bluuebunny/crossref_metadata_2025 huggingface dataset:
Child-Centred Health Dialogue for primary prevention of obesity in Child Health Services – a feasibility study
Authors: Derwig Mariette , Tiberg Irén , Björk Jonas , Hallström Inger
Published: December 2019

Aims: The aim of this study was to test a Child-Centred Health Dialogue model for primary prevention of obesity for 4-year-old children in Child Health Services, for its feasibility and the responsiveness of its outcomes. Methods: A feasibility study was set up with a non-randomised quasi-experimental cluster design comparing usual care with a structured multicomponent Child-Centred Health Dialogue consisting of two parts: (1) a universal part directed to all children and (2) a targeted part for families where the child is identified with overweight. Results: In total, 203 children participated in Child-Centred Health Dialogue while 582 children received usual care. Nurses trained in the model were able to execute both the universal health dialogue and the targeted part of the intervention. Tutorship enabled the nurses to reflect on and discuss their experiences, which strengthened their confidence and security. One year after the intervention fewer normal-weight 4-year-olds in the intervention group had developed overweight at the age of five compared with the control group, and none had developed obesity. The difference in overweight prevalence at follow-up did not reach statistical significance. Conclusions: This study demonstrates that a child-centred, multicomponent, interactive intervention for the promotion of healthy lifestyles and primary prevention of obesity for all 4-year-old children participating in Child Health Services is feasible on a small scale. As almost all caregivers make use of Child Health Services in Sweden, the findings should be confirmed in a randomised controlled trial before the intervention can be implemented on a larger scale.
Associations between a risky psychosocial childhood and recurrent addiction compulsory care as adult
Authors: Grahn Robert , Padyab Mojgan , Lundgren Lena
Published: December 2019

Background:

Treatment for substance use disorder (SUD), results, in general, in improvements in terms of both drug use and social functioning. However, there are clients who are in need of repeated treatment. The aim of this retrospective study was to identify, for adults in compulsory care for severe SUD, the association between reporting having experienced a risky psychosocial childhood and repeated entries into the Swedish compulsory care system for SUD.

Method:

Hierarchical logistic regression and mediation analysis methods were used to analyse data from the Swedish National Board of Institutional Care (SiS) database. The sample included 2719 adults assessed at their compulsory care intake. The study examined the association between history of institutional care, family with SUD or psychiatric problem and repeated compulsory care entries as an adult controlling for main drug, age and gender.

Results:

In the regression model the factor with the strongest association with repeated compulsory care intakes for SUD, was as a child having been in mandated institutional care ( OR = 2.0 (1.60–2.51)). The proportion of the total effect that is mediated through LVU (law (1990:52) the care of young persons (special provisions) act) was 33% for SUD problems in family during childhood, 44% for psychiatric problems in family during childhood, and 38% for having been in foster care.

Conclusion:

Having been in mandated institutional care as a youth was strongly associated with repeated compulsory care for SUD as an adult. This is concerning since receipt of services as a child is supposed to mediate against the consequences of risky childhood conditions. These adults, as a group, are in need of a well-coordinated and integrated system of extensive aftercare services to reduce the likelihood of re-entry into compulsory care for an SUD.
Delegation of committee reports in the European Parliament
Authors: Chiou Fang-Yi , Hermansen Silje SL , Høyland Bjørn
Published: December 2019

Committee coordinators face a classic delegation problem when assigning reports to their committee members. Although a few theoretical developments have focused on the effects of expertise on delegation, empirical studies have commonly assumed monotonic effects. Based on existing informational models, we argue that a more loyal committee member, everything else being equal, is more likely to be appointed as a rapporteur and that more expertise, holding preference divergence constant, has a non-monotonic effect because of informational credibility. Employing accumulated committee service as an expertise measure, these theoretical expectations are tested on all committee report delegations in the European Parliament from 1979 to 2014. Our empirical analysis with non-parametric and parametric hierarchical conditional logit models renders strong support for these expectations. The results hold across member states, political groups, procedures, committees and over time.
Photomorphogenesis of wheat sprouts with LED irradiation of different intensities
Authors: Han T , Astafurova T , Turanov S , Burenina A , Butenkova A , Surnina E , Valiev D
Published: December 2019

Definition of the growth and development characteristics of plants in varied light conditions is a key factor for the creation of highly efficient light facilities for plant cultivation. Experimental research was conducted using an LED irradiation facility with photosynthetic photon flux densities ranging from 0 to 261 μmol m−2 s−1 and a continuous spectrum with maxima at 445 and 600 nm. Under the maximum photosynthetic photon flux density (261 μmol m− 2 s−1) wheat germs demonstrated diminishing leaf surface with high values of specific leaf area, enhanced pubescence of ground tissues, increases in the number of stomata on the upper epidermis and palisade, and an increase in the thickness of the leaves as well as an increase in carotenoids but a decrease in the chlorophyll a+b/carotenoids relation. It was revealed that the optimum level of photosynthetic photon flux density for the referred spectrum was in the range from 82 to 100 µmol m−2 s−1, which may enable a reduction of irradiance under specific conditions during early development with no harm to the plants while minimizing energy consumption during cultivation.
Protecting Refugees Inside, Protecting Borders Abroad? Gender in the EU’s Responses to the ‘Refugee Crisis’
Authors: Welfens Natalie
Published: December 2019

Migration tends to be denoted as a crisis which needs a solution. The European Union has developed policies for dealing with this crisis internally, within its borders, and externally. Both the experiences of migrants and European Union policy responses are gendered and have gendered effects. This article analyses how the European Union refers to gender in its definitions of and responses to the crisis. Grounded in feminist policy analysis, I scrutinize European Union internal and external policies under its Agenda of Migration. The analysis finds that European Union internal crisis responses demonstrate a more comprehensive understanding of gendered vulnerabilities and a commitment to human right provisions. External crisis responses reduce gender considerations to refugee women and the policy objective of reducing refugee arrivals which leads to further curtailing refugees’ access to protection. Showing how the crisis transforms the very meaning and scope of gender considerations to various degrees, the article furthers insights on how the European Union’s normative commitments develop in times of crisis.
Doctor Who, Ma’am: YouTube Reactions to the 2017 Reveal of the New Doctor
Authors: Eeken Sophie , Hermes Joke
Published: December 2019

In 2017, BBC released a video revealing that Jodie Whittaker would be the actor to play the thirteenth Doctor in the 2018 season of Doctor Who (1963–), the popular BBC television series. The “reveal” that a woman had been cast in the role of the Doctor prompted an overwhelming backlash and fierce online discussion. The same period saw a number of popular films and series cast women as leads. The intense discussion that the reveal generated indicates that televisual representations of gender continue to matter greatly to viewers. The question is how? Fan comments posted below the reveal video on YouTube suggest that viewing publics are less engaged in a controversy over feminism than bewildered by gender categories becoming unstable. Notably, once the series aired, discussion about the Doctor’s gender died down. Seeing the Doctor addressed as “Ma’am,” it turned out, was not what upset viewers.
Mapping Influence: Partisan Networks across the United States, 2000 to 2016
Authors: Reuning Kevin
Published: December 2019

The parties as networks approach has become a critical component of understanding American political parties. Research on it has so far mainly focused on variation in the placement of candidates within a network at the national level. This is in part due to a lack of data on state-level party networks. In this article, I fill that gap by developing state party networks for 47 states from 2000 to 2016 using candidate donation data. To do this, I introduce a backboning network analysis method not yet used in political science to infer relationships among donors at the state level. Finally, I validate these state networks and then show how parties have varied across states and over time. The networks developed here will be made publicly available for future research. Being able to quantify variation in party network structure will be important for understanding variation in party-policy linkages at the state level.
Complex Wound Healing Outcomes for Outpatients Receiving Care via Telemedicine, Home Health, or Wound Clinic: A Randomized Controlled Trial
Authors: Téot Luc , Geri Chloé , Lano Julie , Cabrol Marjorie , Linet Christine , Mercier Grégoire
Published: December 2019

Use of telemedicine has expanded rapidly in recent years, yet there are few comparative studies to determine its effectiveness in wound care. To provide experimental data in the field of telemedicine with regard to wound care, a pilot project named “Domoplaies” was publicly funded in France in 2011. A randomized, controlled trial was performed to measure the outcomes of patients with complex wounds who received home wound care from a local clinician guided by an off-site wound care expert via telemedicine, versus patients who received in-home or wound clinic visits with wound care professionals. The publicly funded network of nurses and physicians highly experienced in wound healing was used to provide wound care recommendations via telemedicine for the study. The healing rate at 6 months was slightly better for patients who received wound care via telemedicine (61/89; 68.5%) versus wound care professional at home (38/59; 64.4%) versus wound care clinic (22/35; 62.9%), but the difference was not significant ( P = .860833). The average time to healing for the 121/183 wounds that healed within 6 months was 66.8 ± 32.8 days for the telemedicine group, 69.3 ± 26.7 for the wound care professional at home group, and 55.8 ± 25.0 days for the wound care clinic group. Transportation costs for the telemedicine and home health care groups were significantly lower than the wound clinic group, and death rate was similar between all the 3 groups ( P < .01). Telemedicine performed by wound healing clinicians working in a network setting offered a safe option to remotely manage comorbid, complex wound care patients with reduced mobility.
Ganoderma lucidum Exerts an Anticancer Effect on Human Osteosarcoma Cells via Suppressing the Wnt/β-Catenin Signaling Pathway
Authors: Zhang Qi-Hao , Hu Qin-Xiao , Xie Da , Chang Bo , Miao Hou-Guang , Wang Yun-Guo , Liu De-Zhong , Li Xue-Dong
Published: December 2019

Background: Current treatment of osteosarcoma is limited in part by side effects and low tolerability, problems generally avoided with traditional Chinese medicine. Ganoderma lucidum, a traditional Chinese medicine with antitumor effects, offers a potential alternative, but little is known about its molecular mechanisms in osteosarcoma cells. Objective: To investigate the effect of G lucidum on osteosarcoma cells and its mechanism. Methods: Osteosarcoma MG63 and U2-OS cells were treated with G lucidum, followed by assays for cell proliferation (Cell Counting Kit-8), colony formation, and apoptosis (Alexa Fluor 647-Annexin V/propidium iodide, flow cytometry). Migration and invasion of cells were assessed by wound healing and Transwell invasion assays, and the effect of G lucidum on Wnt/β-catenin signal transduction was studied by real-time quantitative polymerase chain reaction, western blot, and dual-luciferase assay. Results: G lucidum inhibited the proliferation, migration, and invasion, and induced apoptosis of human osteosarcoma MG63 and U2-OS cells. Dual-luciferase assay showed that G lucidum suppressed the transcriptional activity of T-cell factor/lymphocyte enhancer factor in the Wnt/β-catenin signaling pathway. Moreover, G lucidum blocked Wnt/β-catenin signaling by inhibiting the Wnt co-receptor LRP5 and Wnt-related target genes, such as β-catenin, cyclin D1, C-Myc, MMP-2, and MMP-9. At the same time, when Wnt/β-catenin was inhibited, the expression of E-cadherin was upregulated. Conclusions: Our results suggest that G lucidum broadly suppresses osteosarcoma cell growth by inhibiting Wnt/β-catenin signaling.
Why Some Students with Severe Disabilities Are Not Placed in General Education
Authors: Kauffman James M. , Travers Jason C. , Badar Jeanmarie
Published: December 2019

We acknowledge that some students with severe disabilities are not being taught in general education. We do not agree that inclusion in general education is inherently better, nor do we think it is always appropriate, and we provide some reasons that a full continuum of alternative placements is not only legally mandated but appropriate. We are supportive of placement in general education for children with severe disabilities when it is appropriate.
Baseline Lighter Sleep and Lower Saturation Are Associated With Improved Sleepiness and Adherence on Continuous Rather Than Autotitrating Positive Airway Pressure
Authors: Sangal R. Bart , Sudan Nimish
Published: December 2019

The objective was to test whether there were better outcomes on switching from autotitrating positive airway pressure (APAP) to continuous positive airway pressure (CPAP) in a clinic sample of patients with obstructive sleep apnea (OSA). Patients prescribed APAP in 2015-2016 and belonging to a subset characterized by side effects, or suboptimal response or adherence, were advised a switch to CPAP following a CPAP titration polysomnography. The main analysis was for improvement (after switch from APAP to CPAP) in (1) sleepiness, wakefulness inability, and fatigue, using change from baseline in the Sleepiness–Wakefulness Inability and Fatigue Test (delta SWIFT), and Epworth Sleepiness Scale (delta ESS), and (2) adherence using percentage of days with ≥4-hour use and whether there was ≥4-hour use on ≥70% days. To determine possible predictors for switching, additional analysis was performed for differences at baseline between patients switching and those staying on APAP. A total of 148 patients were switched from APAP to CPAP and had greater improvement in delta SWIFT (5.2 vs 4.1, P = .004), greater improvement in delta ESS (3.6 vs 2.9, P = .011), and better adherence (79.4% vs 74.3%, P = .006) on CPAP than on APAP. More patients were adherent on CPAP than on APAP (83.1% vs 68.9%, P = .006). Patients switching had higher baseline arousal index and stage N1 sleep, and lower nadir oxygen saturation, than 96 patients not switching. Thus, there is a subset of patients with better outcomes after switching to CPAP than on APAP. Patients with baseline lighter sleep (indicated by more arousals and stage N1), or greater desaturation, may be more likely to do better on CPAP than on APAP. CPAP may be the preferable treatment in a significant subset of patients. If APAP is used first anyway, side effects, or suboptimal response or adherence, should lead to consideration of switching to CPAP based on a CPAP titration polysomnography.
Distributed hybrid consensus–based square-root cubature quadrature information filter and its application to maneuvering target tracking
Authors: Liu Jun , Liu Yu , Dong Kai , Ding Ziran , He You , Li Qichao
Published: December 2019

To handle nonlinear filtering problems with networked sensors in a distributed manner, a novel distributed hybrid consensus–based square-root cubature quadrature information filter is proposed. The proposed hybrid consensus–based square-root cubature quadrature information filter exploits fifth-order spherical simplex-radial quadrature rule to tackle system nonlinearities and incorporates a novel measurement update strategy into the hybrid consensus filtering framework, which takes the predicted measurement error into account and hence produces more accurate estimates. In addition, the proposed hybrid consensus–based square-root cubature quadrature information filter inherits the complementary positive features of both consensus on information and consensus on measurements methods and avoids sensitive matrix operations such as square-root decompositions and inversion of covariances, which is beneficial for numerical stability. Stability analysis with respect to consensus, convergence, and consistency for the proposed hybrid consensus–based square-root cubature quadrature information filter is also developed. The effectiveness of the proposed hybrid consensus–based square-root cubature quadrature information filter is validated through a maneuvering target tracking scenario. The simulation results show that the proposed hybrid consensus–based square-root cubature quadrature information filter outperforms the existing algorithms at the expense of a slight increase in computational cost.
Prospective Study of Lactose Intolerance as a Potential Cause of Gas Bloat Syndrome in Patients Treated Surgically for Gastroesophageal Reflux
Authors: Pérez Lara Francisco Javier , Hernández Gonzalez Jose Manuel , Doblas Fernández Juan , Corrales Valero Elena , Oehling de los Reyes Herman
Published: December 2019

Introduction. The high incidence of lactose intolerance leads us to consider that many of our patients could suffer from this alteration. Therefore, as its main sign (even when asymptomatic) is increased intestinal gas, patients recovering from a Nissen fundoplication have a significant probability of suffering from gas bloat syndrome. Materials and Methods. This prospective study was conducted from November 2012 to January 2017, we included all the patients who had been treated by the Nissen technique for gastroesophageal reflux disease with gas bloat syndrome detected during follow-up and tested positive for lactose intolerance. The study participants were then prescribed a lactose-poor diet to be followed for 3 months. The patients were asked to complete quality of life and symptomatology questionnaires before and after diet. The pre- and post-diet results were then compared. Results. The pre- and post-diet results showed statistically significant improvements in both questionnaires. Conclusion. Lactose intolerance may account for the symptoms presented by a significant number of patients with gas bloat syndrome following antireflux surgery; these patients could benefit from consuming a lactose-free diet, which we expect to alleviate or, in some cases, eliminate the above symptoms.
A Systematic Review and Meta-Analysis of Single-Incision Versus Multiport Laparoscopic Complete Mesocolic Excision Colectomy for Colon Cancer
Authors: Athanasiou Christos , Pitt James , Malik Arshad , Crabtree Michael , Markides Georgios A.
Published: December 2019

Background. Our aim was to compare the emerging technique of single-incision laparoscopic surgery complete mesocolic excision (SILS CME) colectomy with the standard multiport laparoscopic CME (MPL CME) colectomy. Methods. MEDLINE (PubMed), Scopus, EMBASE, Ovid, and the Cochrane library were searched. Studies comparing the SILS CME with MPL CME in adults with colon adenocarcinoma were included. The Jadad and Newcastle Ottawa Scales were used to critically appraise the studies. The presence of statistical heterogeneity or publication bias was examined. Results. Seven studies (3 randomized) with a total number of 1344 patients were included (546 SILS CME and 798 MPL CME). No difference was found in anastomotic leakage (odds ratio [OR] = 0.79 [0.31 to 2.03]; P = .63), number of lymph nodes (weighted mean difference [WMD] = 0.85 [−0.97 to 2.66]; P = .36), hospital stay (WMD = 0.01 [−0.19 to 0.20]; P = .96), overall survival (hazard ratio [HR] = 1.19 [0.29 to 4.80]; P = .81), and disease-free survival (HR = 1.30 [0.30 to 5.61]; P = .72). Skin incision was shorter in SILS CME group (WMD = −3.02 [−3.25 to −2.80]; P < .00001) but with no difference in pain reported in postoperative day 1 (standardized mean difference [SMD] = −0.21 [−0.50 to 0.09]; P = .17) or day 2 (SMD = 0.16 [−0.52 to 0.84]; P = .64). Conclusions. SILS CME, although technically more demanding, has equivalent short- and long-term outcomes when compared with MPL CME. Potential benefits in cosmesis or postoperative pain need to be further explored by high-quality randomized controlled trials.
“Fractal Heuristics” for Mixed Methods Research: Applying Abbott’s “Fractal Distinctions” as a Conceptual Metaphor for Method Integration
Authors: Knappertsbusch Felix
Published: December 2019

With the interest in advancing integration in the field of mixed methods research (MMR), researchers need powerful metaphors for conceiving and implementing mixing strategies. This article contributes to the field of MMR by showing how Abbott’s “fractal distinctions” provide a valuable heuristic for the application of method combinations as well as the methodological reflection of MMR. Based on its core notion, the “self-similarity” of methods approaches, I propose three heuristic guidelines: (a) deliberately seek out qualitative aspects in quantitative methods (and vice versa); (b) assume a nonessentialist, theory-oriented approach toward method integration; and (c) aim to reconcile rigor and innovation in empirical research. I discuss similarities between fractal heuristics and other conceptualizations of difference-within, including dialectical and feminist approaches to MMR.
Cerebral aneurysms treated with low-profile visualized intraluminal support device (LVIS Jr) Y-stent constructs: Technical experience with a single microcatheter technique
Authors: Son Colin , Page Paul , Niemann David
Published: December 2019

Background

The LVIS Jr device holds a number of advantages but poses unique technical challenges compared to such, especially, complex multistent constructs. We report our experience with the technical feasibility and early to mid-term outcomes of Y-stent-assisted coiling with the LVIS Jr using a simple, single microcatheter technique.

Methods

Using a departmental database, we retrospectively reviewed a single surgeon’s experience with Y-stent-assisted coiling with LVIS Jr over a three-year period. Eighteen aneurysms in 17 patients were treated over this period. We assessed the technical success of the procedures, the initial and follow-up radiographic success with the modified Raymond-Roy occlusion score and follow-up clinical outcome with the modified Rankin scale.

Results

All stents were successfully deployed, and 17 of 18 aneurysms were successfully coiled at the initial treatment for a technical success rate of 94.4%. Of the 17 aneurysms with follow-up imaging, all were modified Raymond-Roy grade 1 or 2. One aneurysm required retreatment for coil compaction and a growing neck. There were two immediate postprocedure symptomatic strokes and one delayed stroke related to antiplatelet non-compliance. The two immediate symptomatic strokes recovered to neurological baseline with no residual deficits by the time of discharge. The long-term morbidity rate was 5.5%. The mortality rate was 0%. All patients had a modified Rankin Scale ≤ 2 at most recent follow-up.

Conclusion

Treatment with LVIS Jr Y-stent constructs via a single microcatheter technique is technically feasible with good radiographic and clinical outcomes.
Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) study protocol
Authors: Kate Mahesh Pundlik , Arora Deepti , Verma Shweta Jain , Sylaja PN , Renjith Vishnu , Sharma Meenakshi , Pandian Jeyaraj Durai ,   on behalf of SPRINT India Collaborators
Published: December 2019

Rationale

Recurrent stroke, cardiovascular morbidity, and mortality are important causes of poor outcome in patients with index stroke. Despite the availability of best medical management recurrent stroke occur in up to 15–20% of patients with stroke in India. Education for stroke prevention could be a strategy to prevent recurrent strokes.

Hypothesis

We hypothesize that a structured semi-interactive stroke prevention package can reduce the risk of recurrent strokes, acute coronary artery syndrome, and death in patients with sub-acute stroke at the end of one year.

Design

Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in INDIA (SPRINT INDIA) is a multi-center stroke trial involving 25 centers under the Indian Stroke Clinical Trial Network. Patients with first ever sub-acute stroke within two days to three months of onset, age 18–85 years, mRS <5, showing recent stroke in imaging are included. Participants or caregivers able to read and complete tasks suggested in a stroke prevention workbook and have a cellular device for receiving short message service and watching videos. A total of 5830 stroke patients speaking 11 different languages are being randomized to intervention or control arm. Patients in the intervention arm are receiving a stroke prevention workbook, regular educational short messages, and videos. All patients in the control arm are receiving standard of care management.

Structured semi-interactive stroke prevention package may reduce the risk of recurrent strokes, acute coronary artery syndrome, and death in patients with sub-acute stroke.

Trial registration

This trial is registered with clinicaltrials.gov (NCT03228979) and CTRI (Clinical Trial Registry India; CTRI/2017/09/009600).
Before the ‘Arab Spring’: How challengers pushed counter-issues in Egypt’s hybrid media system
Authors: Badr Hanan
Published: December 2019

Eight years after the ‘Arab Spring’, literature is still marked by techno-deterministic interpretations. This article contributes to examining the role of agenda-building processes just before the outbreak of the Egyptian uprising in 2011 within authoritarian systems. Using the ‘hybrid media system’ concept, the article not only focuses on new media effects but, by including print media, it takes into consideration the media system in its entirety. Focusing on Khaled Said’s case as a counter-issue, the qualitative content analysis investigates how challengers in Egypt successfully pushed the media salience of police torture onto the mainstream media agenda. By reconstructing the issue cycle and intermedia spill-over effects, the author investigates the agenda-building processes within hybrid media systems in Arab authoritarian contexts.

The qualitative content analysis includes 415 articles and posts from 12 diverse print, online and social media outlets between June 2010 and January 2011. The central finding is that successful spill-over effects occurred from online media to private print media, even though state media tried to ignore the issue. The coverage transferred the issue’s salience from new media into mainstream media, thus reaching wider non-politicized audiences. These proven interlinkages between old and new media are often an overlooked aspect in the literature on media and the ‘Arab Spring’.
Rhabdomyolysis caused by carnitine palmitoyltransferase 2 deficiency: A case report and systematic review of the literature
Authors: Ivin Nicholas , Della Torre Valentina , Sanders Francis , Youngman Matthew
Published: December 2019

Carnitine palmitoyltransferase 2 deficiency is an inherited metabolic disorder involving a deficiency in a mitochondrial enzyme necessary for long chain fatty acid oxidation, and therefore decreased utilisation of fatty acids. The adult form of this condition leads to recurrent rhabdomyolysis triggered by exercise, fasting and infection. It is a very rare condition with only a few hundred reported cases worldwide. Here we present a case of severe rhabdomyolysis in the context of carnitine palmitoyltransferase 2 deficiency in which major organ involvement was avoided, and organ support was not needed. This prompted us to perform a systematic review of the existing case reports in the literature to ascertain the most frequent patterns of organ involvement and assess the outcomes that are seen in these patients. Our findings suggest that these patients most frequently develop isolated renal failure, often requiring renal replacement therapy; however, the outcomes following this are very good, supporting the early involvement of intensive care teams.
Comment: A Relational Framework for Integrating the Study of Empathy in Children and Adults
Authors: Hollan Douglas
Published: December 2019

I strongly agree with Main and Kho’s primary contention that a relational approach can provide clarity regarding how empathy-related processes become increasingly coordinated over the lifespan. However, I go further to suggest that their “relational approach” should be expanded to include the larger social, cultural, economic, political, and moral contexts that shape and influence more intimate interpersonal relations, including empathic processes. Such an ethnographic, comparative approach has the advantage of helping us ascertain the extent to which empathic processes vary in different times and places (including the ways in which “empathy” is defined and conceptualized), but also aids us in identifying more accurately what is most “basic” or translocal about these processes.
Reasons to switch: a noninterventional study evaluating immunotherapy switches in a large German multicentre cohort of patients with relapsing-remitting multiple sclerosis
Authors: Mäurer Mathias , Tiel-Wilck Klaus , Oehm Eckard , Richter Nils , Springer Michael , Oschmann Patrick , Manzel Arndt , Hieke-Schulz Stefanie , Zingler Vera , Kandenwein Julia A. , Ziemssen Tjalf , Linker Ralf A.
Published: December 2019

Background:

With a large array of disease modifying therapies (DMTs) for relapsing-remitting MS (RRMS), identifying the optimal treatment option for the individual patient is challenging and switching of immunotherapies is often required. The objective of this study was to systematically investigate reasons for DMT switching in patients on immunotherapies for mild/moderate MS, and provide real-life insights into currently applied therapeutic strategies.

Methods:

This noninterventional, cross-sectional study (ML29913) at 50 sites in Germany included RRMS patients on therapies for mild/moderate MS who switched immunotherapy in the years 2014–2017. The key outcome variable was the reason to switch, as documented in the medical charts, based on failure of current therapy, cognitive decline, adverse events (AEs), patient wish, or a woman’s wish to become pregnant. Expectations of the new DMT and patients’ assessment of the decision maker were also recorded.

Results:

The core analysis population included 595 patients, with a mean age of 41.6 years, of which 69.7% were female. More than 60% of patients had at least one relapse within 12 months prior to the switch. The main reasons to switch DMT were failure of current therapy (53.9%), patient wish (22.4%), and AEs (19.0%). Most patients (54.3%) were switched within DMTs for mild/moderate MS; only 43.5% received a subsequent DMT for active/highly active MS. While clinical and outcome-oriented aspects were the most frequently mentioned expectations of the new DMT for physicians, aspects relating to quality of life played a major role for patients.

Conclusions:

Our data indicate suboptimal usage of DMTs, including monoclonal antibodies, for active/highly active MS in German patients. This illustrates the medical need for DMTs combining high efficacy, low safety risk, and low therapy burden.
Naphthoquinones From Cultured Mycobiont of Marcelaria cumingii (Mont.) and Their Cytotoxicity
Authors: Jarupinthusophon Suekanya , Luangsuphabool Theerapat , Aree Thammarat , Duong Thuc-Huy , Lugsanangarm Kiattisak , Onsrisawat Prayumat , Siripong Pongpun , Sangvichien Ek , Chavasiri Warinthorn
Published: December 2019

Five naphthoquinones including 4 compounds with new absolute configurations, (–)-2' S-trypethelone methyl ether (1), (–)-2' S-8-methoxytrypethelone methyl ether (2), (–)-(2' S,3' S)-4'-hydroxytrypethelone (3), and (–)-(2' S,3' R)-4'-hydroxy-8-methoxy trypethelone methyl ether (5), together with a known compound, (–)-2' S-trypethelone (4), were isolated from cultured mycobiont of Marcelaria cumingii. These compounds were structurally elucidated by high-resolution mass spectra, nuclear magnetic resonance, circular dichroism, optical rotation, and single-crystal X-ray analysis. The cytotoxicity against several cancer cell lines of the isolated compounds were tested. (–)-2' S-Trypethelone methyl ether (1) showed selective inhibition of HCT116 and A549 cell lines with half-maximal inhibitory concentration values of 0.32 ± 0.03 and 1.05 ± 0.12 µM, respectively. The binding conformation and molecular interactions including the effect of substituent modification were also revealed.
Predictors of pre-rehabilitation exercise capacity in elderly European cardiac patients – The EU-CaRE study
Authors: Marcin Thimo , Eser Prisca , Prescott Eva , Mikkelsen Nicolai , Prins Leonie F , Kolkman Evelien K , Lado-Baleato Óscar , Cardaso-Suaréz Carmen , Bruins Wendy , van der Velde Astrid E , Peña Gil Carlos , Iliou Marie Christine , Ardissino Diego , Zeymer Uwe , Meindersma Esther P , Van’t Hof Arnoud WJ , de Kluiver Ed P , Wilhelm Matthias
Published: December 2019

Aims

Functional capacity is an important endpoint for therapies oriented to older adults with cardiovascular diseases. The literature on predictors of exercise capacity is sparse in the elderly population. In a longitudinal European study on effectiveness of cardiac rehabilitation of seven European countries in elderly (>65 years) coronary artery disease or valvular heart disease patients, predictors for baseline exercise capacity were determined, and reference ranges for elderly cardiac patients provided.

Methods

Mixed models were performed in 1282 patients (mean age 72.9 ± 5.4 years, 79% male) for peak oxygen consumption relative to weight (peak VO2; ml/kg per min) with centre as random factor and patient anthropometric, demographic, social, psychological and nutritional parameters, as well as disease aetiology, procedure, comorbidities and cardiovascular risk factors as fixed factors.

Results

The most important predictors for low peak VO2 were coronary artery bypass grafting or valve surgery, low resting forced expiratory volume, reduced left ventricular ejection fraction, nephropathy and peripheral arterial disease. Each cumulative comorbidity or cardiovascular risk factors reduced exercise capacity by 1.7 ml/kg per min and 1.1 ml/kg per min, respectively. Males had a higher peak VO2 per body mass but not per lean mass. Haemoglobin was significantly linked to peak VO2 in both surgery and non-surgery patients.

Conclusions

Surgical procedures, cumulative comorbidities and cardiovascular risk factors were the factors with the strongest relation to reduced exercise capacity in the elderly. Expression of peak VO2 per lean mass rather than body mass allows a more appropriate comparison between sexes. Haemoglobin is strongly related to peak VO2 and should be considered in studies assessing exercise capacity, especially in studies on patients after cardiac surgery.
Aortic root remodelling in competitive athletes
Authors: Abulí Marc , Grazioli Gonzalo , Sanz de la Garza Maria , Montserrat Silvia , Vidal Bàrbara , Doltra Adelina , Sarquella-Brugada Georgia , Bellver Montserrat , Pi Ramon , Brotons Daniel , Oxborough David , Sitges Marta
Published: December 2019

Background

Controversy remains about the cut-off limits for detecting aortic dilatation in athletes, particularly in large-sized individuals. The allometric scaling model has been used to obtain size-independent measurements in cardiovascular structures in the general population.

Aim

The purpose of this study was to validate the use of allometric scaling in the measurement of the aortic root for competitive athletes and to offer reference values.

Methods

This was a cross-sectional study that analyses the dimensions of aortic root found in the echocardiogram performed as part of pre-participation sports screening in competitive athletes between 2012–2015. Beta exponents were calculated for height and body surface area in the whole cohort. In order to establish whether a common exponent could be used in both genders the following model was assessed y = a xb*exp(c*sex). If a common exponent could not be applied then sex-specific beta exponents were calculated.

Results

Two thousand and eighty-three athletes (64% men) were included, from a broad spectrum of 44 different sports disciplines, including basketball, volleyball and handball. The mean age was 18.2 ± 5.1 years (range 12–35 years) and all athletes were Caucasian, with a training load of 12.5 ± 5.4 h per week. Indexed aortic root dimension showed a correlation with ratiometric scaling by body surface area (r: −0.419) and generated size independence values with a very light correlation with height (r: −0.084); and with the allometric scaling by body surface area (r: −0.063) and height (r: −0.070). The absolute value of aortic root was higher in men than in women ( p < 0.001). These differences were maintained with allometric scaling.

Conclusion

Size-independent aortic root dimension values are provided using allometric scaling by body surface area and height in a large cohort of competitive athletes. Aortic root values were larger in men than in women, both in absolute values and after allometric scaling. The use of these indexed aortic reference ranges can be useful for the early detection of aortic pathologies.
The Effects of Temporal Action-Sound Congruence on Evaluations of Conductor Quality
Authors: Meals Cory D. , Morrison Steven J. , Confredo Deborah A.
Published: December 2019

Vision serves a fundamental role in the human experience of musical performance. In conducting, this particular heuristic influences both expressive and coordinative aspects of musical activity. Ensemble conductors present a special case of musical gesture, as their activities are coordinative rather than directly sound-producing. While the influence of vision on evaluations of musical expressivity has been well studied, less attention has been paid to the temporal aspect of conductors’ gestures. Given anecdotal observations of a flexibly congruent relationship between conductor gesture and ensemble response and the ability of entrainment to promote preference, we theorize that alterations to natural action-sound congruence in conductor-to-ensemble settings may influence evaluations of conductor quality. Naturalistic performance video of five conductors was left intact or adjusted to an audio- or video-lead condition by a percentage of each excerpt tempo (intact, ±15%, ±30%) and fully crossed into stimuli orders. Participants were asked to rate the quality of the conductor, the ensemble, and the performance overall using a Likert-type scale bound by “ poor” and “ excellent.” Our results indicate that any offset, whether audio- or video-led, resulted in a lower level of conductor quality than intact, unaltered performance. While our effect size was small (η p2 = .02), participant ratings reinforce the role of action-sound congruence on observers’ perceptions and overall evaluation of conductors’ activities.
The application of patient-derived induced pluripotent stem cells for modeling and treatment of Alzheimer’s disease
Authors: Han Fabin , Liu Chuanguo , Huang Jin , Chen Juanli , Wei Chuanfei , Geng Xiwen , Liu Yanming , Han Dong , Li Mengpeng
Published: December 2019

Alzheimer’s disease (AD) is the most prevalent age-related neurodegenerative disease which is mainly caused by aggregated protein plaques in degenerating neurons of the brain. These aggregated protein plaques are mainly consisting of amyloid β (Aβ) fibrils and neurofibrillary tangles (NFTs) of phosphorylated tau protein. Even though the transgenic murine models can recapitulate some of the AD phenotypes, they are not the human cell models of AD. Recent breakthrough in somatic cell reprogramming made it available to use induced pluripotent stem cells (iPSCs) for patientspecific disease modeling and autologous transplantation therapy. Human iPSCs provide alternative ways to obtain specific human brain cells of AD patients to study the molecular mechanisms and therapeutic approaches for familial and sporadic forms of AD. After differentiation into neuronal cells, iPSCs have enabled the investigation of the complex aetiology and timescale over which AD develops in human brain. Here, we first go over the pathological process of and transgenic models of AD. Then we discuss the application of iPSC for disease model and cell transplantation. At last the challenges and future applications of iPSCs for AD will be summarized to propose cell-based approaches for the treatment of this devastating disorder.
Coping With Tragedy via Reflected Glory: How the Houston Astros’ World Series Win Contributed to Locals’ Process of Overcoming Hurricane Harvey
Authors: Erlichman Sara R. , Harrison Virginia S.
Published: December 2019

This study investigates the effects of the Houston Astros’ first World Series win on locals who were affected by the natural disaster, Hurricane Harvey. Approaching the topic to understand whether organizational identification has similar positive outcomes to basking in reflected glory, this study specifically measures whether Houston residents were able to cope better and whether their meaning in life increased. After distributing surveys to Houston residents who reported being impacted by the hurricane, the findings indicated stronger organizational identification with the Houston Astros led to stronger reflected glory. Additionally, fans who felt reflected glory were more able to cope with tragedy, and self-efficacy toward overcoming the disaster partially contributed to this relationship. Lastly, fans who coped with the disaster felt a greater meaning in life. Theoretically, our study makes new connections between organizational identity and reflected glory, while tying reflected glory to coping outcomes. The relationship between coping and meaning in life is also explored. Our findings demonstrate how a city hit by tragedy could potentially see positive outcomes when their local professional team achieves major successes, such as winning the World Series.
Feasibility of Single-Staged Bilateral Anterior Scoliosis Correction in Growing Patients
Authors: Baroncini Alice , Rodriguez Luis , Verma Kushagra , Trobisch Per D.
Published: December 2019

Study Design:

Retrospective analysis.

Objectives:

The objective of this study was to analyze the feasibility of correcting double-curve scoliosis using dynamic scoliosis correction (DSC, also known as vertebral body tethering), which requires a bilateral anterior approach with deflation of both lungs. Typically, this approach falls under the exclusionary criteria for the eligibility for anterior scoliosis surgery. No data exists on the feasibility of single-staged bilateral DSC.

Methods:

A retrospective analysis was performed utilizing the data from 25 patients who underwent a bilateral anterior thoracic approach and instrumentation. Thirty-day postoperative complication rates were analyzed. A learning curve subanalysis was also performed to compare the first 12 patients to the remainder of the 13 patients, with a T-test ( P ≤ .05).

Results:

Of the 25 patients treated, there was 1 intraoperative event: After performing lumbar DSC, the contralateral DSC was abandoned due to unexpected pleural scarring and staged selective thoracic fusion was performed. We observed 4 postoperative complications: 2 patients had recurrent pleural effusions, 1 patient was diagnosed with pneumonia, and 1 patient had a minor pulmonary embolism without cardiopulmonary consequences (after an international 24 hour flight). All patients recovered well. We observed a significant influence of learning curve on surgical time (328 vs 280 min, P = .03) and blood loss (480 vs 197 mL, P = .03).

Conclusion:

Data suggests that bilateral, single-stage surgery for DSC is feasible albeit with an elevated complication rate that may partially attributable to the learning curve. Future research should focus on the cause of pulmonary complications and include a matched comparative analysis with traditional posterior fusion.
Walmart’s Acquisition of Flipkart: Emerging Paradigm of the Digital Era
Authors: Bhaskaran P. Bala , Bandookwala Nasheman
Published: December 2019

The case is set around the acquisition of majority shares of Flipkart by Walmart. The case traces the evolution of Flipkart as a startup and explores the context of acquisition by Walmart as well as the strategic fit between the two firms. Technological changes—mainly the proliferation of internet, mobile technology and the consequent digitization—have irretrievable impacts on the retail segment in terms of convergence of on-line and off-line retail and globalization of the markets. The case explores the emerging digitization scenario and its impact on the retail segment as a trigger to the merger process. Flipkart as an Indian startup had to re-incorporate outside India due to policy restrictions on fundraising. The case points to the inadequacies in the Indian policy regime with respect to startup fundraising and differential voting rights. Based on international comparisons, the case triggers discussion on the directions to policy changes if India hopes to create a congenial start-up ecosystem and if the dream of Digital India is to be achieved.