bluuebunny/crossref_metadata_2025 huggingface dataset:
Retinal oedema in central retinal artery occlusion develops as a function of time
Authors: Ochakovski G. Alex , Wenzel Daniel A. , Spitzer Martin S. , Poli Sven , Härtig Florian , Fischer Manuel Dominik , Dimopoulos Spyridon , Schultheiss Maximilian
Published: February 2020

Purpose

Time is the key criterion in the management of non‐arteritic central retinal artery occlusion (NA‐CRAO). However, the precise onset of vision loss is often difficult to determine. This study aimed to evaluate the temporal changes of retinal thickness in acute NA‐CRAO and the potential of this parameter to be used as a surrogate marker to estimate the onset of retinal ischaemia.

Methods

Optical coherence tomography was used to continuously assess retinal thickness and oedema progression rate in six porcine eyes. Additionally, a retrospective analysis of 12 patients with acute NA‐CRAO was performed to determine association strength and progression rate between retinal thickness and onset of ischaemia. All Optical coherence tomography (OCT) scans (pigs and NA‐CRAO patients) were performed within an ischaemic time frame of up to 9 hr.

Results

Retinal oedema progression rate in pigs was 25.32 µm/hr [CI 95%: 24.24–26.40 µm/hr]. Retrospective analysis of the patients revealed a strong correlation between retinal oedema and duration of ischaemia (Spearman's rho = 0.77, p = 0.004) with an estimated progression rate of 10.02 µm/hr [CI 95%: 3.30–16.74 µm/hr].

Conclusion

Retinal thickness increases with oedema formation, and ischaemia onset is strongly correlated with this structural biomarker in both, pigs and NA‐CRAO patients. Prospective clinical trials will have to determine the clinical feasibility of retinal thickness measurements as a biomarker to support clinical management of NA‐CRAO.
Applications of CRISPR‐Cas9 in gynecological cancer research
Authors: Zhang Wei , Liu Yan , Zhou Xing , Zhao Rong , Wang Hongbo
Published: February 2020

Gynecological cancers pose a significant threat to women's health worldwide, with cervical cancer, ovarian cancer, and endometrial cancer having high incidences. Current gynecological cancer treatment methods mainly include surgery, chemotherapy, radiotherapy, and chemoradiotherapy. The CRISPR‐Cas9 gene editing technology as a new therapeutic method has shown tremendous effect in the treatment of other cancers, promoting research on its potential therapeutic effect in gynecological cancer. In this article, we reviewed the current research status of CRISPR‐Cas9 technology in gynecological cancer, focusing on the importance of studying the mechanism of CRISPR‐Cas9 in gynecological cancer treatment, thereby laying a foundation for further research on its clinical application.
FAMILY PLANNING AND WOMEN'S EDUCATIONAL ATTAINMENT: EVIDENCE FROM THE ONE‐CHILD POLICY
Authors: Jiang Xuan
Published: February 2020

This paper exploits China's one‐child policy (OCP) to study the relationship between fertility and educational attainment of the mothers of China's “sibling‐less generation.” I take two difference‐in‐differences approaches to estimate the OCP's effect on women's education: one compares gender difference among the ethnic majority group and the other compares ethnicity differences between ethnic majority women and ethnic minority women. I also explore the heterogeneity of the policy's effects by parent's status at the Communist Party. I find that the OCP has a positive and significant effect on women's education and explains about half of the increase in educational attainment for women born between 1960 and 1980. Their increased educational attainment associates with delayed entry into first marriage, delayed entry to parenthood and increased labor supply. (JEL I20, J13, J16, J18)
Eliminating international normalized ratio threshold for transfusion in pediatric patients with acute liver failure
Authors: Lee Angela , Mendoza Julianne , Brubaker Aleah L. , Stoltz Daniel J. , McKenzie Rebecca , Bonham Clark A. , Esquivel Carlos O. , Gallo Amy E.
Published: February 2020

Introduction

Transfusion protocols are not well‐studied for pediatric patients with acute liver failure (ALF). This study evaluates the utility of an international normalized ratio (INR)‐based transfusion threshold for these patients.

Methods

Forty‐four ALF pediatric patients from 2009 to 2018 were reviewed and divided into two groups: (a) a threshold group including patients between 2009 and 2015 who were transfused for an INR above 3.0, per institutional policy (n = 30), and (b) a post‐threshold group including patients after 2015 through 2018 who were transfused based on clinical judgment (n = 14). Preoperative INRs, preoperative transfusions, intraoperative transfusions, early reoperation, renal function, graft function and deaths were compared.

Results

Liver failure severity was similar between threshold and post‐threshold groups. Threshold patients had a lower average INR prior to transplantation, 2.8 (range 1.8‐3.8) vs 4.4 (range 2.1‐9.0), respectively (P = .01). Twenty‐six threshold patients (87%) received preoperative FFP compared with seven post‐threshold patients (50%, P = .0088). Two threshold patients (7%) received preoperative cryoprecipitate compared with five post‐threshold patients (36%, P = .014). The incidence of pre‐transplant bleeding, operative transfusions, and 1‐year patient and graft survival did not differ significantly.

Conclusion

Clinical judgment vs an INR‐based threshold for transfusions did not increase perioperative complications in children with ALF.
Quality of life cannot be predicted from a brain scan
Authors: Fayed Nora , Cohen Eyal , Houtrow Amy
Published: February 2020

This commentary is on the original article by Dorner et al. on pages 500–505 of this issue.
Maternal presence influences vocal development in the Japanese quail (Coturnix c. japonica)
Authors: Desmedt Lucie , George Isabelle , Mohamed Benkada Aïcha , Hervé Maxime , Aubin Thierry , Derégnaucourt Sébastien , Lumineau Sophie
Published: February 2020

Social influences on vocal development of young birds have been widely studied in oscine songbirds who learn to sing by vocal imitation of conspecifics, mainly male adults. In contrast, vocal development of non‐vocal learners such as Galliformes is considered as being under strong genetic influence and independent of the social environment. In this study, we investigated the role of the mother on the vocal development of young Japanese quail (Coturnix coturnix japonica). We compared the vocal development of mothered and non‐mothered chicks during the first 21 days of life. We analysed the structural changes of two vocalisations: a) the rally call, emitted during long‐distance communication and in stressful situations, b) the contact call, emitted during short‐distance communication when chicks are in visual and/or auditory contact with congeners. We showed that temporal and spectral structures of the two types of calls changed during development and differed between mothered and non‐mothered chicks. These results demonstrate that maternal presence influences the vocal development of the young in the Japanese quail. Even if the adaptive value of such changes was not assessed, these results highlight that plasticity of vocalisations in species considered as non‐vocal learners has been underestimated.
Evolution of self‐incompatibility in the Brassicaceae: Lessons from a textbook example of natural selection
Authors: Durand Eléonore , Chantreau Maxime , Le Veve Audrey , Stetsenko Roman , Dubin Manu , Genete Mathieu , Llaurens Violaine , Poux Céline , Roux Camille , Billiard Sylvain , Vekemans Xavier , Castric Vincent
Published: February 2020

Self‐incompatibility (SI) is a self‐recognition genetic system enforcing outcrossing in hermaphroditic flowering plants and results in one of the arguably best understood forms of natural (balancing) selection maintaining genetic variation over long evolutionary times. A rich theoretical and empirical population genetics literature has considerably clarified how the distribution of SI phenotypes translates into fitness differences among individuals by a combination of inbreeding avoidance and rare‐allele advantage. At the same time, the molecular mechanisms by which self‐pollen is specifically recognized and rejected have been described in exquisite details in several model organisms, such that the genotype‐to‐phenotype map is also pretty well understood, notably in the Brassicaceae. Here, we review recent advances in these two fronts and illustrate how the joint availability of detailed characterization of genotype‐to‐phenotype and phenotype‐to‐fitness maps on a single genetic system (plant self‐incompatibility) provides the opportunity to understand the evolutionary process in a unique perspective, bringing novel insight on general questions about the emergence, maintenance, and diversification of a complex genetic system.
Residual fatigue life prediction based on a novel damage accumulation model considering loading history
Authors: Li Z. , Shi D. , Li S. , Yang X.
Published: February 2020

The influence of prior low‐cycle fatigue (LCF) on the residual fatigue life was investigated experimentally. A Ni‐based alloy was cyclically loaded under stress‐controlled low‐high (LH) block loading. In the first loading step, low‐amplitude loading was performed with the stress amplitude of 283.5MPa at 710°C. Different cycles of preloading were performed, varying from 100 to 10 000. Subsequently, high‐amplitude fatigue loading was carried out with the stress amplitude of 315MPa at 800°C. Experimental results show that the previous loading was beneficial to the residual fatigue life when the consumed life fraction is below 0.2 and detrimental when the consumed life fraction is larger than 0.2. A novel nonlinear fatigue damage accumulation model was proposed to estimate the residual LCF life under LH loading path considering the effects of load sequence and preloading cycles. The proposed model provided a better life prediction than some existing models, such as Kwofie‐Rahbar model, Miner' rule, Peng model, and Ye‐Wang model. Lastly, this model was further validated using various materials under LH and high‐low block loadings.
Cold range edges of marine fishes track climate change better than warm edges
Authors: Fredston‐Hermann Alexa , Selden Rebecca , Pinsky Malin , Gaines Steven D. , Halpern Benjamin S.
Published: February 2020

Species around the world are shifting their ranges in response to climate change. To make robust predictions about climate‐related colonizations and extinctions, it is vital to understand the dynamics of range edges. This study is among the first to examine annual dynamics of cold and warm range edges, as most global change studies average observational data over space or over time. We analyzed annual range edge dynamics of marine fishes—both at the individual species level and pooled into cold‐ and warm‐edge assemblages—in a multi‐decade time‐series of trawl surveys conducted on the Northeast US Shelf during a period of rapid warming. We tested whether cold edges show stronger evidence of climate tracking than warm edges (due to non‐climate processes or time lags at the warm edge; the biogeography hypothesis or extinction debt hypothesis), or whether they tracked temperature change equally (due to the influence of habitat suitability; the ecophysiology hypothesis). In addition to exploring correlations with regional temperature change, we calculated species‐ and assemblage‐specific sea bottom and sea surface temperature isotherms and used them to predict range edge position. Cold edges shifted further and tracked sea surface and bottom temperature isotherms to a greater degree than warm edges. Mixed‐effects models revealed that for a one‐degree latitude shift in isotherm position, cold edges shifted 0.47 degrees of latitude, and warm edges shifted only 0.28 degrees. Our results suggest that cold range edges are tracking climate change better than warm range edges, invalidating the ecophysiology hypothesis. We also found that even among highly mobile marine ectotherms in a global warming hotspot, few species are fully keeping pace with climate.
Malnutrition risk and hospital‐acquired falls in older adults: A cross‐sectional, multicenter study
Authors: Eglseer Doris , Hoedl Manuela , Schoberer Daniela
Published: February 2020

Aim

To assess the relationship of malnutrition risk and in‐hospital falls in a patient group of older hospitalized patients (65–79 and ≥80 years).

Methods

A cross‐sectional, multicenter, point‐prevalence study was conducted in 68 Austrian hospitals with 3702 hospitalized older patients. The relationship between malnutrition risk and falls was analyzed using univariate and multivariate binary logistic regression analyses. Data were analyzed separately for two age groups, patients were aged 65–79 years (n = 2320) and ≥80 years (n = 1382).

Results

Prevalence of hospital‐acquired falls was 5.2%, and prevalence of risk of malnutrition was 24.3% (Malnutrition Universal Screening Tool) and 16.2% (definition using body mass index and weight loss). The univariate analysis showed significant associations of malnutrition risk and in‐hospital falls for patients aged ≥80 years (odds ratio 2.1; 95% confidence interval 1.2–3.6) but not for patients aged 65–79 years. The multivariate logistic regression analysis did not show significant associations between malnutrition risk and hospital‐acquired falls.

Conclusions

The results of this study show that malnutrition risk is a predictor for in‐hospital falls in very old patients (≥80 years). In this patient group, the screening and assessment of nutritional status as well as nutritional interventions for the prevention/treatment of malnutrition risk should be considered as one important factor for successful fall prevention. Studies are necessary to assess the effect of nutritional interventions as part of a multifaceted fall‐prevention program. Geriatr Gerontol Int 2020; 20: 348–353.
A Randomized Trial to Evaluate OnabotulinumtoxinA for Prevention of Headaches in Adolescents With Chronic Migraine
Authors: Winner Paul K. , Kabbouche Marielle , Yonker Marcy , Wangsadipura Veronica , Lum Arlene , Brin Mitchell F.
Published: February 2020

Objective

As a post‐approval commitment, this dose‐ranging study was undertaken to evaluate efficacy and safety of onabotulinumtoxinA in adolescents.

Background

In adolescents, migraine is often undiagnosed or misdiagnosed and can present unique management challenges. OnabotulinumtoxinA was approved for prevention of chronic migraine (CM) in adults in 2010.

Methods

This multicenter, double‐blind, parallel‐group, randomized trial assessed a single treatment of onabotulinumtoxinA (155 U or 74 U) vs placebo (intramuscular saline) administered via the recommended fixed‐dose fixed site paradigm in adolescents with CM aged 12 to <18 years. The primary efficacy measure was change in frequency of headache days from baseline at week 12; other measures included change in frequency of headache days at weeks 4 and 8 and change in frequency of severe headache days. Safety and tolerability were assessed.

Results

Of 125 randomized patients (onabotulinumtoxinA 155 U, n = 45; onabotulinumtoxinA 74 U, n = 43; placebo, n = 37), all were included in the primary efficacy analysis, and 115 (92.0%) completed the study. Lack of efficacy was the primary reason for discontinuing (n = 4; 3.2%); no patients discontinued because of adverse events. All treatments reduced frequency of headache days at week 12, with no significant differences between treatments. The mean (95% confidence interval) changes from baseline in the frequency of headache days during the 28‐day period ending at week 12 (primary endpoint) were −6.3 (−8.5, −4.2), −6.4 (−8.8, −4.0), and −6.8 (−9.6, −4.1) days in the onabotulinumtoxinA 155 U, onabotulinumtoxinA 74 U, and placebo groups, respectively (P ≥ .474). All treatments reduced frequency of severe headache days and were well‐tolerated; serious adverse events (n = 3) were considered unrelated to treatment and resolved without sequelae. The most commonly reported treatment‐emergent adverse events were neck pain (n = 8), upper respiratory tract infection (n = 7), migraine, and nasopharyngitis (n = 5 each).

Conclusion

Although this study did not meet its efficacy endpoints, onabotulinumtoxinA was well tolerated in this adolescent population. Given previous data demonstrating the benefits of onabotulinumtoxinA in adults with CM, additional studies with design modifications, including adequate statistical power, to assess the efficacy of multiple treatment cycles of onabotulinumtoxinA for CM prevention in adolescents may be informative.
Justice through higher education: Revisiting White Paper 3 of 1997
Authors: Kumalo Siseko H.
Published: February 2020

Interrogating the White Paper 3 of 1997 which upholds academic freedom, institutional autonomy and public accountability, I make the case for justice through higher education using public accountability. I argue that the higher education system in South Africa is capable of fulfilling such a role in the context of extreme injustices but not without a critical engagement of the extent and causes of these injustices and an understanding of their implications for academic curricula, practices and deeply embedded conceptions of knowledge. A redefinition of higher education institutions' public accountability in terms of responsibility to their ‘institutional locale’ or community (the populations whose needs they should be meeting) can be an effective ‘proactive tool’ with which higher education can redress social injustices. This requires an interrogation of the social, political and economic conditions of possibility that either inhibit or aid educational desire and attainment. An investigation of this nature entails a rigorous reappraisal of all three of the key principles within which higher education systems operate—academic freedom, institutional autonomy and public accountability—if they are to guard against the continued perpetuation of epistemic and social injustices.
New insights from old eggs – the shape and thickness of Great Auk Pinguinus impennis eggs
Authors: Birkhead Tim , Russell Douglas , Garbout Amin , Attard Marie , Thompson Jamie , Jackson Duncan
Published: February 2020

We compared the shape and eggshell thickness of Great Auk Pinguinus impennis eggs with those of its closest relatives, the Razorbill Alca torda, Common Guillemot Uria aalge and Brünnich's Guillemot Uria lomvia, in order to gain additional insights into the breeding biology of the extinct Great Auk. The egg of the Great Auk was most similar in shape to that of Brünnich's Guillemot. The absolute thickness of the Great Auk eggshell was greater than that of the Common Guillemot and Razorbill egg, which is as expected given its greater size, but the relative shell thickness at the equator and pointed end (compared with the blunt end) was more similar to that of the Common Guillemot. On the basis of these and other results we suggest that Great Auk incubated in an upright posture in open habitat with little or no nest, where its pyriform egg shape provided stability and allowed safe manoeuvrability during incubation. On the basis of a recent phylogeny of the Alcidae, we speculate that a single brood patch, a pyriform egg and upright incubation posture, as in the Great Auk and the two Uria guillemots, is the ancestral state, and that the Razorbill – the Great Auk's closest relative – secondarily evolved two brood patches and an elliptical egg as adaptations for horizontal incubation, which provides flexibility in incubation site selection, allowing breeding in enclosed spaces such as crevices, burrows or under boulders, as well as on open ledges.
Microstructure design of CTAC:FA and BTAC:FA lamellar gels for optimized rheological performance utilizing automated formulation platform
Authors: Davies A.R. , Amin S.
Published: February 2020

Objectives

The main objective of this paper was to optimize hair conditioner performance through variation of composition utilizing automated cosmetic formulation platform and advanced characterization techniques as well as develop understanding of how performance (wet combing and wet lubrication) of hair conditioner is affected by its rheology (i.e. yield stress) and controlled breakdown of the formulations (dilution). The experimental results show that yield stress greatly impacts rheology, stability and performance of the lamellar gels for hair conditioning.

Methods

All samples were prepared on the Chemspeed Flex Formax. A mechanical rheometer was used to measure bulk viscosity and yield stress in each sample. Dia‐stron tensile tester was used to measure the lamellar gels ability to reduce combing force. Potential stronger lamellar gel network formation in the formed lamellar gels potentially leads to higher yield stress exhibited. Viscosity values were also measured after a controlled breakdown (i.e. dilution) of each sample. This was also carried out using a mechanical rheometer.

Results

Yield stress of the formulations was engineered through composition variation and was recorded in each system. The highest yield stress value is 251.179 Pa at a BTAC/CA ratio of 6:10, and the lowest yield stress is 50.14 Pa at a BTAC/CA ratio of 6:5. The highest yield stress value is 50.14 Pa at a CTAC/CA ratio of 6:10, and the lowest yield stress is 19.98 Pa at a CTAC/CA ratio of 2:10. The highest overall yield stress values can also be observed in the BTAC/CA system, whereas the CTAC/CA system has relatively lower yield stress values. Dilution of each formulation caused a breakdown in viscosity of each formulation with the formulations with highest yield stress maintaining higher viscosity than the other formulations. The formulations with highest yield stress in each system which also maintains the highest dilution viscosity (6% BTAC/10% CA and 6% CTAC/10% CA) have the best effect on reducing overall combing force, that is from dry hair tress to wet hair tress and after product is rinsed off. At a BTAC/CA system of ratio 6:5, there is an 89% reduction in combing force and a 95% reduction in combing force in the BTAC/CA system of ratio 6:10. At a CTAC/CA system of ratio 2:10, there is a 65% reduction in combing force and a 88% reduction in combing force in the CTAC/CA system of ratio 6:10. A ‘conditioned’ soft feel was observed on each hair tress as the sample was applied and after it was rinsed off.

Conclusions

The overall performance of the lamellar gels for hair conditioning can be engineered through optimization of the formulation microstructure and formulation microstructure breakdown on dilution.
Evaluation of alumina reinforced oil fly ash composites prepared by spark plasma sintering
Authors: Ali Sadaqat , Ahmed Bilal Anjum , Irshad Hafiz Muzammil , Bakare Akolade Idris , Hakeem Abbas Saeed , Qamaruddin Muhammad , Ehsan Muhammad Ali , Ali Sameer , Azam Muhammad Umar
Published: February 2020

The thermomechanical behavior of micro/nano‐alumina (Al2O3) ceramics reinforced with 1‐5 wt.% of acid‐treated oil fly ash (OFA) was investigated. Composites were sintered using spark plasma sintering (SPS) technique at a temperature of 1400°C by applying a constant uniaxial pressure of 50 MPa. It was evaluated that the fracture toughness of micro‐ and nanosized composites improved in contrast with the monolithic alumina. Highest fracture toughness value of 4.85 MPam1/2 was measured for the nanosized composite reinforced with 5 wt.% OFA. The thermal conductivity of the composites (nano‐/microsized) decreased with the increase in temperature. However, the addition of OFA (1‐5 wt.%) in nanosized alumina enhanced the thermal conductivity at an evaluated temperature. Furthermore, a minimum thermal expansion value of 6.17 ppm*K−1 was measured for nanosized Al2O3/5 wt.% OFA composite. Microstructural characterization of Al2O3‐OFA composites was done by x‐ray diffraction and Raman spectroscopy. Oil fly ash particles were seen to be well dispersed within the alumina matrix. Moreover, the comparative analysis of the nano‐/microsized Al2O3/OFA composites shows that the mechanical and thermal properties were improved in nanosized alumina composites.
From Intended to Actual and Beyond: A Cross‐Disciplinary View of (Human Resource Management) Implementation
Authors: Trullen Jordi , Bos‐Nehles Anna , Valverde Mireia
Published: February 2020

Despite increasing interest in human resource management (HRM) implementation as an explanation for the association between HRM and firm performance, considerable confusion remains about what implementation means. In order to develop conceptual definitions of HRM implementation and implementation effectiveness, this study builds on three different literatures outside the HRM field (strategy, innovation, and change management), which have addressed this topic extensively. As a result, implementation is characterized as a dynamic process, involving the interaction among multiple actors, starting with the adoption of a new practice and ending with its routinization. This is distinguished from implementation effectiveness as an outcome of that process. The study helps to achieve construct clarity, hence providing a more solid basis for future research and allowing for a better consolidation of findings. The authors also develop an agenda for further research by reviewing a number of theoretical and methodological approaches that have been used in implementation research across fields, including HRM. Overall, the study aims to establish implementation research as a highly relevant academic and practical quest not only in HRM, but also in other management literatures.
Family history in primary hormone therapy for prostate cancer: Analysis from a community‐based multi‐institutional Japan‐wide database
Authors: Shiota Masaki , Onozawa Mizuki , Hinotsu Shiro , Eto Masatoshi , Naito Seiji , Akaza Hideyuki ,   the Japan Study Group of Prostate Cancer (J‐CaP)
Published: February 2020

Objectives

To determine the association between hormone therapy and outcomes in a cohort of prostate cancer patients with a family history of prostate cancer.

Methods

Data of patients with prostate cancer who had received hormone therapy were extracted from a nationwide community‐based database established by the Japan Study Group for Prostate Cancer. Family history of prostate cancer was available for 13 346 of these patients, who thus comprised the study cohort. Prognostic variables, including progression‐free survival, cancer‐specific survival and overall survival, were compared between men with familial and men with sporadic prostate cancer.

Results

A positive family history was identified in 220 patients (1.6%). Patients with a positive family history were younger than those without; however, other clinicopathological characteristics and prognoses were comparable. In subgroup analysis, family history was identified as a possible favorable prognostic factor for overall survival among patients with a prostate‐specific antigen level at diagnosis <100 ng/mL and those with low or intermediate Japan Cancer of the Prostate Risk Assessment.

Conclusions

Our findings show that familial prostate cancer has an early‐onset feature or is diagnosed earlier than sporadic prostate cancer. However, the prognosis of individuals with familial prostate cancer undergoing hormone therapy is comparable to those with sporadic prostate cancer.
Recent history of psittacosis in Australia: expanding our understanding of the epidemiology of this important globally distributed zoonotic disease
Authors: Polkinghorne Adam , Weston Kathryn M. , Branley James
Published: February 2020

Psittacosis is a human systemic disease caused by infection with Chlamydia psittaci. Shortly after reports emerged of a global pandemic associated with contact with imported parrots, Australian researchers including Macfarlane Burnet and others demonstrated that C. psittaci was widespread in Australian parrots. Australian cases over the last two decades have revealed that environmental exposure and contact with infected horses are also risk factors in an increasingly complicated epidemiological picture for this zoonotic disease.
Lead poisoning associated with illicit opium use
Authors: Wong Joshua , Bourke Elyssia , Roberts Vanessa , Lim Seok M. , Johnson Douglas , Hamblin Peter S. , Karunajeewa Harin , Greene Shaun
Published: February 2020

Lead poisoning is an uncommon and challenging diagnosis to make. In 2018, The Victorian Department of Health issued a health warning following four cases of lead poisoning associated with illicit opium use in Melbourne, Australia. We present these cases to highlight clinical features and the relevant investigations leading to diagnosis. All cases occurred in recent immigrants to Australia, who had access to non‐traditional sources of opioids. Health care professionals should consider lead poisoning in patients with appropriate symptoms and a history of illicit opium use.
Who is asking about medicinal cannabis in palliative care?
Authors: Panozzo Stacey , Le Brian , Collins Anna , Weil Jennifer , Whyte Jan , Barton Michael , Coperchini Maria , Rametta Meri , Philip Jennifer
Published: February 2020

Following legislative changes in the availability and prescribing of medicinal cannabis in Australia, we sought to understand prospectively the nature of information seeking and requests for medicinal cannabis in consultations between palliative care clinicians and patients with cancer. The 104 discussions were overwhelmingly initiated by patients and carers (93%) and were for a variety of symptoms, reflecting high levels of patient interest in the use of medicinal cannabis in cancer.
Electrophysiological findings during atrial fibrillation reablation: Extending from pulmonary vein reconnection to sequential bipolar voltage map information
Authors: Huo Yan , Kronborg Mads Brix , Richter Utz , Guo Jianping , Ulbrich Stefan , Zedda Angela M. , Kirstein Bettina , Mayer Julia , Pu Liying , Piorkowski Judith , Wagner Michael , Gaspar Thomas , Piorkowski Christopher
Published: February 2020

Background

Left atrial substrate modification targeting low voltage zones (LVZ) is an ablation strategy that—in addition to pulmonary vein (PV) isolation—tries to eliminate arrhythmogenic mechanisms harbored in such tissue. Electrophysiological findings at reablation include (a) PV reconnection, (b) reconnection over previous substrate ablation, and (c) de‐novo LVZ.

Objective

To study, prevalence and contribution of these arrhythmogenic electrophysiological entities in patients with atrial fibrillation (AF) recurrences.

Methods

Consecutive patients with highly symptomatic AF undergoing index and reablation were included (n = 113). In all patients' PV reconnection, reconnection over previous substrate ablation and spontaneous de‐novo LVZ were quantitatively assessed and integrated into an individual reablation strategy. Follow‐up was based on continuous device monitoring.

Results

At re‐do procedure, 45 out of 113 (39.8%) patients showed PV reconnection as the only electrophysiological abnormality. Reconduction over previous lines was the only electrophysiological abnormality in 8 out of 113 (7.1%) patients. Spontaneous de‐novo LVZ was the only electrophysiological abnormality in 12 out of 113 (10.6%) patients. Combined findings of PV reconnection, line reconduction, and/or spontaneous de‐novo LVZ were seen in 40 out of 113 (35.4%) patients. No detectable electrophysiological abnormality was observed in 8 out of 113 (7.1%) patients. In univariate analysis, none of the tested electrophysiological characteristics independently predicted the outcome after re‐do.

Conclusions

In patients undergoing reablation, we could show that reconduction over previous substrate ablation as well as the development of new low voltage areas are frequent findings besides classical PV reconnection—without a clear leading cause for recurrences. These findings impact reablation strategies as well as the strategic focus during index procedures.
Deconstructing the repetitive behaviour phenotype in autism spectrum disorder through a large population‐based analysis
Authors: Uljarević Mirko , Cooper Matthew N. , Bebbington Keely , Glasson Emma J. , Maybery Murray T. , Varcin Kandice , Alvares Gail A. , Wray John , Leekam Susan R. , Whitehouse Andrew J.O.
Published: February 2020

Objective

Restricted and repetitive pattern of behaviours and interests (RRB) are a cardinal feature of autism spectrum disorder (ASD), but there remains uncertainty about how these diverse behaviours vary according to individual characteristics. This study provided the largest exploration to date of the relationship between Repetitive Motor Behaviours, Rigidity/Insistence on Sameness and Circumscribed Interests with other individual characteristics in newly diagnosed individuals with ASD.

Method

Participants (N = 3,647; 17.7% females; Mage = 6.6 years [SD = 4.7]) were part of the Western Australian (WA) Register for ASD, an independent, prospective collection of demographic and diagnostic data of newly diagnosed cases of ASD in WA. Diagnosticians rated each of the DSM‐IV‐TR criteria on a 4‐point Likert severity scale, and here we focused on the Repetitive Motor Behaviours, Insistence on Sameness and Circumscribed Interests symptoms.

Results

The associations between RRB domains, indexed by Kendall's Tau, were weak, ranging from non‐significant for both Circumscribed Interests and Repetitive Motor Behaviours to significant (.20) for Insistence on Sameness and Repetitive Motor Behaviours. Older age at diagnosis was significantly associated with lower Circumscribed Interests and significantly associated with higher Insistence on Sameness and Repetitive Motor Behaviours. Male sex was significantly associated with higher Repetitive Motor Behaviours but not Insistence on Sameness or Circumscribed Interests.

Conclusions

The pattern of associations identified in this study provides suggestive evidence for the distinctiveness of Repetitive Motor Behaviours, Insistence on Sameness and Circumscribed Interests, highlighting the potential utility of RRB domains for stratifying the larger ASD population into smaller, more phenotypically homogeneous subgroups that can help to facilitate efforts to understand diverse ASD aetiology and inform design of future interventions.
Phylogeography of the European brook lamprey (Lampetra planeri) and the European river lamprey (Lampetra fluviatilis) species pair based on mitochondrial data
Authors: De Cahsan Binia , Nagel Rebecca , Schedina Ina‐Maria , King James J. , Bianco Pier G. , Tiedemann Ralph , Ketmaier Valerio
Published: February 2020

The European river lamprey Lampetra fluviatilis and the European brook lamprey Lampetra planeri (Block 1784) are classified as a paired species, characterized by notably different life histories but morphological similarities. Previous work has further shown limited genetic differentiation between these two species at the mitochondrial DNA level. Here, we expand on this previous work, which focused on lamprey species from the Iberian Peninsula in the south and mainland Europe in the north, by sequencing three mitochondrial marker regions of Lampetra individuals from five river systems in Ireland and five in southern Italy. Our results corroborate the previously identified pattern of genetic diversity for the species pair. We also show significant genetic differentiation between Irish and mainland European lamprey populations, suggesting another ichthyogeographic district distinct from those previously defined. Finally, our results stress the importance of southern Italian L. planeri populations, which maintain several private alleles and notable genetic diversity.
High‐pressure freezing followed by freeze substitution of a complex and variable density miniorgan: the wool follicle
Authors: VELAMOOR S. , RICHENA M. , MITCHELL A. , LEQUEUX S. , BOSTINA M. , HARLAND D.
Published: February 2020

Cryofixation by high‐pressure freezing (HPF) followed by freeze substitution (FS) is a preferred method to prepare biological specimens for ultrastructural studies. It has been shown to achieve uniform vitrification and ultrastructure preservation of complex structures in different cell types. One limitation of HPF is the small sample volume of <200 µm thickness and about 2000 µm across. A wool follicle is a rare intact organ in a single sample about 200 µm thick. Within each follicle, specialized cells derived from multiple cell lineages assemble, mature and cornify to make a wool fibre, which contains 95% keratin and associated proteins. In addition to their complex structure, large density changes occur during wool fibre development. Limited water movement and accessibility of fixatives are some issues that negatively affect the preservation of the follicle ultrastructure via conventional chemical processing. Here, we show that HPF‐FS of wool follicles can yield high‐quality tissue preservation for ultrastructural studies using transmission electron microscopy.
A Model of Group Prenatal Care for Patients with Prenatally Diagnosed Fetal Anomalies
Authors: Schwarz Jessica G. , Froh Elizabeth , Farmer Mari‐Carmen , Oser Maren , Howell Lori J. , Moldenhauer Julie S.
Published: February 2020

The model of group prenatal care was initially developed to include peer support and to improve education and health‐promoting behaviors during pregnancy. This model has since been adapted for populations with unique educational needs. Mama Care is an adaptation of the CenteringPregnancy Model of prenatal care. Mama Care is situated within a national and international referral center for families with prenatally diagnosed fetal anomalies. In December 2013, the Center for Fetal Diagnosis and Treatment at Children's Hospital of Philadelphia began offering a model of group prenatal care to women whose pregnancies are affected by a prenatal diagnosis of a fetal anomaly. The model incorporates significant adaptations of CenteringPregnancy in order to accommodate these women, who typically transition their care from community‐based settings to the Center for Fetal Diagnosis and Treatment in the late second or early third trimester. Unique challenges associated with caring for families within a referral center include a condensed visit schedule, complex social needs such as housing and psychosocial support, as well as an increased need for antenatal surveillance and frequent preterm birth. Outcomes of the program are favorable and suggest group prenatal care models can be developed to support the needs of patients with prenatally diagnosed fetal anomalies.
Complex sex and estrous cycle differences in spontaneous transient adenosine
Authors: Borgus Jason R. , Puthongkham Pumidech , Venton B. Jill
Published: February 2020

Adenosine is a ubiquitous neuromodulator that plays a role in sleep, vasodilation, and immune response and manipulating the adenosine system could be therapeutic for Parkinson's disease or ischemic stroke. Spontaneous transient adenosine release provides rapid neuromodulation; however, little is known about the effect of sex as a biological variable on adenosine signaling and this is vital information for designing therapeutics. Here, we investigate sex differences in spontaneous, transient adenosine release using fast‐scan cyclic voltammetry to measure adenosine in vivo in the hippocampus CA1, basolateral amygdala, and prefrontal cortex. The frequency and concentration of transient adenosine release were compared by sex and brain region, and in females, the stage of estrous. Females had larger concentration transients in the hippocampus (0.161 ± 0.003 µM) and the amygdala (0.182 ± 0.006 µM) than males (hippocampus: 0.134 ± 0.003, amygdala: 0.115 ± 0.002 µM), but the males had a higher frequency of events. In the prefrontal cortex, the trends were reversed. Males had higher concentrations (0.189 ± 0.003 µM) than females (0.170 ± 0.002 µM), but females had higher frequencies. Examining stages of the estrous cycle, in the hippocampus, adenosine transients are higher concentration during proestrus and diestrus. In the cortex, adenosine transients were higher in concentration during proestrus, but were lower during all other stages. Thus, sex and estrous cycle differences in spontaneous adenosine are complex, and not completely consistent from region to region. Understanding these complex differences in spontaneous adenosine between the sexes and during different stages of estrous is important for designing effective treatments manipulating adenosine as a neuromodulator.

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An experience of slow‐Mohs micrographic surgery for the treatment of Dermatofibrosarcoma protuberans: A long‐term cohort study
Authors: Asilian Ali , Honarjou Navid , Faghihi Gita , Saber Mina , Mozafarpoor Samaneh , Hafezi Hossein
Published: February 2020

Background

Dermatofibrosarcoma protuberans (DFSP) is a rare dermal mesenchymal tumor known as a low‐grade, slow‐growing malignancy. The local invasion and high rate of recurrence following surgical treatment are the main concerns to plan the best surgical approach of treatment.

Aims

In the current study, it is aimed to provide an experience of slow‐Mohs surgery for the treatment of patients with DSFP.

Patients/Methods

Number of 25 patients with the diagnosis of DFSP through histological and immunostaining study was included. The slow‐Mohs was performed by excision of the tumor with margins accounting for 1–2 cm from both the tumor margins and three‐dimensional thickness. The obtained tissue margins were horizontally, and if any of the specimens was not margin‐free, the procedure was repeated. The patients' opinion about the procedure was assessed using Patient‐Observer Scar Assessment Scale (POSAS).

Results

Number of 25 patients were included and followed for a median of 46.9 months. The median of the area of excision was 35.56 cm2, and the median clinical excision margins were 19 mm (tumor excision margins + thickness of the three‐dimensional excision). The surgery was performed once for 16 (64%), and postoperative skin closure within 5–7 days after the procedure was performed for 19 (76%) patients. None of the patients represented any recurrence. The patients' overall opinion and satisfaction POSAS score accounted for 2.3 ± 1.65 and 1.6 ± 0.59, respectively.

Conclusion

The findings of the current study are in favor of slow‐Mohs surgery for the management of DFSP, while more extensive studies are strongly recommended for generalization of this procedure.
Family versus Non‐Family Firm Franchisors: Behavioural and Performance Differences
Authors: Chirico Francesco , Welsh Dianne H. B. , Ireland R. Duane , Sieger Philipp
Published: February 2020

Drawing from resource‐based theory, we argue that family firm franchisors behave and perform differently compared to non‐family firm franchisors. Our theorizing suggests that compared to a non‐family firm franchisor, a family firm franchisor cultivates stronger relationships with franchisees and provides them with more training. Yet, we predict that a family firm franchisor achieves lower performance than a non‐family firm franchisor. We argue, however, that this performance relationship reverses itself when family firm franchisors are older and larger. We test our hypotheses with a longitudinal dataset including a matched‐pair sample of private U.S. family and non‐family firm franchisors.
Family understanding and communication about an adult relative’s mental health problem: A systematic narrative review
Authors: Gammage Rebecca J. , Nolte Lizette
Published: February 2020

Accessible summary

What is known on the subject?

Adults who support an adult family member with a severe and enduring mental health problem often experience carer burden. Over time, this often negatively affects their mental and physical health and social well‐being.

Understanding and communicating about mental health problems in families can help to improve resilience and coping among both adults and children.

What does this paper add to existing knowledge?

We conducted a review of studies looking at how adult relatives understand and communicate about an adult family member's mental health problem.

The findings highlight that how relatives make sense of MHP is related to historical family relationships, their mental health literacy and whether they see themselves as a “carer” or not.

The findings also show that little research to date has explored how adult relatives talk with children about their parent's difficulties, and how the adults’ understanding might affect what children learn about the MHP.

What are the implications for practice?

There is a research gap to be addressed regarding family communication with children about parental mental health problems. This knowledge gap likely impacts family‐focused mental health nursing and therapy provision.

Mental health nursing, therapeutic and support workers and advocates are ideally positioned to assist relatives with improving their mental health literacy and confidence communicating about mental health, and to promote inclusion of relatives and children in interventions.

Introduction

Relatives are profoundly affected by an adult family member's severe and enduring mental health problem (MHP). The burdens of caring impact on adult relatives’ emotional, physical and social well‐being. How relatives make meaning and communicate about the MHP is thought to affect family talk about mental health, and this can impact family coping and well‐being.

Aim

No review has yet drawn together research about how adult relatives of people with severe and enduring MHP make meaning and communicate about their relatives’ difficulties. We aimed to address this gap.

Method

We conducted a systematic review of peer‐reviewed primary research. SCOPUS, PubMed, Psychnet, SCIE, Cochrane and CINAHL+ databases were searched.

Results

Nineteen papers qualified for inclusion. Findings are organized under four themes: making meaning about the MHP and affected individual; conceptualizing the self in the presence of the MHP; meaning‐making processes underlying relatives’ well‐being outcomes; and relatives’ perspectives on family talk about the MHP.

Discussion

Historical relationships, caregiver identity and mental health literacy moderate relatives’ understanding and talk about the MHP.

Implications for practice

Psychoeducation and communication support for relatives should be provided by mental health practitioners. Future research should address familial communication about MHP, including with children.
The State of Inclusion With Students With Intellectual and Developmental Disabilities in the United States
Authors: Wehmeyer Michael L. , Shogren Karrie A. , Kurth Jennifer
Published: February 2020

This article describes the state of inclusion and inclusive practices with students with intellectual and developmental disabilities (I/DD) in the United States. It reviews the legislative history of the right to a free, appropriate public education for students with disabilities and the requirement in U.S. law for special education services to be provided in the least restrictive environment (LRE). Despite a focus on the LRE and appropriate supplementary aids and services to promote success in regular education environments for students with I/DD, students with I/DD are still educated largely in segregated classrooms and settings in the United States. However, a large and growing body of research suggests the positive benefits of inclusive education providing a compelling need for ongoing change to make inclusive placements the default for students with I/DD, consistent with the law. Research clearly suggests that inclusive placements benefit students with I/DD, and emerging research highlights that engagement and access to the general education curriculum is higher in inclusive vs. segregated settings. There is an ongoing need for the implementation of the policy establishing the right to education in the LRE for students with ID, and recent court cases suggesting the importance of an “appropriately ambitious” education program provide new direction for progress in inclusive practices.