bluuebunny/crossref_metadata_2025 huggingface dataset:
Tactical agency? Young people’s (dis)engagement with WhatsApp and Facebook Messenger
Authors: Gangneux Justine
Published: April 2020

Drawing on empirical data, this article examines the ways in which young people negotiated messaging apps such as Facebook Messenger and WhatsApp in their everyday lives, focusing in particular on the read-receipt feature embedded in the applications. While it is important to continue exposing and critically examining the power structures and socio-technological relations in which young people’s everyday engagement with social media platforms and messaging applications are entangled, the article argues that it is also crucial not to overlook the possibilities and forms of agency that can exist in this complex environment. Combining insights from Foucault and de Certeau, the article seeks to shed new light on the ways in which tactical agency can be enacted and cultivated by young people. This article contributes to current debates about agency, resistance and power in contemporary digital society as well as makes recommendations to foster more responsive digital literacies.
Changes in Target Vessel Anatomy Following Fenestrated Endovascular Aneurysm Repair: Midterm Results
Authors: Keschenau Paula R. , Sattler Christina , Berger Tanja , Kotelis Drosos , Jacobs Michael J. , Kalder Johannes
Published: April 2020

Purpose: To analyze the changes in target vessel (TV) anatomy after fenestrated endovascular aneurysm repair (fEVAR) during midterm follow-up. Materials and Methods: A retrospective single-center study analyzed 56 patients (mean age 71±7 years; 49 men) who underwent fEVAR using custom-made stent-grafts (22 Zenith and 34 Anaconda) between June 2010 and July 2016. Advanta V12 (V12; 74, 53%) and BeGraft (BeG; 66, 47%) stent-grafts were used to bridge to the 140 TVs. Measurements of the TV deviation at the aortic origin, the vessel shift distal to the bridging stent-graft (BSG), and the outer and inner BSG curve lengths were performed after 3-dimensional reconstruction of the serial computed tomography angiography scans. The results of the measurements for the main devices, the TVs, and the bridging stent-grafts were compared using univariable and multivariable analysis. Results: Of the 140 BSGs examined (74 V12s and 66 BeGs), 393 measurements (38 celiac trunks, 102 superior mesenteric arteries, 121 left renal arteries, and 132 right renal arteries) were analyzed. The outer/inner BSG curve length ratio was larger after implantation of Zenith devices compared with Anaconda (p<0.001). The vessel shift distal to the BSG was significantly associated with the interaction of the TV and type of BSG only in the univariable analysis (p=0.001). There were no significant changes of the TV deviation at the aortic origin. Only the outer BSG curve length was significantly associated with TV complications (p=0.033). Median follow-up was 24 months (range 2–61). The BSG curve length ratio showed a significant increase over time (p<0.001) but did not differ between the BeG and V12 (p=0.381). Conclusion: No difference was found between the V12 and the BeG stent-grafts regarding anatomical TV changes during midterm follow-up after fEVAR. Both stent-grafts adapt to the TV anatomy over time, and moderate anatomical changes seem to be tolerated without increasing the risk for TV complications. The type of main device also influences the TV anatomy.
Outcomes of Therapeutic Artmaking in Patients Undergoing Radiation Oncology Treatment: A Mixed-Methods Pilot Study
Authors: Kaimal Girija , Carroll-Haskins Katrina , Mensinger Janell L. , Dieterich-Hartwell Rebekka , Biondo Jacelyn , Levin William P.
Published: April 2020

A cancer diagnosis can be extremely stressful and life-altering for patients. Chronically high levels of stress can increase inflammation and affect the progression of the cancer. Psychosocial interventions could reduce stress and address cancer patients’ emotional, psychological, and spiritual needs. This mixed-methods pilot study compared 2 single-session arts-based approaches for patients in active radiation treatment in a large urban hospital. Participants were assigned to either the active control of independent coloring or the therapeutic intervention of open studio art therapy. Participants completed pre-session and post-session saliva samples and standardized psychosocial measures of stress, affect, anxiety, self-efficacy, and creative agency. Both conditions significantly increased participants’ positive affect, self-efficacy, and creative agency, and decreased negative affect, perceived stress, and anxiety. No changes of note were seen in the salivary measures. Participants’ narrative responses corroborated the quantitative findings and highlighted additional benefits such as supporting meaning-making and spiritual insights. Both arts-based interventions can support the emotional, psychological, and spiritual needs of cancer patients while each has features that may be more suited to the needs of certain patients. Further replication of these findings could support our initial findings that suggest that patients could benefit from having art studio spaces with art therapists and choices of art materials available on the oncology unit.
A Single-Center Experience of Paclitaxel in the Treatment of Femoropopliteal Disease—No Evidence for an Association With Mortality
Authors: Linehan Victoria , Doyle Maria , Barrett Brendan , Gullipalli Ravindra
Published: April 2020

Purpose:

Paclitaxel-coated devices have been increasingly used in endovascular treatment of femoropopliteal disease as they limit recurrence of lesions and improve patient outcomes. However, a recent meta-analysis reported that these devices increase mortality risk at 2 years post-intervention but did not account for confounding variables. Therefore, our goal was to evaluate mortality after paclitaxel treatment of femoropopliteal disease using patient-level data.

Methods:

We performed a retrospective review of all patients who received endovascular treatment for femoropopliteal lesions at our center between December 2009 and July 2017. There were 388 patients in the paclitaxel group and 314 control patients.

Results:

Survival analysis with hazard ratios showed no difference between mortality in the paclitaxel and control groups. Age, renal insufficiency, and chronic limb-threatening ischemia were significant predictors of mortality. We also used logistic regression to evaluate mortality at 1, 2, and 5 years post-intervention and found no difference between the paclitaxel and control groups at any time point, while age, renal insufficiency, and chronic limb-threatening ischemia at the time of intervention were all associated with the risk of death. Finally, we tallied the causes of death in our cohort and found no difference in the distribution of causes between groups.

Conclusion:

Our single-center, retrospective study provides no evidence of increased risk of death with paclitaxel treatment in femoropopliteal disease. Contrastingly, age, renal insufficiency, and chronic limb-threatening ischemia were the most important factors contributing to mortality and therefore should be included as potential confounders in future studies assessing mortality in femoropopliteal disease.
Neural network control of a wheeled mobile robot based on optimal trajectories
Authors: Bozek Pavol , Karavaev Yury L , Ardentov Andrey A , Yefremov Kirill S
Published: April 2020

This article is concerned with developing an intelligent system for the control of a wheeled robot. An algorithm for training an artificial neural network for path planning is proposed. The trajectory ensures steering optimal motion from the current position of the mobile robot to a prescribed position taking its orientation into account. The proposed control system consists of two artificial neural networks. One of them serves to specify the position and the size of the obstacle, and the other forms a continuous trajectory to reach it, taking into account the information received, the coordinates, and the orientation at the point of destination. The neural network is trained on the basis of samples obtained by modeling the equations of motion of the wheeled robot which ensure its motion along trajectories in the form of Euler’s elastica.
Path following for underactuated surface vessels with disturbance compensating predictive control
Authors: Liu Zhilin , Li Guosheng , Zhang Jun , Zheng Linhe
Published: April 2020

It is common that underactuated surface vessels sailing on the sea suffer from strong external sea disturbances, such that the large roll motion can be probably caused resulting to the bad performance of path following. In order to realize the coordinate control of the rudder roll stabilization and path following, a robust controller with roll constraints is designed by combining predictive control with disturbance observer. Firstly, the rudder angle operating range is divided in the Serret–Frenet coordination frame, and then linear models corresponding to different equilibrium can be established with heading control and roll dynamics. Secondly, considering external disturbance and unmodeled error as the lumped disturbances, the disturbance observer can be utilized to achieve the real-time feedforward compensation leading to the improved system robustness. Thirdly, the output redefinition method is adopted to transfer the original system into a new minimum phase system. Based on the receding horizon and state prediction strategies of the predictive control, the analytical control law can be obtained, and the linear programming method is used to guarantee the roll constraint for the simplified computational burden. Lastly, the simulations have been carried out to show the good performance of the proposed algorithm with the heading control and roll reduction.
Knowledge management for improving school strategic planning
Authors: Cheng Eric C. K.
Published: April 2020

The objective of this paper is to determine the extent to which adopting Nonaka’s SECI knowledge-creation processes enhances strategic planning capacity in the context of Hong Kong school education.A quantitative questionnaire survey is conducted to examine the predictive effects of the knowledge-creation processes of the SECI model on strategic planning processes. Data is collected from 42 principals and 392 teachers from 42 schools. A multilevel structural equation model is applied to examine the predictive effects of the mechanism on strategic planning capacity. Results show that the combination process of the SECI knowledge-creation model predicts strategic planning capacity, while a collaborative culture enables the process of knowledge externalization and combination. In response to the international debate on culture and context-dependent issues in using Nonaka’s SECI model for knowledge creation, this study reaffirms that the SECI model is largely dependent on Japanese collaborative culture. The study also brings theories of knowledge management into discussion of strategic management in the school context. To enhance school planning capacity, school leaders should cultivate a collaborative culture to support the alignment of different departments in the knowledge combination process to craft strategies for development planning.
Clipped wings: School leaders’ identities in ICT-enriched education landscapes – a narrative inquiry
Authors: Reyes Vicente Chua
Published: April 2020

This qualitative research inquiry explores how school leaders shape their identities while navigating incessant and seemingly endless school transformations. The central questions addressed are the following: how do school leaders make sense of their identities in rapid periods of reform? And how do they view themselves in new educational landscapes? An exploratory case study of four target schools that took part in policy reform initiatives directed at the ubiquitous use of Information Communication and Technology was undertaken for this inquiry. Using narrative inquiry as an analytical frame for the focus group discussions interviews and field notes, this inquiry investigates and builds emerging explanations to school leaders’ sense-making in periods of reform.
Employing teachers with disabilities: A multifaceted prism of school principals’ ethical dilemmas
Authors: Tal-Alon Noa , Shapira-Lishchinsky Orly
Published: April 2020

The aim of this study was to identify the ethical dilemmas of school principals who employ teachers with different physical disabilities. By conducting 18 in-depth interviews with principals from different school levels and different sectors in Israel, we identified the ethical dilemmas that emerged and their causes. The findings reveal that principals who employ teachers with disabilities struggle with multifaceted ethical dilemmas. These dilemmas reflect the tension between the educational ideology that was demonstrated by the principals’ inclination for integration and inclusion versus the three different elements of the principals’ professional responsibilities, namely commitment to the educational system, commitment to the wellbeing of the school staff, and commitment to the wellbeing of the students. Comprehending these dilemmas and understanding the ways in which these values contradict each other is a critical step on the way to building a more inclusive school.
Academic leadership: Perceptions of academic leaders and staff in diverse contexts
Authors: Dinh Ngoc Bich Khuyen , Caliskan Aysun , Zhu Chang
Published: April 2020

Universities have been coping with various challenges and pressures over the last decade. Therefore, capacity building for academic leaders is a critical point for universities to survive in this challenging era. Yet, existing studies suffer from several limitations. Among others, they do not consider the examination of academic staff members’ and leaders’ perceptions from diverse contexts, thus capturing insight into current practices. Using a qualitative study, we explored the perceptions of 18 academic staff members and leaders from eight Chinese and European universities, under which the perceived concept, a profile of effective academic leadership, and the motivators to become academic leaders from cross-cultural perspectives were emphasized. The results demonstrated that academic staff and leaders widely perceive the notion of academic leadership in diverse contexts as a complex concept. In addition, the findings provided several insights into understanding the profile of an effective academic leader who possesses a range of capacities and specific leadership styles. Furthermore, significant motivators that stimulate academic staff and leaders to pursue academic leadership positions were also examined and discussed. The results of this study can serve as a stepping stone for designing the framework used in leadership development programs as well as for collaboration in capacity development for university academic leaders.
An evaluation of outcomes for service users with an intellectual disability admitted to an assessment and treatment unit
Authors: Davies Bronwen , Josham Scarlett , Francis Nicky
Published: April 2020

This service evaluation comprised pre- and post measures with service users and their carers on admission to and discharge from an assessment and treatment (A&T) unit. The Behaviour Problems Inventory (BPI), Psychiatric Assessment Scale for Adults with Developmental Disabilities Checklist–Revised (PASSAD) and World Health Organisations Quality of Life Scale (WHO-QOL 8; adapted for people with intellectual disabilities) were used to evaluate outcomes of their admission to the unit. Significant improvements were found after admission in relation to behaviour that challenges (measured by the BPI), mental health symptoms (measured by the PASSAD) and quality of life (measured by the WHO-QOL). The importance of completing outcome measures as feedback for the service user, team and wider service managers are discussed, but also in this political context when the role of A&T units are being questioned, the importance of showing good practice and clinical outcomes for individuals.
The Reality of “Real-Life” Neuroscience: A Commentary on Shamay-Tsoory and Mendelsohn (2019)
Authors: Holleman Gijs A. , Hooge Ignace T. C. , Kemner Chantal , Hessels Roy S.
Published: April 2020

The main thrust of Shamay-Tsoory and Mendelsohn’s ecological approach is that “the use of real-life complex, dynamic, naturalistic stimuli provides a solid basis for understanding brain and behavior” (p. 851). Although we support the overall goal and objectives of Shamay-Tsoory and Mendelsohn’s approach to “real-life” neuroscience, their review refers to the terms “ecological validity” and “representative design” in a manner different from that originally introduced by Egon Brunswik. Our aim is to clarify Brunswik’s original definitions and briefly explain how these concepts pertain to the larger problem of generalizability, not just for history’s sake, but because we believe that a proper understanding of these concepts is important for researchers who want to understand human behavior and the brain in the context of everyday experience, and because Brunswik’s original ideas may contribute to Shamay-Tsoory and Mendelsohn’s ecological approach. Finally, we argue that the popular and often misused concept of “ecological validity” is ill-formed, lacks specificity, and may even undermine the development of theoretically sound and tractable research.
Coffee consumption and mortality from cardiovascular diseases and total mortality: Does the brewing method matter?
Authors: Tverdal Aage , Selmer Randi , Cohen Jacqueline M , Thelle Dag S
Published: April 2020

Aim

The aim of this study was to investigate whether the coffee brewing method is associated with any death and cardiovascular mortality, beyond the contribution from major cardiovascular risk factors.

Methods and results

Altogether, 508,747 men and women aged 20–79 participating in Norwegian cardiovascular surveys were followed for an average of 20 years with respect to cause-specific death. The number of deaths was 46,341 for any cause, 12,621 for cardiovascular disease (CVD), 6202 for ischemic heart disease (IHD), and 2894 for stroke. The multivariate adjusted hazard ratios (HRs) for any death for men with no coffee consumption as reference were 0.85 (082–0.90) for filtered brew, 0.84 (0.79–0.89) for both brews, and 0.96 (0.91–1.01) for unfiltered brew. For women, the corresponding figures were 0.85 (0.81–0.90), 0.79 (0.73–0.85), and 0.91 (0.86–0.96) for filtered, both brews, and unfiltered brew, respectively. For CVD, the figures were 0.88 (0.81–0.96), 0.93 (0.83–1.04), and 0.97 (0.89–1.07) in men, and 0.80 (0.71–0.89), 0.72 (0.61–0.85), and 0.83 (0.74–0.93) in women. Stratification by age raised the HRs for ages ≥60 years. The HR for CVD between unfiltered brew and no coffee was 1.19 (1.00–1.41) for men and 0.98 (0.82–1.15) for women in this age group. The HRs for CVD and IHD were raised when omitting total cholesterol from the model, and most pronounced in those drinking ≥9 of unfiltered coffee, per day where they were raised by 9% for IHD mortality.

Conclusion

Unfiltered brew was associated with higher mortality than filtered brew, and filtered brew was associated with lower mortality than no coffee consumption.
Prehospital study of survival outcomes from out-of-hospital cardiac arrest in ST-elevation myocardial infarction in Queensland, Australia (the PRAISE study)
Authors: Schultz Brendan V , Doan Tan N , Bosley Emma , Rogers Brett , Rashford Stephen
Published: April 2020

Aim

Patients that experience an out-of-hospital cardiac arrest in the context of a paramedic-identified ST-segment elevation myocardial infarction are a unique cohort. This study identifies the survival outcomes and determinants of survival in these patients.

Methods

A retrospective analysis was undertaken of all patients, attended between 1 January 2013 and 31 December 2017 by the Queensland Ambulance Service, who had a ST-segment elevation myocardial infarction identified by the attending paramedic prior to deterioration into out-of-hospital cardiac arrest. We described the ‘survived event’ and ‘survived to discharge’ outcomes of patients and performed univariate analysis and multivariate logistic regression to identify factors associated with survival.

Results

In total, 287 patients were included. Overall, high rates of survival were reported, with 77% of patients surviving the initial out-of-hospital cardiac arrest event and 75% surviving to discharge. Predictors of event survival were the presence of an initial shockable rhythm (adjusted odds ratio 8.60, 95% confidence interval (CI) 4.16–17.76; P < 0.001) and the administration of prehospital medication for subsequent primary percutaneous coronary intervention (adjusted odds ratio 2.54, 95% CI 1.17–5.50; P = 0.020). These factors were also found to be associated with survival to hospital discharge, increasing the odds of survival by 13.74 (95% CI 6.02–31.32; P < 0.001) and 6.96 (95% CI 2.50–19.41; P < 0.001) times, respectively. The administration of prehospital fibrinolytic medication was also associated with survival in a subgroup analysis.

Conclusion

This subset of out-of-hospital cardiac arrest patients was found to be highly salvageable and responsive to resuscitative measures, having arrested in the presence of paramedics and presented with an identified reversible cause.
How does clientelism foster electoral dominance? Evidence from Turkey
Authors: Arslantaş Düzgün , Arslantaş Şenol
Published: April 2020

This article reveals how the AKP’s use of clientelism contributes to its electoral dominance. It does so by examining the features and actors as well as the structure of the clientelist network. The arguments are based on fieldwork in one of the poorest and most densely populated districts of Bağcılar, where in the 2015 legislative elections the AKP achieved more votes than in any other district in Istanbul.
Extramedullary Hematopoiesis in the Sinonasal Cavity: A Case Report and Review of the Literature
Authors: Clark Carly A. , Worden Cameron P. , Thorp Brian D. , Ebert Charles S. , Zanation Adam M. , Senior Brent A. , M. Johnson Steven , McClain Wade G. , Kimple Adam J.
Published: April 2020

Background

Extramedullary hematopoiesis (EMH) occurs in patients with hematologic disorders, but rarely within the paranasal sinuses. We report a case of EMH in a 17-year-old male with sickle cell disease (SCD) who presented with occipital pain and sinusitis. A computed tomography (CT) scan demonstrated heterogeneous opacification of the right maxillary sinus concerning for allergic fungal sinusitis or a fungal ball with bony erosion. He was taken to the operating room for endoscopic biopsy and a limited endoscopic sinus surgery. Grossly, his maxillary sinus was filled with spiculated osseous tissue. Final pathology demonstrated active hematopoietic bone marrow filling the sinus.

Methods

We present a case report and literature review of sinonasal EMH.

Results

We identified 14 articles with 15 patients. EMH was typically associated with SCD or beta thalassemia. The average age of presentation was 30. There was a male sex predilection with a ratio of 11:15. The most common presenting symptom was a headache and nasal obstruction (33% for both). The most common finding on CT was a soft tissue expansile mass (73%). The most commonly affected location was the maxillary sinus (60%).

Conclusions

This case report serves as a reminder to consider EMH as an uncommon cause of sinus opacification, particularly in patients with SCD or beta thalassemia. The expansion of hematopoietic tissue may be identified as a sinus mass on CT. By recognizing the potential manifestations of chronic anemia, an accurate and timely diagnosis can be made.
Effort, Avolition, and Motivational Experience in Schizophrenia: Analysis of Behavioral and Neuroimaging Data With Relationships to Daily Motivational Experience
Authors: Culbreth Adam J. , Moran Erin K. , Kandala Sri , Westbrook Andrew , Barch Deanna M.
Published: April 2020

Recent research suggests that schizophrenia is associated with reduced effort allocation. We examined the willingness to expend effort, neural correlates of effort allocation, and the relationship of effort to daily motivational experience in individuals with schizophrenia. We recruited 28 individuals with schizophrenia and 30 control participants to perform an effort task during functional MRI. Individuals with schizophrenia also completed a protocol involving ecological momentary assessment (EMA). Individuals with schizophrenia with severe negative symptoms were less willing to expend effort for rewards. Daily EMAs of motivation were positively associated with effort allocation on a trend level. Individuals with schizophrenia and control participants displayed similar increases in blood-oxygen-level-dependent (BOLD) activation in frontal, cingulate, parietal, and insular regions during effort-based decision making. However, negative symptoms were associated with reduced BOLD activation in the bilateral ventral striatum. These results replicate previous reports of reduced effort allocation in patients with severe negative symptoms and provide evidence for the role of the ventral striatum in effort impairments.
Correlates of Single Versus Multiple Functional Disabilities Among Aging Americans: Race/Ethnicity and Region of Birth
Authors: Moore Ami R. , Bohm-Jordan Maggie , Amey Foster , Mpofu Elias
Published: April 2020

Background:

Significant racial/ethnic disparities exist in the prevalence of functional disability among older Americans.

Objective:

The study analyzed the odds of older people in the United States experiencing single and multiple disabilities, by race and region of birth.

Method:

Data came from the American Community Survey (2011–2015). Multinomial logistic regression analysis was used.

Results:

Region of birth, race/ethnicity, age, citizenship status, duration of stay, sex, marital status, veteran status, educational attainment, poverty status, and class of workers were all significantly associated with reports of either single or multiple disabilities. However, the introduction of the interaction terms for citizenship status by race modified some of the significant results. For instance, being born in Latin America no longer reduced the odds in reports of both single and multiple disabilities. However, compared with Whites and native-born of all races, both Hispanics who were either naturalized or were noncitizens had lower odds of reporting multiple disabilities (27% and 28% lower, respectively), whereas naturalized Hispanics also had significantly reduced odds (22%) for a single disability.

Conclusion:

These findings add to the disability, race/ethnicity, and place of birth literature.
Second Metatarsophalangeal Joint Interpositional Arthroplasty Using Decellularized Human Dermal Allograft: Operative Technique
Authors: Bohl Daniel D. , Idarraga Alex J. , Hur Edward S. , Lee Simon , Hamid Kamran S. , Lin Johnny
Published: April 2020

Arthrodesis of an osteoarthritic second metatarsophalangeal (MTP) joint is suboptimal because of altered gait mechanics; hence, joint-preserving procedures are of value. Autograft interpositional arthroplasty is one available option with excellent results, but there are potential concerns regarding donor site morbidity and insufficiency of the autograft material. We present here an alternative technique, an interpositional arthroplasty using allograft. Our technique includes a dorsal incision and joint exposure, removal of cartilage from the metatarsal head, and interposition of human decellularized dermal allograft sutured to the metatarsal head. Allograft interpositional arthroplasty is a feasible technique and can be further investigated as an alternative procedure for patients with second MTP osteoarthritis.

Level of Evidence:

Level V, expert opinion.
Thromboembolism Prophylaxis in Adult Patients with Acute Lymphoblastic Leukemia Treated in the GRAALL-2005 Study
Authors: Orvain Corentin , Balsat Marie , Tavernier Emmanuelle , Marolleau Jean-Pierre , Pabst Thomas , Chevallier Patrice , de Gunzburg Noémie , Cacheux Victoria , Rigal-Huguet Françoise , Chantepie Sylvain P , Caillot Denis , Chalandon Yves , Frayfer Jamilé , Bonmati Caroline , Lheritier Veronique , Ifrah Norbert H , Dombret Hervé , Boissel Nicolas , Hunault-Berger Mathilde M
Published: April 2020

Patients undergoing treatment for acute lymphoblastic leukemia (ALL) are at risk for thrombosis, in part due to the use of L-asparaginase (L-ASP). Antithrombin (AT) replacement has been suggested to prevent VTE and thus might increase exposure to ASP. We report herein the results of the prophylactic replacement strategy in the pediatric-inspired prospective GRAALL-2005 study. Between 2006 and 2014, 784 adult patients with newly diagnosed Philadelphia-negative ALL were included. The incidence rate of VTE was 16% with 69% of them occurring during induction therapy. Most patients received AT supplementation (87%). After excluding patients who did not receive L-ASP or developed thrombosis before L-ASP, AT supplementation did not have a significant impact on VTE (8% versus 14%, OR: 0.6, p=0.1). Fibrinogen concentrates administration was associated with an increased risk of VTE (17% versus 9%, OR 2.2, p=0.02) whereas transfusion of fresh-frozen plasma had no effect. Heparin prophylaxis was associated with an increased risk of VTE (13% versus 7%, OR 1.9, p=0.04). Prophylactic measures were not associated with an increased risk of grade 3-4 bleeding complications. The rate of VTE recurrence after L-ASP reintroduction was 3% (1/34). In ALL patients receiving L-ASP therapy, the use of fibrinogen concentrates may increase the risk of thrombosis and should be restricted to rare patients with hypofibrinogenemia-induced hemorrhage. Patients developed VTE despite extensive AT supplementation which advocates for additional prophylactic measures. While this large descriptive study was not powered to demonstrate the efficacy of these prophylactic measures, it provides important insight to guide future trial design. NCT00327678.
Risk factors for skin, mucosal, and organ bleeding in adults with primary ITP: a nationwide study in Japan
Authors: Hato Takaaki , Shimada Naoki , Kurata Yoshiyuki , Kuwana Masataka , Fujimura Kingo , Kashiwagi Hirokazu , Takafuta Toshiro , Murata Mitsuru , Tomiyama Yoshiaki
Published: April 2020

Bleeding manifestations in primary immune thrombocytopenia (ITP) range from skin petechiae to life-threatening intracranial hemorrhage (ICH). However, the relation between these various bleeding manifestations and the platelet count in ITP remains poorly characterized. Using a nationwide database of patients with ITP during the years 2005 to 2014 (10 years) in Japan, we analyzed 19 415 adult patients newly diagnosed with ITP, including 222 with ICH. The frequency of skin purpura was 64.8%, and this increased linearly with thrombocytopenia without a specific platelet count threshold. In contrast, mucosal bleeding (epistaxis and gingival bleeding) and organ bleeding (melena, hematuria, and ICH) increased exponentially with thrombocytopenia at a platelet count threshold of 10 to 15 × 109/L. Age showed a much weaker correlation than platelet count with skin and mucosal bleeding. However, the incidence of organ bleeding increased exponentially above 60 years of age. Multivariate analysis showed that the presence of mucosal bleeding was a risk factor for occurrence of melena and hematuria but not for ICH. The frequency of ICH was 1.1% and risk factors for ICH were age ≥60 years (odds ratio [OR], 3.09; 95% confidence interval [CI], 2.13-4.47; P < .001), platelet count <10 × 109/L (OR, 2.96; 95% CI, 2.11-4.15; P < .001), and the presence of hematuria (OR, 1.56; 95% CI, 1.04-2.35; P = .033). The relation between ICH and platelet count varied with age. This large-scale analysis of risk factors for bleeding in ITP has revealed distinct characteristics of skin, mucosal, and organ bleeding in adult patients with newly diagnosed ITP, thus indicating those who are at a high risk of severe organ bleeding.
Positive physiological effects of touching sugi (Cryptomeria japonica) with the sole of the feet
Authors: Ikei Harumi , Miyazaki Yoshifumi
Published: April 2020

In Japanese households, it is customary to walk barefoot on wood floors. This study sought to clarify the physiological effects produced via tactile application of sugi (Cryptomeria japonica) to the sole of the feet, using the brain and autonomic nervous activities as indicators. Twenty-seven female university students (mean age, 21.9 ± 1.9 years) participated in this study. Oxy-hemoglobin (oxy-Hb) concentrations in the prefrontal cortex were determined using near-infrared time-resolved spectroscopy. High frequency (HF), denoted parasympathetic nervous activity, and low frequency (LF)/HF indicated sympathetic nervous activity; both were measured using heart rate variability. The wooden material was unpainted sugi wood with two different finishes uzukuri brushing or sanding. A similarly sized marble plate served as a control. The sole of the feet of each participant touched each material for 90 s. The results found that the uzukuri wood significantly decreased oxy-Hb concentration in the left prefrontal cortex compared with touching the marble. Furthermore, compared to before contact, the uzukuri wood showed significantly decreased oxy-Hb concentrations in the right prefrontal cortex, increased ln(HF), and decreased the ln(LF/HF) ratio. Moreover, the contact with sanded wood significantly decreased oxy-Hb concentrations in the right prefrontal cortex compared with before contact. Thus, it is concluded that tactile application of sugi to the sole of the feet induced physiological relaxation.
Multi-omic profiling reveals associations between the gut mucosal microbiome, the metabolome, and host DNA methylation associated gene expression in patients with colorectal cancer
Authors: Wang Qing , Ye Jianzhong , Fang Daiqiong , Lv Longxian , Wu Wenrui , Shi Ding , Li Yating , Yang Liya , Bian Xiaoyuan , Wu Jingjing , Jiang Xianwan , Wang Kaicen , Wang Qiangqiang , Hodson Mark P. , Thibaut Loïc M. , Ho Joshua W. K. , Giannoulatou Eleni , Li Lanjuan
Published: April 2020

Background

The human gut microbiome plays a critical role in the carcinogenesis of colorectal cancer (CRC). However, a comprehensive analysis of the interaction between the host and microbiome is still lacking.

Results

We found correlations between the change in abundance of microbial taxa, butyrate-related colonic metabolites, and methylation-associated host gene expression in colonic tumour mucosa tissues compared with the adjacent normal mucosa tissues. The increase of genusFusobacteriumabundance was correlated with a decrease in the level of 4-hydroxybutyric acid (4-HB) and expression of immune-related peptidase inhibitor 16 (PI16), Fc Receptor Like A (FCRLA) and Lymphocyte Specific Protein 1 (LSP1). The decrease in the abundance of another potentially 4-HB-associated genus,Prevotella 2,was also found to be correlated with the down-regulated expression of metallothionein 1 M (MT1M). Additionally, the increase of glutamic acid-related familyHalomonadaceaewas correlated with the decreased expression of reelin (RELN). The decreased abundance of genusPaeniclostridiumand genusEnterococcuswere correlated with increased lactic acid level, and were also linked to the expression change of Phospholipase C Beta 1 (PLCB1) and Immunoglobulin Superfamily Member 9 (IGSF9) respectively. Interestingly, 4-HB, glutamic acid and lactic acid are all butyrate precursors, which may modify gene expression by epigenetic regulation such as DNA methylation.

Conclusions

Our study identified associations between previously reported CRC-related microbial taxa, butyrate-related metabolites and DNA methylation-associated gene expression in tumour and normal colonic mucosa tissues from CRC patients, which uncovered a possible mechanism of the role of microbiome in the carcinogenesis of CRC. In addition, these findings offer insight into potential new biomarkers, therapeutic and/or prevention strategies for CRC.
Identification of QTLs associated with curd architecture in cauliflower
Authors: Zhao Zhen-Qing , Sheng Xiao-Guang , Yu Hui-Fang , Wang Jian-Sheng , Shen Yu-Sen , Gu Hong-Hui
Published: April 2020

Background

Curd architecture is one of the most important characters determining the curd morphology of cauliflower. However, the genetic mechanism dissection of this complex trait at molecular level is lacking. Genes/QTLs responsible for the morphological differences between present-day loose-curd and compact-curd cauliflower haven’t been well revealed.

Results

Herein, by using a common compact-curd parent and two loose-curd parents, we developed two double haploid (DH) populations including 122 and 79 lines, respectively. For each population, we decomposed the curd architecture concept into four parameters (basal diameter, stalk length, stalk angle and curd solidity), and collected corresponding phenotypic data for each parameter across two environments. The Kosambi function and composite interval mapping algorithm were conducted to construct the linkage map and analyze the QTLs associated with curd architecture parameters. A total of 20 QTLs were detected with the minimum likelihood of odd (LOD) values ranging from 2.61 to 8.38 and the percentage of the phenotypic variance explained by each QTL (PVE) varying between 7.69 and 25.10%. Of these, two QTLs controlling stalk length (qSL.C6–1, qSL.C6–2) and two QTLs controlling curd solidity (qCS.C6–1 and qCS.C6–2) were steadily expressed in both environments. Further, qSL.C6–1, qSL.C6–2, qCS.C6–1 and qCS.C6–4 fell into the same chromosomal region of the reference genome, indicating that these loci are involved in pleiotropic effects or are tightly linked.

Conclusion

The current study identified a series of QTLs associated with curd architecture parameters, which might contribute essentially to the formation of present-day loose-curd cauliflower that is widely cultivated in China. These results may pave the way for intensive deciphering the molecular mechanisms of curd development and for marker-assisted selection of curd morphology in cauliflower breeding.
Determinants of childhood blood pressure using structure equation model: the CASPIAN–V study
Authors: Angoorani Pooneh , Mostafaei Shayan , Kiani Toktam , Ejtahed Hanieh-Sadat , Motlagh Mohammad Esmaeil , Shafiee Gita , Gorabi Armita Mahdavi , Qorbani Mostafa , Heshmat Ramin , Kelishadi Roya
Published: April 2020

Background

Childhood hypertension is a predictor of later diseases, increases the risk for cardiovascular morbidity and mortality in adulthood and results in major economic burdens.

The purpose of this study was to investigate the direct and indirect effect of anthropometric, socioeconomic and lifestyle factors on blood pressure (BP) in a large population-based sample of children and adolescents using a path analysis.

Methods

This multi-centric nationwide study was performed on students aged 7–18 years. Anthropometric indices and blood pressure were measured by standard methods and demographic data, socioeconomic status, dietary habits and health related behaviors were obtained using validated questionnaires. Path analysis was applied to evaluate the relationships among the study variables and to implement the subsequent structural modeling.

Results

Totally, 7235 students (50.6% boys; the mean age 12.3 ± 3.1 years) were assessed. Systolic and diastolic BP positively correlated with age (r = 0.35 and 0.26; respectively), BMI (r = 0.06 and 0.04; respectively) and WC (r = 0.05 and 0.03; respectively). According to path analysis, age had significant direct effect on BMI, WC, and BP (β = 0.035, 0.043 and 0.345; respectively), which was greater for BP. BMI and WC had the greatest direct effect on BP (β = 0.05 and 0.03; respectively). Education level, subjective health complaints, health-related behaviors and dietary habits had positive direct effects on BP (β = 0.036, 0.030, 0.018 and 0.017; respectively). Socioeconomic status and positive changes in diet had negative indirect effect on BP (β = − 0.001 for both).

Conclusion

Our findings strengthen the importance of weight and body composition in BP control. It is suggested to improve diet and health related behaviors especially in families with low socioeconomic position.
Analysis of Bayesian posterior significance and effect size indices for the two-sample t-test to support reproducible medical research
Authors: Kelter Riko
Published: April 2020

Background

The replication crisis hit the medical sciences about a decade ago, but today still most of the flaws inherent in null hypothesis significance testing (NHST) have not been solved. While the drawbacks of p-values have been detailed in endless venues, for clinical research, only a few attractive alternatives have been proposed to replace p-values and NHST. Bayesian methods are one of them, and they are gaining increasing attention in medical research, as some of their advantages include the description of model parameters in terms of probability, as well as the incorporation of prior information in contrast to the frequentist framework. While Bayesian methods are not the only remedy to the situation, there is an increasing agreement that they are an essential way to avoid common misconceptions and false interpretation of study results. The requirements necessary for applying Bayesian statistics have transitioned from detailed programming knowledge into simple point-and-click programs like JASP. Still, the multitude of Bayesian significance and effect measures which contrast the gold standard of significance in medical research, the p-value, causes a lack of agreement on which measure to report.

Methods

Therefore, in this paper, we conduct an extensive simulation study to compare common Bayesian significance and effect measures which can be obtained from a posterior distribution. In it, we analyse the behaviour of these measures for one of the most important statistical procedures in medical research and in particular clinical trials, the two-sample Student’s (and Welch’s) t-test.

Results

The results show that some measures cannot state evidence for both the null and the alternative. While the different indices behave similarly regarding increasing sample size and noise, the prior modelling influences the obtained results and extreme priors allow for cherry-picking similar to p-hacking in the frequentist paradigm. The indices behave quite differently regarding their ability to control the type I error rates and regarding their ability to detect an existing effect.

Conclusion

Based on the results, two of the commonly used indices can be recommended for more widespread use in clinical and biomedical research, as they improve the type I error control compared to the classic two-sample t-test and enjoy multiple other desirable properties.
Age-dependent effect of metabolic phenotypes on carotid atherosclerotic disease in coronary heart disease patients (CORDIOPREV study)
Authors: Gutierrez-Mariscal Francisco M. , García-Ríos Antonio , Gómez-Luna Purificación , Fernández-Gandara Carolina , Cardelo Magdalena P. , de la Cruz-Ares Silvia , Rodriguez-Cantalejo Fernando , Luque Raul M. , León-Acuña Ana , Delgado-Lista Javier , Perez-Martinez Pablo , Yubero-Serrano Elena M. , Lopez-Miranda Jose
Published: April 2020

Background

Aging is associated with a high risk for cardiovascular disease. The relation of obesity and risk of cardiovascular events appears to be more closely linked to certain clinical or metabolic phenotypes than to obesity itself. Our aim was to establish whether aging influenced the metabolic phenotypes regarding to cardiovascular risk, evaluated by changes in the intima media thickness-common carotid (IMT-CC), in coronary heart disease (CHD) patients.

Methods

In this cross-sectional study, 1002 CHD patients were studied at entry from the CORDIOPREV study. We performed carotid ultrasound assessment to obtain their IMT-CC values. Carotid atherosclerosis was considered to exist if IMT-CC > 0.7 mm.

Results

Age determined a higher IMT-CC, regardless metabolic phenotype (all p < 0.05). Metabolically healthy non-obese (MHNO) aged< 60 showed a lesser prevalence for carotid atherosclerotic disease than metabolically sick non-obese (MSNO) and obese (MSO), while MHNO aged≥60 only showed less prevalence for the disease than the MSO. Carotid atherosclerosis associated with age, sex, impaired fasting glucose (IFG), hypertension and high sensitivity C-reactive protein (hsCRP). However, in patients aged< 60, it associated with sex and IFG and in the age ≥ 60 group, with hypertension and hsCRP.

Conclusions

Our results suggest that CHD patients aged≥60 are less metabolic flexible compared to patients aged< 60. Thus, MHO patients aged≥60 show the same risk of suffering carotid atherosclerosis as those with metabolic disease, while MHO patients aged< 60 show lower risk than MSO. This fact indicates the need to focus on therapeutic strategies in order to modify those parameters related to obesity and metabolic inflexibility in patients with CHD before entering old age.
Uptake and willingness to use PrEP among Chinese gay, bisexual and other men who have sex with men with experience of sexualized drug use in the past year
Authors: Wang Zixin , Mo Phoenix K. H. , Ip Mary , Fang Yuan , Lau Joseph T. F.
Published: April 2020

Background

Sexualized drug use (SDU) refers to use of any psychoactive substance before/during sexual intercourse. Chemsex is a subset of SDU, which is defined as the use of some specific psychoactive substances (methamphetamine, mephedrone, γ-hydroxybutyrate, ketamine and cocaine) before/during sexual intercourse. SDU and chemsex are prevalent among gay, bisexual and other men who have sex with men (GBMSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among a sample of GBMSM in Hong Kong with experience of SDU in the past year.

Methods

A total of 600 GBMSM were recruited by convenient sampling through outreaching in gay venues, online recruitment and peer referral. Participants completed a cross-sectional anonymous telephone interview. This study was based on a subsample of 580 GBMSM self-reported as HIV negative/unknown sero-status.

Results

Of the participants, 82 (14.1%) and 37 (6.4%) had experience of SDU and chemsex in the past year. The prevalence of PrEP uptake was 4.0% among all participants and 14.6% among those with experience of SDU in the past year. Among GBMSM with experience of SDU in the past year who were not on PrEP (n = 70), 67.1% were willing to use daily oral PrEP in the next 6 months. Multivariate logistic regression models showed that positive attitudes toward PrEP (AOR: 2.37, 95%CI: 1.47, 3.82), perceived support from significant others to use PrEP (AOR: 9.67, 95%CI: 2.95, 31.71), and perceived behavioral control of using PrEP (AOR: 19.68, 95%CI: 5.44, 71.26) were significantly associated with higher willingness to use PrEP.

Conclusion

GBMSM with experience of recent SDU are potentially good candidates of PrEP implementation. This group of GBMSM reported high prevalence of uptake and willingness to use PrEP. Perceptions related to PrEP based on the Theory of Planned Behavior were significantly associated with willingness to use PrEP.