bluuebunny/crossref_metadata_2025 huggingface dataset:
Bullying, harassment and sexual discrimination among ophthalmologists in Australia and New Zealand
Authors: Meyer Juliette A. , Troutbeck Robyn , Oliver Genevieve F. , Gordon Lynn K. , Danesh‐Meyer Helen V.
Published: November 2020

Background

Discrimination, bullying and sexual harassment (DBSH) impact the psychological well‐being of doctors and contribute to poor health outcomes. The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) commissioned independent surveys to evaluate DBSH among members/trainees.

Methods

Anonymous online surveys by Best Practice Australia were undertaken in 2015 and 2018. Cross‐sectional analysis was prevalence of perceived DBSH, rates of reporting, intervention and resolution undertaken. Response rate was 50% (658/1319) in 2015 and 40% (557/1401) in 2018. In both surveys, 29% were female. This is representative of the distribution of the RANZCO members.

Results

In a 2015 survey, 37.6% of respondents experienced DBSH, with prevalence being the highest for females (62.3%; N = 104 cf males 27.7%; N = 167) and trainees (49.2%; N = 61). In 2018, 49.2% of respondents reported DBSH with rates low for all forms of DBSH (22%‐29%). Sexual harassment was reported by 12% and the least discussed or reported. Respondents strategy for taking action included draw on personal support network (25‐43%), official complaints to supervisors (16‐22%), human resources (2%‐10%) and RANZCO (0%‐6%). Reasons for not taking action included fear of impact of future career options (54.1%‐60.7%), fear of victimization (35.7%‐50.4%) and afraid of not being believed (31.9%‐52.4%). Satisfactory resolution rates were 6% to 25%. A majority of respondents (77%) were positive about RANZCO initiatives.

Conclusions

DBSH is commonly reported by RANZCO members with female ophthalmologists more than two times more likely to experience any one of the four behaviours, three times more likely to experience discrimination and six times for sexual harassment. Fear of compromising personal and career progression contribute to low levels of reporting.
Global pattern of interkinetic nuclear migration in tracheoesophageal epithelia of the mouse embryo: Interorgan and intraorgan regional differences
Authors: Getachew Dereje , Matsumoto Akihiro , Uchimura Yasuhiro , Udagawa Jun , Mita Nanako , Ogawa Noriko , Moriyama Shigeru , Takami Akiyasu , Otani Hiroki
Published: November 2020

Interkinetic nuclear migration (INM) is an apicobasal (AB) polarity‐based regulatory mechanism of proliferation/differentiation in epithelial stem/progenitor cells. We previously documented INM in the endoderm‐derived tracheal/esophageal epithelia at embryonic day (E) 11.5 and suggested that INM is involved in the development of both organs. We here investigated interorgan (trachea vs esophagus) and intraorgan regional (ventral vs dorsal) differences in the INM mode in the tracheal and esophageal epithelia of the mouse embryo. We also analyzed convergent extension (CE) and planar cell movement (PCM) in the epithelia based on cell distribution. The pregnant C57BL/6J mice were intraperitoneally injected with 5‐ethynyl‐2′‐deoxyuridine at E11.5 and E12.5 and were sacrificed 1, 4, 6, 8, and 12 hours later to obtain the embryos. The distribution of labeled cell nuclei along the AB axis was chronologically analyzed in the total, ventral, and dorsal sides of the epithelia. The percentage distribution of the nuclei population was represented by histogram and the chronological change was analyzed statistically using multidimensional scaling. The interorgan comparison of the INM mode during E11.5‐E12.0, but not E12.5‐E13.0, showed a significant difference. During E11.5‐E12.0 the trachea, but not the esophagus, showed a significant difference between ventral and dorsal sides. During E12.5‐E13.0 neither organ showed regional differences. CE appeared to occur in both organs during E11.5‐E12.0 while PCM was unclear in both organs. These findings suggest a difference between the trachea and esophagus, and a regional difference in the trachea, not in the esophagus, in the INM mode, which may be related with the later differential organogenesis/histogenesis of these organs.
Machine learning models predict coagulopathy in spontaneous intracerebral hemorrhage patients in ER
Authors: Zhu Fengping , Pan Zhiguang , Tang Ying , Fu Pengfei , Cheng Sijie , Hou Wenzhong , Zhang Qi , Huang Hong , Sun Yirui
Published: November 2020

Aims

Coagulation abnormality is one of the primary concerns for patients with spontaneous intracerebral hemorrhage admitted to ER. Conventional laboratory indicators require hours for coagulopathy diagnosis, which brings difficulties for appropriate intervention within the optimal window. This study evaluates the possibility of building efficient coagulopathy prediction models using data mining and machine learning algorithms.

Methods

A retrospective cohort enrolled 1668 cases with acute spontaneous intracerebral hemorrhage from three medical centers, excluding those under antithrombotic therapies. Coagulopathy‐related clinical parameters were initially screened by univariate analysis. Two machine learning algorithms, the random forest and the support vector machine, were deployed via an approach of four‐fold cross‐validation to screen out the most important parameters contributing to the occurrence of coagulopathy. Model discrimination was assessed using metrics, including accuracy, precision, recall, and F1 score.

Results

Albumin/globulin ratio, neutrophil count, lymphocyte percentage, aspartate transaminase, alanine transaminase, hemoglobin, platelet count, white blood cell count, neutrophil percentage, systolic and diastolic pressure were identified as major predictors to the occurrence of acute coagulopathy. Compared to support vector machine, the model based on the random forest algorithm showed better accuracy (93.1%, 95% confidence interval [CI]: 0.913‐0.950), precision (92.4%, 95% CI: 0.897‐0.951), F1 score (91.5%, 95% CI: 0.889‐0.964), and recall score (93.6%, 95% CI: 0.909‐0.964), and yielded higher area under the receiver operating characteristic curve (AU‐ROC) (0.962, 95% CI: 0.942‐0.982).

Conclusion

The constructed models exhibit good prediction accuracy and efficiency. It might be used in clinical practice to facilitate target intervention for acute coagulopathy in patients with spontaneous intracerebral hemorrhage.
Information needs for recovery after colorectal surgery: a patient focus group study
Authors: Chapman Stephen J. , Czoski Murray Carolyn , Lonsdale Maria D. S. , Boyes Sheila , Tiernan Jim P. , Jayne David G.
Published: November 2020

Aim

The provision of information to patients is an important part of recovery after colorectal surgery. This study aimed to define patient information needs, barriers to effective understanding and insights into how information provision may be improved.

Method

A patient focus group was convened. This comprised a broad, convenience sample of 11 participants from across the United Kingdom with experience of major colorectal surgery. A semistructured topic guide was used to facilitate discussion about previous experiences of information provision and how this may be improved. Data were analysed thematically and are presented as major themes.

Results

Overall, participants felt that their information needs are poorly prioritized by healthcare professionals. Barriers to understanding and retaining information include highly emotional situations (such as receiving bad news) and inappropriate information design (such as the use of inaccessible language). Participants expressed how information resources should: (a) address patients’ individual information needs; (b) empower patients to take an active role in their recovery; (c) support patients with meaningful education and sign‐posted resources; and (d) recognize patients’ heightened need for information during recovery at home.

Conclusion

This study provides key insights into the information needs of patients undergoing colorectal surgery. These should inform the development of future information resources, whose format, timing and design are currently supported by low‐quality evidence.
Capital Heterogeneity and the Decline of the Labour Share
Authors: O’Mahony Mary , Vecchi Michela , Venturini Francesco
Published: November 2020

We investigate the decline of the labour share in a world characterized by increasing heterogeneity of capital assets. Our results show that over the 1970–2007 period, the decline of the labour share has been driven mainly by Information and Communication Technology assets and is mitigated by increasing investments in R&D‐based knowledge assets. Extending to other forms of intangible capital from 1995 onwards, we find that intangible investments related to innovation increase the labour share while those related to the organization of firms contribute to its decline, particularly for low‐ and intermediate‐skilled workers. Our results are robust to an array of econometric issues, namely heterogeneity, cross‐sectional dependence and endogeneity.
Violent conflict and institutional change*
Authors: O'Reilly Colin
Published: November 2020

Violent conflict such as civil war may influence institutional quality by changing the political equilibrium or by changing preferences and norms. This study presents empirical evidence that in some cases civil war deteriorates institutional quality. By applying the synthetic control method to 25 cases of civil war between 1960 and 2010, I construct the counterfactual path of institutional quality in the absence of civil war. The effects of civil war are heterogeneous, but for a substantial minority of cases civil war appears to deteriorate institutional quality. These findings have implications for post‐civil war economic recovery as well as long run economic development.
Role of pre‐transplant MRD level detected by flow cytometry in recipients of allogeneic stem cell transplantation with AML
Authors: Klyuchnikov Evgeny , Christopeit Maximilian , Badbaran Anita , Bacher Ulrike , Fritzsche‐Friedland Ulrike , von Pein Ute‐Marie , Wolschke Christine , Kröger Nicolaus
Published: November 2020

Objectives and Methods

We analyzed the impact of pretransplant MRD level in bone marrow measured by flow cytometry using “different from normal” method on outcomes for 189 AML patients (108 males; median age, 58 (21‐80) years). All patients were subdivided into negative (n = 96), “low” (0.1%‐0.5%, n = 32), and “high” MRD (>0.5%, n = 61) groups.

Results

In multivariate analysis, the hazard ratios for “high” and “low” MRD levels related to MRD negativity were 7.9 (95% CI 3.5‐18.1, P < .001) and 5.4 (95% CI 2.1‐14, P = .0058) for relapse; 2.3 (95% CI 1.3‐4.1, P = .006) and 1.6 (95% CI 0.82‐3.3, P = .16) for OS; and 2.8 (95% CI 1.7‐4.7, P < .001) and 2.2 (95% CI 1.1‐4.2, P = .02) for LFS, respectively. We found no significant impact of “low” MRD level on relapses (0.68, 95% CI 0.33‐1.4, P = .30), OS (0.72, 95% CI: 0.36‐1.5, P = .36) and LFS (0.79, 95% CI: 0.42‐1.5, P = .46) related to “high” MRD group.

Conclusions

Presence of detectable MRD was indicative for a high relapse risk, low LFS and OS. “Low” MRD level showed no significant impact on relapse, LFS and OS related to “high” MRD group.
Individual differences in the encoding of contextual details following acute stress: An explorative study
Authors: Sep Milou S. C. , Joëls Marian , Geuze Elbert
Published: November 2020

Information processing under stressful circumstances depends on many experimental conditions, like the information valence or the point in time at which brain function is probed. This also holds true for memorizing contextual details (or ‘memory contextualization’). Moreover, large interindividual differences appear to exist in (context‐dependent) memory formation after stress, but it is mostly unknown which individual characteristics are essential. Various characteristics were explored from a theory‐driven and data‐driven perspective, in 120 healthy men. In the theory‐driven model, we postulated that life adversity and trait anxiety shape the stress response, which impacts memory contextualization following acute stress. This was indeed largely supported by linear regression analyses, showing significant interactions depending on valence and time point after stress. Thus, during the acute phase of the stress response, reduced neutral memory contextualization was related to salivary cortisol level; moreover, certain individual characteristics correlated with memory contextualization of negatively valenced material: (a) life adversity, (b) α‐amylase reactivity in those with low life adversity and (c) cortisol reactivity in those with low trait anxiety. Better neutral memory contextualization during the recovery phase of the stress response was associated with (a) cortisol in individuals with low life adversity and (b) α‐amylase in individuals with high life adversity. The data‐driven Random Forest‐based variable selection also pointed to (early) life adversity—during the acute phase—and (moderate) α‐amylase reactivity—during the recovery phase—as individual characteristics related to better memory contextualization. Newly identified characteristics sparked novel hypotheses about non‐anxious personality traits, age, mood and states during retrieval of context‐related information.
Transcriptional and signalling regulation of skin epithelial stem cells in homeostasis, wounds and cancer
Authors: Guan Yinglu , Yang Youn Joo , Nagarajan Priyadharsini , Ge Yejing
Published: November 2020

The epidermis and skin appendages are maintained by their resident epithelial stem cells, which undergo long‐term self‐renewal and multilineage differentiation. Upon injury, stem cells are activated to mediate re‐epithelialization and restore tissue function. During this process, they often mount lineage plasticity and expand their fates in response to damage signals. Stem cell function is tightly controlled by transcription machineries and signalling transductions, many of which derail in degenerative, inflammatory and malignant dermatologic diseases. Here, by describing both well‐characterized and newly emerged pathways, we discuss the transcriptional and signalling mechanisms governing skin epithelial homeostasis, wound repair and squamous cancer. Throughout, we highlight common themes underscoring epithelial stem cell plasticity and tissue‐level crosstalk in the context of skin physiology and pathology.
LRP1/CD91 is highly expressed in monocytes from patients with vitiligo – even after repigmentation
Authors: Piquero‐Casals Jaime , Martínez‐Martínez Laura , Alomar Agustín , Rozas‐Muñoz Eduardo , Juarez Candido , Puig Luis
Published: November 2020

Vitiligo pathophysiology is mediated by antigen‐specific cytotoxic T cells. Environmental stressors cause susceptible melanocytes to secrete damage‐associated molecular patterns (DAMPs). DAMPs are recognized by receptors such as the endocytic low‐density lipoprotein receptor‐related protein (LRP1/CD91), expressed in antigen‐presenting cells, which activate self‐reactive CD8+ T cells, leading to melanocyte destruction. Within this response, interferon gamma triggers production of cytokine CXCL10, recruiting more activated T cells causing further melanocytic damage. We hypothesized that expression of LRP1/CD91 was higher in vitiligo patients compared to non‐vitiligo individuals. And further that levels/expression of CXCL10 in plasma were linked to disease severity. We enrolled forty individuals in this study: 18 patients with vitiligo and 22 healthy volunteers. We assessed LRP1/CD91 expression and plasma CXCL10 in patients with vitiligo and healthy volunteers. Additionally, vitiligo patients received combined treatment for 16 weeks following which the said parameters were reassessed. Vitiligo Area Scoring Index was calculated before and after treatment for these patients. Analysis of LRP1/CD91 MFI values in monocytes from vitiligo patients showed high surface levels of LRP1/CD91 than from healthy volunteers (10.50 ± 0.77 vs. 6.55 ± 0.77 MFI units, p < 0.001). This expression did not change after treatment. Plasma levels of CXCL10 were higher in vitiligo patients than healthy volunteers (93.78 ± 7.73 vs. 40.17 ± 6.25 pg/ml). The patients with a good clinical response to treatment had a parallel reduction in plasma CXCL10 levels (105.8 ± 18.44 vs. 66.13 ± 4.87 pg/ml) before and after treatment. LRP1/CD91 expression may reflect susceptibility to vitiligo. Plasma levels of CXCL10 can represent a biomarker for monitoring treatment response. LRP1 and CXCL10 may represent therapeutic targets.
Beyond energy storage: roles of glycogen metabolism in health and disease
Authors: Zhang Huafeng , Ma Jingwei , Tang Ke , Huang Bo
Published: November 2020

Beyond storing and supplying energy in the liver and muscles, glycogen also plays critical roles in cell differentiation, signaling, redox regulation, and stemness under various physiological and pathophysiological conditions. Such versatile functions have been revealed by various forms of glycogen storage diseases. Here, we outline the source of carbon flux in glycogen metabolism and discuss how glycogen metabolism guides CD8+ T‐cell memory formation and maintenance. Likewise, we review how this affects macrophage polarization and inflammatory responses. Furthermore, we dissect how glycogen metabolism supports tumor development by promoting tumor‐repopulating cell growth in hypoxic tumor microenvironments. This review highlights the essential role of the gluconeogenesis‐glycogenesis‐glycogenolysis‐PPP metabolic chain in redox homeostasis, thus providing insights into potential therapeutic strategies against major chronic diseases including cancer.
Down‐regulation of dual‐specificity phosphatase 6, a negative regulator of oncogenic ERK signaling, by ACA‐28 induces apoptosis in NIH/3T3 cells overexpressing HER2/ErbB2
Authors: Kanda Yuki , Mizuno Ayami , Takasaki Teruaki , Satoh Ryosuke , Hagihara Kanako , Masuko Takashi , Endo Yuichi , Tanabe Genzoh , Sugiura Reiko
Published: November 2020

Dual‐specificity phosphatase 6 (DUSP6) is a key negative feedback regulator of the member of the RAS‐ERK MAPK signaling pathway that is associated with cellular proliferation and differentiation. Deterioration of DUSP6 expression could therefore result in deregulated growth activity. We have previously discovered ACA‐28, a novel anticancer compound with a unique property to stimulate ERK phosphorylation and induce apoptosis in ERK‐active melanoma cells. However, the mechanism of cancer cell‐specific‐apoptosis by ACA‐28 remains obscure. Here, we investigated the involvement of DUSP6 in the mechanisms of the ACA‐28‐mediated apoptosis by using the NIH/3T3 cells overexpressing HER2/ErbB2 (A4‐15 cells), as A4‐15 exhibited higher ERK phosphorylation and are more susceptible to ACA‐28 than NIH/3T3. We showed that A4‐15 exhibited high DUSP6 protein levels, which require ERK activation. Notably, the silencing of the DUDSP6 gene by siRNA inhibited proliferation and induced apoptosis in A4‐15, but not in NIH/3T3, indicating that A4‐15 requires high DUSP6 expression for growth. Importantly, ACA‐28 preferentially down‐regulated the DUSP6 protein and proliferation in A4‐15 via the proteasome, while it stimulated ERK phosphorylation. Collectively, the up‐regulation of DUSP6 may exert a growth‐promoting role in cancer cells overexpressing HER2. DUSP6 down‐regulation in ERK‐active cancer cells might have the potential as a novel cancer measure.
Histological characteristics of lung adenocarcinoma with uncommon actionable alterations: special emphasis on MET exon 14 skipping alterations
Authors: Hayashi Takuo , Kohsaka Shinji , Takamochi Kazuya , Kishikawa Satsuki , Ikarashi Daiki , Sano Kei , Hara Kieko , Onagi Hiroko , Suehara Yoshiyuki , Takahashi Fumiyuki , Saito Tsuyoshi , Nakatsura Tetsuya , Kitano Shigehisa , Suzuki Kenji , Yao Takashi
Published: November 2020

Aims

In the evolving era of precision medicine, increasing emphasis is placed on detecting molecular alterations driving the development of specific cancers and targeting them with matched therapies that can yield the best outcomes for patients. Lung adenocarcinomas with uncommon actionable alterations, including MET exon 14 skipping (METex14), ERBB2 and BRAF mutations, are rare and poorly characterised cancers.

Methods and results

To more clearly understand the histopathological features of lung adenocarcinoma with uncommon actionable alterations, we compared the histological features of 678 cases with mitogenic driver alterations from 996 surgically resected lung adenocarcinomas. Genomic data from our cohort revealed METex14, ERBB2 and BRAF mutations in 13, 16 and 15 cases, respectively. Patients who had lung adenocarcinoma with METex14 were often elderly females. Histological features such as clear cell features (23%), hyaline globules (31%) and nuclear pleomorphism (39%) were the most frequently identified in METex14‐positive cases; among those, three cases (23%) had tumour cells with bizarre giant or multilobulated nuclei. Additionally, the micropapillary pattern was the most frequently identified in ERBB2‐mutated lung adenocarcinoma (31%). Lung adenocarcinoma with BRAF mutations tended to be less invasive, and the BRAF V600E mutation was identified in only one case with lepidic adenocarcinoma. Immunohistochemically, all METex14, ERBB2 and BRAF‐positive tumours, except for invasive mucinous adenocarcinoma, were positive for thyroid transcription factor 1 (TTF‐1).

Conclusions

Our data from Japanese patients showed that lung adenocarcinoma with METex14 had unique clinicopathological characteristics: tumour cells with marked nuclear pleomorphism, hyaline globules and expression of TTF‐1 in elderly women who never or lightly smoked.
Environmental impact estimation of ceramic lightweight aggregates production starting from residues
Authors: Barbieri Luisa , Bigi Alessandro , Andreola Fernanda , Lancelotti Isabella , Ghermandi Grazia , Teresa Cotes Palomino Maria , Martínez García Carmen
Published: November 2020

Within a circular economy approach, this study investigates the environmental impact of lightweight aggregates (LWAs) produced starting from different mixes of different clays with brewery sludge and cattle bone flour ash (CBA), used as poring and fertilizing agents, respectively. The environmental impact was evaluated by means of release tests, insulation capacity, carbon footprint (CFP), and particulate matter emission during pellet firing. Release tests representative of LWAs realistic application showed very high release of phosphate and satisfactory release of potassium. The thermal insulation of the LWAs was tested by thermal imaging camera and resulted highly variable depending on the composition, with the mix containing CBA performing best. This latter composition leads also to the smallest CO2 equivalent emission, due to the calorific power of CBA, allowing lower consumption of fossil fuels during the LWA production. Finally, total particulate emissions during the thermal treatment resulted similar in terms of mass for all mixes, while differences in terms of particle morphology and composition occurred. Samples containing residue resulted with a quite good release behavior, CFP, and insulation properties, but higher emission of particles, particularly when glass is added.
Effect of physicochemical characteristics on the use of clays from Kindia (Guinea) in ceramic compositions
Authors: Balde Mamadou Yaya , Njiomou Djangang Chantale , Bah Aissatou , Blanchart Philippe , Njopwouo Daniel
Published: November 2020

To evaluate their potential uses in ceramic compositions, two different types of abundant clays from Kindia (Guinea Conakry), denoted ABD and ARD, were characterized with the chemical and mineralogical compositions, the specific surface area, the plasticity index, the particle size distribution, and the thermal behavior. Kaolinite and muscovite are the main clay minerals that are identified. Besides, non‐plastic minerals are large amount of quartz with a small particles size, goethite, hematite, anatase, and a small quantity of gibbsite. The two clays have a high plasticity index that is consistent with the small particle size and the broad size distribution. During heating, the fluxing behavior of the two clays induces a significant densification that is favored by the muscovite mineral combined with the reactive fine quartz. Besides, the firing shrinkage is limited to values of 4.5% and 3.5% for ABD and ARD respectively. In the objective of manufacturing ceramics, the two clays present the required properties. They present a sufficient plastic index in the green state, and after firing they lead to dense ceramics with an interesting bright color. The limited firing shrinkage is favorable to maintain the dimensional stability of vitrified ceramics as porcelain.
International Council for Standardization in Haematology (ICSH) laboratory guidance for the evaluation of haemostasis analyser‐reagent test systems. Part 1: Instrument‐specific issues and commonly used coagulation screening tests
Authors: Gardiner Chris , Coleman Robyn , de Maat Moniek P. M. , Dorgalaleh Akbar , Echenagucia Marión , Gosselin Robert C. , Ieko Masahiro , Kitchen Steve
Published: November 2020

Before a new method is used for clinical testing, it is essential that it is evaluated for suitability for its intended purpose. This document gives guidance for the performance of verification, validation and implementation processes required by regulatory and accreditation bodies. It covers the planning and execution of an evaluation of the commonly performed screening tests (prothrombin time, activated partial thromboplastin time, thrombin time and fibrinogen assay), and instrument‐specific issues. Advice on selecting an appropriate haemostasis analyser, planning the evaluation, and assessing the reference, interval, precision, accuracy, and comparability of a haemostasis test system are also given. A second companion document will cover specialist haemostasis testing.
MXene‐derived TiC/SiBCN ceramics with excellent electromagnetic absorption and high‐temperature resistance
Authors: Ding Jinxue , Chen Fengbo , Chen Jianxin , Liang Jin , Kong Jie
Published: November 2020

Demand for high‐performance electromagnetic (EM) wave absorbing materials with high‐temperature resistance is always urgent for application in a harsh environment. In this contribution, two‐dimensional material, Ti3C2Tx MXene, was introduced into a hyperbranched polyborosilazane. After pyrolyzation, the as‐prepared TiC/SiBCN ceramics present excellent EM wave absorption in X‐band. The TiC nanograins appearing after annealing provide multilevel reflection and interface polarization. Dipole polarization formed at interface defects, in company with interfacial polarization, also makes a great contribution to enhanced EM wave absorption. The TiC/SiBCN nanocomplex prepared with 5 wt% Ti3C2Tx MXene possesses a minimum reflection coefficient of −45.44 dB at 10.93 GHz and abroad bandwidth 8.4 and 12.4 GHz, almost covering the entire X‐band. Tuning the thickness in the range of 2.35‐2.54 mm, the effective absorption band can achieve the entire X‐band. And the EM wave absorbing performance has been maintained to a large extent at 600°C with the minimum reflection coefficient of −26.12 dB at 12.13 GHz and the effective absorption bandwidth of 2 GHz. Last but not the least, TiC/SiBCN ceramics offer a good thermal stability in argon as well as in air atmosphere, making it possible to serve in high‐temperature detrimental environments. This study is expected to provide a new perspective for the design of high‐performance absorbing materials that are able to be used in harsh environments, especially in high temperatures.
Group‐randomized trial of tailored brief shared decision‐making to improve asthma control in urban black adults
Authors: George Maureen , Bruzzese Jean‐Marie , (Lynn) S. Sommers Marilyn , Pantalon Michael V. , Jia Haomiao , Rhodes Joseph , Norful Allison A. , Chung Annie , Chittams Jesse , Coleman Danielle , Glanz Karen
Published: November 2020

Aims

To assess the intervention effects of BREATHE (BRief intervention to Evaluate Asthma THErapy), a novel brief shared decision‐making intervention and evaluate feasibility and acceptability of intervention procedures.

Design

Group‐randomized longitudinal pilot study.

Methods

In total, 80 adults with uncontrolled persistent asthma participated in a trial comparing BREATHE (N = 40) to a dose‐matched attention control intervention (N = 40). BREATHE is a one‐time shared decision‐making intervention delivered by clinicians during routine office visits. Ten clinicians were randomized and trained on BREATHE or the control condition. Participants were followed monthly for 3 months post‐intervention. Data were collected from December 2017 – May 2019 and included surveys, lung function tests, and interviews.

Results

Participants were Black/multiracial (100%) mostly female (83%) adults (mean age 45). BREATHE clinicians delivered BREATHE to all 40 participants with fidelity based on expert review of audiorecordings. While the control group reported improvements in asthma control at 1‐month and 3‐month follow‐up, only BREATHE participants had better asthma control at each timepoint (β = 0.77; standard error (SE)[0.17]; p ≤ 0.0001; β = 0.71; SE[0.16]; p ≤ 0.0001; β = 0.54; SE[0.15]; p = .0004), exceeding the minimally important difference. BREATHE participants also perceived greater shared decision‐making occurred during the intervention visit (β = 7.39; SE[3.51]; p = .03) and fewer symptoms at follow‐up (e.g., fewer nights woken, less shortness of breath and less severity of symptoms) than the controls. Both groups reported improved adherence and fewer erroneous medication beliefs.

Conclusion

BREATHE is a promising brief tailored intervention that can be integrated into office visits using clinicians as interventionists. Thus, BREATHE offers a pragmatic approach to improving asthma outcomes and shared decision‐making in a health disparity population.

Impact

The study addressed the important problem of uncontrolled asthma in a high‐risk vulnerable population. Compared with the dose‐matched attention control condition, participants receiving the novel brief tailored shared decision‐making intervention had significant improvements in asthma outcomes and greater perceived engagement in shared decision‐making. Brief interventions integrated into office visits and delivered by clinicians may offer a pragmatic approach to narrowing health disparity gaps. Future studies where other team members (e.g., office nurses, social workers) are trained in shared decision‐making may address important implementation science challenges as it relates to adoption, maintenance, and dissemination.

Trail registration

clinicaltrials.gov # NCT03300752.
Nutrition and hydration for people living with dementia near the end of life: A qualitative systematic review
Authors: Barrado‐Martín Yolanda , Hatter Lee , Moore Kirsten J. , Sampson Elizabeth L. , Rait Greta , Manthorpe Jill , Smith Christina H. , Nair Pushpa , Davies Nathan
Published: November 2020

Aims

To synthesize the qualitative evidence of the views and experiences of people living with dementia, family carers, and practitioners on practice related to nutrition and hydration of people living with dementia who are nearing end of life.

Design

Systematic review and narrative synthesis of qualitative studies.

Data sources

MEDLINE, Embase, PsycINFO, CINAHL.

Review methods

Databases were searched for qualitative studies from January 2000‐February 2020. Quantitative studies, or studies reporting on biological mechanisms, assessments, scales or diagnostic tools were excluded. Results were synthesized using a narrative synthesis approach with thematic analysis.

Results

Twenty studies were included; 15 explored the views of practitioners working with people living with dementia in long‐term care settings or in hospitals. Four themes were developed: challenges of supporting nutrition and hydration; balancing the views of all parties involved with ‘the right thing to do’; national context and sociocultural influences; and strategies to support nutrition and hydration near the end of life in dementia.

Conclusion

The complexity of supporting nutrition and hydration near the end of life for someone living with dementia relates to national context, lack of knowledge, and limited planning while the person can communicate.

Impact

This review summarizes practitioners and families’ experiences and highlights the need to include people living with dementia in studies to help understand their views and preferences about nutrition and hydration near the end of life; and those of their families supporting them in the community. The review findings are relevant to multidisciplinary teams who can learn from strategies to help with nutrition and hydration decisions and support.
Incidence and risk factors of symptomatic thrombosis related to peripherally inserted central catheter in patients with lung cancer
Authors: Chen Pei , Wan Guangming , Zhu Bingqian
Published: November 2020

Aims

To determine the incidence and risk factors associated with peripherally inserted central catheter‐related thrombosis (PICC‐RT) in patients with lung cancer.

Design

A retrospective cross‐sectional design.

Methods

Patients with lung cancer receiving PICC insertion during 1 March 2014‐31 May 2019 at a tertiary hospital in Shanghai, China were enrolled (N = 748). Symptomatic PICC‐RT was confirmed by Doppler ultrasonography in the presence of clinical symptoms and signs. Univariate and multivariate logistic regression analyses were performed to identify risk factors of symptomatic PICC‐RT.

Results

Among the patients (mean age, 60.7 years; males, 67.1%), 55 (7.35%) had symptomatic PICC‐RT. Based on the multivariate analysis, history of smoking [OR 2.49 (1.13–5.46), p < .05], use of Carboplatin [OR 2.23 (1.19–4.17), p < .05] or Docetaxel [OR 7.23 (1.65–31.56), p < .05], PICC size [OR 3.52 (1.78–6.99), p < .001], and level of D‐dimer [OR 5.32 (2.39–11.83), p < .001] were significant risk factors of PICC‐RT.

Conclusion

Several modifiable factors (e.g., PICC size and level of D‐dimer) were related to PICC‐RT. In the future, prospective studies are warranted to examine whether those factors could increase the risk of PICC‐RT. Meanwhile, healthcare professionals are recommended to perform a comprehensive assessment of the patients receiving PICC insertion. Close attention should be paid to those at risk for PICC‐RT.

Impact

Identification of risk factors associated with PICC‐RT is an important step towards individualizing the care plan for patients receiving PICC. Our findings provided evidence for the management of PICC‐RT in patients with lung cancer. In clinical practice, nurses could deliver appropriate interventions against modifiable risk factors to reduce the risk of PICC‐RT.
Challenges encountered by patients with end‐stage kidney disease in accessing symptom management services: A narrative inquiry
Authors: Ng Marques Shek Nam , Hui Yun Ho , Law Bernice Yee Shui , Wong Cho Lee , So Winnie Kwok Wei
Published: November 2020

Aim

To understand the storied experiences of accessing symptom management services of patients with end‐stage kidney disease (ESKD) who are receiving maintenance dialysis.

Design

Narrative inquiry.

Methods

Ten patients with ESKD who were receiving dialysis were recruited at two regional hospitals in Hong Kong and interviewed three times each between July 2017–July 2018 to capture their narratives. The data were analysed using the narrative inquiry approach from the perspective of Levesque's framework of access to care.

Results

Five themes emerged from the participants’ narratives. The first theme illustrated access to care as a process by which symptom management needs were met. However, clinicians occasionally identified patients based on their diseases instead of their needs and this process was affected differently by interpersonal and system factors. The themes ‘building trust’ and ‘facilitating communication’ described interpersonal factors that were essential to maintaining a constructive patient–clinician partnership. The themes ‘balancing efficiency’ and ‘navigating fragmented system’ described system‐related factors.

Conclusions

This study identified the factors that influenced the delivery and/or reception of symptom management services for patients with ESKD who were receiving dialysis. The results suggest that healthcare services should be streamlined based on patients’ needs and that this process should address the important elements of trust and communication.

Impact

The study's results suggest potential improvements to symptom management services that would enable patients’ needs to be addressed in a timely and humanistic manner.
Are Paula method exercises effective for gastrointestinal reactivation post‐elective cesarean delivery? Randomized controlled trial
Authors: Liebergall‐Wischnitzer Michal , Shaphir Anna , Solnica Amy , Hochner‐Celnikier Drorith
Published: November 2020

Aim

To examine the effectiveness of the Paula Method exercises in comparison to standard care on resumption of gastrointestinal (GI) activity in women postelective caesarean delivery (CD).

Design

Randomized controlled trial on a postpartum unit of a university medical centre.

Methods

Sixty‐four women following elective CD performed under regional anaesthesia were recruited between 2 February–3 July 2018. Participants were randomized into two groups: The Paula Method exercise group (intervention group) and the control group. Women in the intervention group performed circular muscle exercises according to the Paula Method and received standard care, while those in the control group were treated only with standard care. Time to first bowel sounds, passage of first flatus and first defecation after CD were measured.

Results

A significant difference was found in the time to passage of first flatus, in favour of the intervention group (24.07 [6.85] hours versus 39.07 [10.37] hours; p < .001). No significant differences between the groups were found for other main outcome measures.

Conclusion

Paula Method exercises post CD can serve as natural and convenient alternative to the standard, conservative treatment to promote resumption of GI activity.

Impact

CD can be associated with postoperative ineffective peristalsis that can lead to a paralytic ileus. Since standard methods are not sufficient for all women, there is a need for alternative modalities to accelerate the resumption of bowel functioning. In the Paula Method exercise group, time to first flatus passage occurred significantly sooner compared with the control group. Time to first defecation was earlier in the Paula Method exercise group but this difference did not reach statistical significance. Along with gum chewing, Paula Method exercises can be part of a simple and inexpensive GI activation strategy post CD. Further research should be performed using these exercises post other operative procedures.
Mediating effects of social support between Type D personality and self‐care behaviours among heart failure patients
Authors: Park Chanhee , Won Mi Hwa , Son Youn‐Jung
Published: November 2020

Aims

Patients with heart failure exhibit poor adherence to self‐care behaviours. Recent studies have shown a link between Type D personality, social support, and self‐care behaviours of patients with chronic diseases. However, the mechanisms underlying this relationship have received little empirical attention in those with heart failure. This study aimed to identify the mediating effects of social support in the relationship between Type D personality and self‐care behaviours in patients with heart failure.

Design

This study employed a descriptive cross‐sectional design.

Methods

The sample comprised 170 patients aged over 18 years who had been diagnosed with heart failure for over 6 months and visited a tertiary care university hospital in Seoul. From April–July 2019, data were collected through an interview conducted using a structured questionnaire and a review of medical records by two trained research assistants. Multiple regression models were tested using the SPSS PROCESS procedure with bootstrapping to determine the significance of the mediation.

Results

The prevalence of Type D personality in patients with heart failure was 20.0%. Significant associations were identified among Type D personality, social support, and self‐care behaviours. Results revealed an indirect effect, suggesting that the effects of Type D personality on self‐care behaviours were mediated by social support.

Conclusion

Heart failure patients with Type D personality were likely to lack social support, which may have influenced their low adherence to self‐care behaviours. Thus, to facilitate long‐lasting self‐care behaviours, it is vital to provide supportive care or educational programs for patients with Type D personality.

Impact

Providing sustainable social support can have a positive impact on the long‐term self‐care maintenance of patients with heart failure patients who have a Type D personality. Future studies are required to further elucidate the underlying mechanisms of the relationship between Type D personality, social support, and self‐care behaviours.
Sexual health discussions between healthcare professionals and midlife‐older women living with Type 2 diabetes: An interpretative phenomenological study
Authors: Ejegi‐Memeh Stephanie , Hinchliff Sharron , Johnson Maxine
Published: November 2020

Aim

To explore the barriers and facilitators to sexual discussions in primary care according to a sample of women aged 50 and older living with Type 2 diabetes.

Design

A qualitative, interpretative phenomenological analysis study.

Methods

Ten women aged 50–83 years living with Type 2 diabetes were interviewed between August 2016 ‐March 2017. Data were analysed using interpretative phenomenological analysis.

Results

The participants reported changes to their sexual health and well‐being, which they attributed to diabetes, menopause, ageing and changes in intimate relationships. Not all changes were considered problematic, but those that were, tended not to be discussed with healthcare professionals. The women assumed that the topic of sex was not broached by professionals due to embarrassment (both their own and that of the healthcare professional), ageism and social taboos around older women's sexual pleasure. The place that sexual health and well‐being held in the women's lives also influenced primary care discussions.

Conclusion

These findings demonstrate that social taboos around gender, ageing and sex influenced the barriers to sexual health and well‐being discussions in primary care. Facilitators to overcoming these barriers were professional–patient rapport, consulting with a female healthcare professional and instigation of the conversation by healthcare professionals.

Impact

Type 2 diabetes can have a negative impact on women's sexual health and well‐being. Prior to this study, little evidence existed of the barriers that older women with Type 2 diabetes faced with regard to sexual health care. This study shows that midlife‐older women with Type 2 diabetes can experience sexual health and well‐being problems which are neglected in primary care. It also shows that women want their healthcare professionals to explore these problems. Raising awareness and giving training for healthcare professionals may lead to better provision of sexual health support for midlife‐older women with Type 2 diabetes.
Benefit or burden? A comparison of CFO and CEO outside directorships
Authors: Khan Sarfraz , Mauldin Elaine
Published: November 2020

We study the association between chief financial officer (CFO), compared to chief executive officer (CEO), outside board directorships and their home‐firm strategic investments, capital management, and overall performance. Using a sample of firms from 2003 to 2014, we find that only about 9% of CFOs, compared to about 24% of CEOs, sit on outside boards. We find robust evidence that CFO outside directorships are associated with fewer underinvestment problems, lower sensitivity between cash holdings and cash flows, and higher long‐term performance at their home firm, consistent with positive knowledge transfer by the CFO. On the other hand, we find little evidence of knowledge transfer for CEO outside board directorships, consistent with concerns that executives are too busy to hold outside directorships. Our findings support a need to recognize that outside directorships could provide benefits for some but not all executives. For CFOs, our findings support the argument that outside directorships provide CFOs an opportunity to network with and learn from other executives and directors, enabling these CFOs to improve practices in their home firm.
Admission hyperglycemia as an independent predictor of long‐term prognosis in acute myocardial infarction patients without diabetes: A retrospective study
Authors: Cui Cai‐yan , Zhou Ming‐gang , Cheng Lian‐chao , Ye Tao , Zhang Yu‐mei , Zhu Feng , Li Si‐yi , Jiang Xing‐lin , Chen Qiang , Qi Ling‐yao , Chen Xu , Yang Si‐qi , Cai Lin
Published: November 2020

Aims/Introduction

The predictive value of admission hyperglycemia in the long‐term prognosis of acute myocardial infarction patients is still controversial. We aimed to investigate this value based on the diabetes status.

Materials and Methods

We carried out a multicenter, retrospective study of 1,288 acute myocardial infarction patients enrolled in 11 hospitals between March 2014 and June 2019 in Chengdu, China. The patients were classified into those with diabetes and those without diabetes, each was further divided into: hyperglycemia and non‐hyperglycemia subgroups, according to the optimal cut‐off value of the blood glucose to predict all‐cause mortality during follow up. The end‐points were all‐cause death and major adverse cardiovascular and cerebrovascular events, including all‐cause death, non‐fatal myocardial infarction, vessel revascularization and non‐fatal stroke.

Results

In the follow‐up period of 15 months, we observed 210 (16.3%), 6 (0.5%), 57 (4.4%) and 34 (2.6%) cases of death, non‐fatal myocardial infarction, revascularization and non‐fatal stroke, respectively. The optimal cut‐off values of admission blood glucose for patients with diabetes and patients without diabetes to predict all‐cause mortality during follow up were 14.80 and 6.77 mmol/L, respectively. We divided patients with diabetes (n = 331) into hyperglycemia (n = 92) and non‐hyperglycemia (n = 239), and patients without diabetes (n = 897) into hyperglycemia (n = 425) and non‐hyperglycemia (n = 472). The cumulative rates of all‐cause death and major adverse cardiovascular and cerebrovascular events among the patients in each hyperglycemia group was higher than that in the corresponding non‐hyperglycemia group (P < 0.001). In patients without diabetes, admission hyperglycemia was an independent predictor of all‐cause mortality and major adverse cardiovascular and cerebrovascular events.

Conclusion

Admission hyperglycemia was an independent predictor for long‐term prognosis in acute myocardial infarction patients without diabetes.