forms of discriminatory experiences (i.e., “pervasive discrimination”), and allostatic load (AL) in African Americans and whites in midlife.

Methods

Using data collected in 2004 to 2006 from 226 African American and 978 white adults (57% female; mean [SD] age = 54.7 [0.11] years) in the Midlife in the United States II Biomarker Project, a pervasive discrimination score was created by combining three discrimination scales, and an AL score was created based on 24 biomarkers representing seven physiological systems. Linear regression models were conducted to examine the association between pervasive discrimination and AL, adjusting for demographics and medical, behavioral, and personality covariates. A race by pervasive discrimination interaction was also examined to determine whether associations varied by race.

Results

African Americans had higher pervasive discrimination and AL scores than did whites. In models adjusted for demographics, socioeconomic status, medications, health behaviors, neuroticism, and negative affect, a pervasive discrimination score of 2 versus 0 was associated with a greater AL score (b = 0.30, SE = 0.07, p < .001). Although associations seemed to be stronger among African Americans as compared with whites, associations did not statistically differ by race.

Conclusions

More pervasive discrimination was related to greater multisystemic physiological dysregulation in a cohort of African American and white adults. Measuring discrimination by combining multiple forms of discriminatory experiences may be important for studying the health effects of discrimination.
Emotional Pathways to the Biological Embodiment of Racial Discrimination Experiences
Authors: Hittner Emily F. , Adam Emma K.
Published: February 2020

Objective

Racial discrimination experiences are common among youth with an ethnic minority background, and such experiences affect health. Stress-sensitive systems like the hypothalamic-pituitary-adrenal (HPA) axis have been proposed as one mechanism. HPA-axis activity, measured through daily patterns of salivary cortisol, is altered among individuals who experience discrimination. We know little about the day-to-day processes by which discrimination experiences become embodied in stress biology. The HPA axis is responsive to negative social-evaluative (NSE) emotion. The present study investigated whether NSE emotions are a pathway by which discrimination dysregulates HPA-axis functioning as measured by cortisol levels.

Methods

Perceived discrimination, diurnal cortisol, and changes in NSE emotion were assessed in a sample of 102 young adults. Emotions and cortisol were measured across the day for seven consecutive days in naturalistic settings. Multilevel modeling and regression analyses were used to examine average and day-to-day associations between discrimination, NSE emotion, and cortisol. Mediation and specificity analyses were conducted.

Results

Discrimination was associated with NSE emotion (β = 0.34, p = .001). Day-to-day changes (β = 0.10, p = .002) and average levels (β = 0.03, p = .013) of NSE emotion were associated with dysregulated cortisol. NSE emotion mediated the association between discrimination and diurnal cortisol slopes (β = 0.10 [95% confidence interval = 0.01–0.21]). Findings were robust for covariates including stressful life events, more pronounced for NSE emotion compared with negative affect at the day level, similar for NSE emotion and general negative affect at the person level, and specific to cortisol slopes.

Conclusions

Findings suggest that daily NSE and average negative emotions are important pathways by which racial discrimination gets under the skin, or is embodied, in stress biology.
Quality and Safety in Healthcare, Part LXVI
Authors: Harolds Jay A.
Published: February 2020

Problems in the learning environment are the main contributing factors to medical student burnout. These issues include stresses from mistreatment, poor support, cynical supervisors, pressure to get good grades and learn a huge amount of information quickly, fatigue, lack of control, and so on. Personal risk factors include having been seriously ill recently, having a low grit score, being in debt, and having a job.
Neuro-Ophthalmic Injuries With Systemic Neurologic Injury or Traumatic Brain Injury in Operation Iraqi Freedom and Operation Enduring Freedom
Authors: Jaksha Alexandria F. , Justin Grant A. , Brooks Daniel I. , Elward Cameron J. , Ryan Denise S. , Weichel Eric D. , Colyer Marcus H.
Published: February 2020

Background:

To analyze the final visual acuity (VA) of neuro-ophthalmologic injuries (NOI) in combat ocular trauma and to study the association of NOI with systemic neurologic injury (SNI) and traumatic brain injury (TBI).

Methods:

The Walter Reed Ocular Trauma Database was reviewed. Inclusion criteria were any US service member and Department of Defense civilians who suffered NOI, SNI, or TBI in Operation Iraqi Freedom or Operation Enduring Freedom. The primary outcome measure was the rate of poor final VA in patients with an NOI with secondary outcome measures the rate of SNI and TBI. in patients with NOI.

Results:

One hundred seventy-eight (20.00%) of 890 eyes had an NOI. Optic nerve injury was observed in 79 (44.38%) eyes, other cranial nerve injury in 68 (38.20%), Horner syndrome in 4 (2.25%), diplopia in 45 (25.28%), and ptosis in 13 (7.30%). In patients with NOI, 76 (42.69%) eyes had a final VA less than 20/200. In injured eyes (n = 359) of patients (n = 251) with TBI, 154 eyes (34.26%) had a final VA less than 20/200. In multivariate analysis, optic nerve injury (P< 0.001), unlike TBI (P= 0.47), was associated with final VA less than 20/200. SNI (n = 229) had a statistically significant association (odds ratio 29.8, 95% confidence interval 19.2–47.8,P< 0.001) with NOI. Optic nerve injury and cranial nerve injury were associated with TBI and SNI (all,P< 0.001).

Conclusion:

Optic nerve injury and cranial nerve injury are associated with TBI and SNI. Optic nerve injury, but not TBI or cranial nerve injury, is associated with a poor final VA.
Comparative genomics of the fish pathogens Edwardsiella ictaluri 93-146 and Edwardsiella piscicida C07-087
Authors: Tekedar Hasan C. , Blom Jochen , Kalindamar Safak , Nho Seongwon , Karsi Attila , Lawrence Mark L.
Published: February 2020

Edwardsiella ictaluri

and

Edwardsiella piscicida

are important fish pathogens affecting cultured and wild fish worldwide. To investigate the genome-level differences and similarities between catfish-adapted strains in these two species, the complete

E. ictaluri

93-146 and

E. piscicida

﻿ C07-087 genomes were evaluated by applying comparative genomics analysis. All available complete (10) and non-complete (19) genomes from five

Edwardsiella

species were also included in a systematic analysis. Average nucleotide identity and core-genome phylogenetic tree analyses indicated that the five

Edwardsiella

species were separated from each other. Pan-/core-genome analyses for the 29 strains from the five species showed that genus

Edwardsiella

members have 9474 genes in their pan genome, while the core genome consists of 1421 genes. Orthology cluster analysis showed that

E. ictaluri

and

E. piscicida

﻿ ﻿genomes have the greatest number of shared clusters. However,

E. ictaluri

and

E. piscicida

﻿ also have unique features; for example, the

E. ictaluri

genome encodes urease enzymes and cytochrome o ubiquinol oxidase subunits, whereas

E. piscicida

﻿ genomes encode tetrathionate reductase operons, capsular polysaccharide synthesis enzymes and vibrioferrin-related genes. Additionally, we report for what is believed to be the first time that

E. ictaluri

93-146 and three other

E. ictaluri

genomes encode a type IV secretion system (T4SS), whereas none of the

E. piscicida

﻿ genomes encode this system. Additionally, the

E. piscicida

﻿ C07-087 genome encodes two different type VI secretion systems.

E. ictaluri

genomes tend to encode more insertion elements, phage regions and genomic islands than

E. piscicida

﻿. We speculate that the T4SS could contribute to the increased number of mobilome elements in

E. ictaluri

compared to

E. piscicida

﻿. Two of the

E. piscicida

﻿ genomes encode full CRISPR-Cas regions, whereas none of the

E. ictaluri

genomes encode Cas proteins. Overall, comparison of the

E. ictaluri

and

E. piscicida

﻿ genomes reveals unique features and provides new insights on pathogenicity that may reflect the host adaptation of the two species.