bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility and outcomes of selective tetramodal bladder‐preservation therapy in elderly patients with muscle‐invasive bladder cancer
Authors: Tanaka Hajime , Fukushima Hiroshi , Kijima Toshiki , Nakamura Yuki , Yajima Shugo , Uehara Sho , Yoshida Soichiro , Yokoyama Minato , Ishioka Junichiro , Matsuoka Yoh , Saito Kazutaka , Fujii Yasuhisa
Published: January 2020

Objective

To assess the feasibility and functional/oncological outcomes of selective tetramodal bladder‐preservation therapy in elderly patients with muscle‐invasive bladder cancer.

Methods

This study analyzed 154 patients with non‐metastatic muscle‐invasive bladder cancer who were enrolled into the protocol. After maximal transurethral resection and induction chemoradiotherapy, patients with clinical complete response were offered consolidative partial cystectomy to achieve bladder preservation; otherwise, radical cystectomy was recommended. Postoperative complications, preserved bladder function, and oncological outcomes were compared between elderly (aged ≥75 years) and younger patients (aged <75 years). Frailty and sarcopenia were further assessed as potential factors that could affect the feasibility and outcomes of the protocol.

Results

A total of 44 patients (29%) were elderly, and 31 (20%) were frail (modified frailty index 2–3). Sarcopenia was observed in 68 (54%) of 126 eligible patients. Clinical complete response to induction chemoradiotherapy was achieved in 125 (81%) patients, and the bladder‐preservation protocol was completed in 107 (69%) patients with consolidative partial cystectomy. Over a median follow‐up period of 48 months, 5‐year cancer‐specific and muscle‐invasive bladder cancer recurrence‐free survival rates after protocol completion were 98% and 95%, respectively. There were no significant differences in complication rates related to partial cystectomy, preserved bladder function, and oncological outcomes between the elderly and younger groups. Neither frailty nor sarcopenia negatively affected these outcomes.

Conclusions

Tetramodal bladder‐sparing therapy incorporating consolidative partial cystectomy is feasible and yielded favorable functional/oncological outcomes in patients with muscle‐invasive bladder cancer, regardless of advanced age, frailty or sarcopenia. This protocol could be a viable treatment option for such high‐risk patient populations.
Kit activates interleukin‐4 receptor and effector signal transducer and activator of transcription 6 independent of its cognate ligand in mouse mast cells
Authors: Sethumadhavan Aiswarya , Mani Maheswaran
Published: January 2020

Signaling by Kit has been extensively studied in hematopoietic cells and is essential for the survival, proliferation and maintenance of hematopoietic stem and progenitor cells. In addition to the activation of intrinsic signaling pathways, Kit has been shown to interact with lineage‐restricted type I cytokine receptors and produce cross signals, e.g. erythropoietin receptor, interleukin‐7 receptor (IL‐7R), IL‐3R. Based on the earlier studies, we hypothesize that Kit activate other type I cytokine receptors in a cell‐specific manner and execute cell‐specific function. To investigate other Kit‐activated receptors, we tested Kit and IL‐4R cross‐receptor activation in murine bone‐marrow‐derived mast cells, which express both Kit and IL‐4R at the surface level. Kit upon activation by Kit ligand (KL), activated IL‐4Rα, γC, and signal transducer and activator of transcription 6 independent of its cognate ligand IL‐4. Though KL and IL‐4 are individually mitogenic, combinations of KL and IL‐4 synergistically promoted mast cell proliferation. Furthermore, inhibition of lipid raft formation by methyl‐β‐cyclodextrin resulted in loss of synergistic proliferation. Together the data suggest IL‐4R as a novel Kit‐activated receptor. Such cross‐receptor activations are likely to be a universal mechanism of Kit signaling in hematopoiesis.
Comparative phylogeography of two free‐living cosmopolitan cyanobacteria: Insights on biogeographic and latitudinal distribution
Authors: Ribeiro Karine F. , Ferrero Ana P. , Duarte Leandro , Turchetto‐Zolet Andreia C. , Crossetti Luciane O.
Published: January 2020

Aim

Free‐living bacteria have long been assumed to have little biogeographic signature because of their high potential for passive dispersal. Raphidiopsis raciborskii and Microcystis aeruginosa are free‐living cosmopolitan cyanobacteria with a probable tropical origin, that frequently form toxic blooms and are considered invasive species in middle latitudes. Despite these similarities, their phylogeographic patterns have seldom been directly compared. Our aim was to reconstruct the phylogeographic histories of R. raciborskii and M. aeruginosa, in order to explore whether their current distributions could be attributed to the same biogeographic events.

Location

Global.

Taxa

Raphidiopsis raciborskii (Nostocales) and Microcystis aeruginosa (Chroococcales).

Methods

The phylogeography of these species was studied based on global genetic diversity patterns from a dataset of worldwide 16S rRNA gene sequences. Genetic diversity indices were measured globally and by latitude. Analyses based on distance matrices were performed to evaluate the correlation between genetic divergence, geographic distance and climatic conditions. Demographic history was investigated through neutrality tests and Bayesian Skyline Plot analysis.

Results

For both species, the genetic diversity is highest in tropical latitudes, and the data provided evidence of recent population expansions (in the last 2,500 years). R. raciborskii showed much lower genetic diversity than M. aeruginosa. A significant phylogeographic structure was found for R. raciborskii but not for M. aeruginosa. Climatic conditions had a significant influence on the genetic structure of both species, but this influence was stronger and varied according to latitude only for R. raciborskii.

Main Conclusions

Supporting the hypothesis of a tropical origin and recent dispersal to temperate habitats, both species had higher genetic diversity in tropical latitudes and showed evidence of recent population expansions. R. raciborskii populations showed a significant decline in genetic similarity with increasing geographic distance, indicating an interaction between drift and some dispersal limitation on its phylogeography. In contrast, M. aeruginosa seemed to have a high frequency of intercontinental dispersal. Finally, the particularities of each species, such as the ability to form akinetes in R. raciborskii and high genome plasticity and niche specialization in M. aeruginosa, may be associated with the lower genetic diversity of R. raciborskii when compared to M. aeruginosa.
Impact of cryoballoon applications on lesion gaps detected by magnetic resonance after pulmonary vein isolation
Authors: Trotta Omar , Alarcón Francisco , Guasch Eduard , Benito Eva Maria , San Antonio Rodolfo , Perea Rosario J. , Prat‐Gonzalez Susanna , Apolo Jose , Sitges Marta , Tolosana José María , Mont Lluís ,   other members of the Atrial Fibrillation Unit
Published: January 2020

Introduction

Ablation with second‐generation cryoballoon technology evolves as an effective and safe alternative to radiofrequency for atrial fibrillation ablation procedures. Nevertheless, the optimal freezing strategy remains unknown. Our objective was to identify the procedural cryoablation parameters predicting successful peri‐pulmonary vein (PV) lesions by directly analyzing Postablation gaps in late‐gadolinium‐enhanced cardiac magnetic resonance (LGE‐CMR).

Methods and Results

Forty‐nine consecutive patients (196 PVs) undergoing ablation with second‐generation cryoballoon at our center were included. The number and duration of cryoballoon application to achieve PV isolation were left to operator discretion. Gap number and length were quantified in all patients with a LGE‐CMR performed 3 months postablation. Application time (420 ± 217 seconds), number of applications (2.1 ± 1.2), application time after electrical isolation (311 ± 194 seconds) and minimum temperature (−45.8 ± 6.5°C) were similar in the 4 PVs. Gaps were observed in 148 PVs (76%), averaging 1.3 ± 1 gaps per vein. Gaps were longer and more frequent in the right PVs (91% vs 59% in left PVs, P < .001). Neither the number, total duration of applications, nor postisolation application time predicted relative length or number of gaps.

Conclusions

After successful PV isolation was achieved in patients undergoing cryoablation, increasing the number of applications, the total application time or application time postisolation did not result in a reduction in the number or the relative length of gaps.
Hyperbaric oxygen activates visfatin expression and angiogenesis via angiotensin II and JNK pathway in hypoxic human coronary artery endothelial cells
Authors: Chiu Chiung‐Zuan , Wang Bao‐Wei , Yu Ying‐Ju , Shyu Kou‐Gi
Published: January 2020

Visfatin is an adipocytokine with important roles in endothelial angiogenesis. Hyperbaric oxygen (HBO) has been widely used to treat various medical illness with enhanced angiogenesis. The molecular effects of HBO on visfatin under hypoxia are poorly understood. This study aimed to investigate the effect of HBO on visfatin in hypoxic human coronary arterial endothelial cells (HCAECs). HCAECs under chemical hypoxia (antimycin A, 0.01 mmol/L) were exposed to HBO (2.5 atmosphere absolute; ATA) for 2‐4 hours. Western blot, real‐time polymerase chain reaction, electrophoretic mobility shift assay, luciferase promoter activity, migration and tube formation assay, and in vitro glucose uptake were measured. Visfatin protein expression increased in hypoxic HCAECs with earlier angiotensin II (AngII) secretion and c‐Jun N‐terminal kinase (JNK) phosphorylation, which could be effectively suppressed by the JNK inhibitor (SP600125), AngII antibody or AngII receptor blocker (losartan). In hypoxic HCAECs, HBO further induced earlier expression of visfatin and AngII. Hypoxia significantly increased DNA‐protein binding activity of hypoxia‐inducible factor‐1α (HIF‐1α) and visfatin. Hypoxia, hypoxia with HBO and exogenous addition of AngII also increased promoter transcription to visfatin; SP600125 and losartan blocked this activity. In HCAECs, glucose uptake, migration and tube formation were increased in the presence of hypoxia with HBO, but were inhibited by visfatin small interfering RNA, SP600125 and losartan. In conclusion, HBO activates visfatin expression and angiogenesis in hypoxic HCAECs, an effect mediated by AngII, mainly through the JNK pathway.
Updates on mechanistic insights and targeting of tumour metastasis
Authors: Feng Zeru , Yu Qiuxuan , Zhang Ting , Tie Wanpeng , Li Jing , Zhou Xikun
Published: January 2020

Malignant tumours are one of the major diseases that seriously endanger human health. The characteristics of their invasion and metastasis are one of the main causes of death in cancer patients, and these features cannot be separated from the participation of various molecules‐related cells living in the tumour microenvironment and specific structures. Tumour invasion can approximately be divided into several specific steps according to the movement of tumour cells. In each step, there are different actions in the tumour microenvironment that mediate the interactions among substances. Researchers are attempting to clarify every mechanism of the tumour dissemination. However, there is still a long way to the final determination. Here, we review these interactions in tumour invasion and metastasis at the structural, molecular and cellular levels. We also discuss the ongoing studies and the promise of targeting metastasis in tumour therapy.
Isoalantolactone restores the sensitivity of gram‐negative Enterobacteriaceae carrying MCR‐1 to carbapenems
Authors: Lu Na , Lv Qianghua , Sun Xiaodi , Zhou Yonglin , Guo Yan , Qiu Jiazhang , Zhang Peng , Wang Jianfeng
Published: January 2020

Polymyxin B has been re‐applied to the clinic as the final choice for the treatment of multidrug‐resistant gram‐negative pathogenic infections, but the use of polymyxin B has been re‐assessed because of the emergence and spread of the plasmid‐mediated mcr‐1 gene. The purpose of this study was to search for an MCR inhibitor synergistically acting with polymyxin to treat the infection caused by this pathogen. In this study, we used the broth microdilution checkerboard method to evaluate the synergistic effect of isoalantolactone (IAL) and polymyxin B on mcr‐1‐positive Enterobacteriaceae. Growth curve analysis, time‐killing assays and a combined disc test were used to further verify the efficacy of the combined drug. Colonization of the thigh muscle in mice, survival experiments and lung tissue section observations was used to determine the effect of synergy in vivo after Klebsiella pneumoniae and Escherichia coli infection. We screened a natural compound, IAL, which can enhance the sensitivity of polymyxin B to mcr‐1‐positive Enterobacteriaceae. The results showed that the combined use of polymyxin B and IAL has a synergistic effect on mcr‐1‐positive Enterobacteriaceae, such as K pneumoniae and E coli, not only in vitro but also in vivo. Our results indicate that IAL is a natural compound with broad application prospects that can prolong the service life of polymyxin B and make outstanding contributions to the treatment of gram‐negative Enterobacteriaceae infections resistant to polymyxin B.
Failure of Traditional Risk Factors to Adequately Predict Cardiovascular Events in Older Populations
Authors: Dalton Jarrod E. , Rothberg Michael B. , Dawson Neal V. , Krieger Nikolas I. , Zidar David A. , Perzynski Adam T.
Published: January 2020

BACKGROUND

Accurate assessment of atherosclerotic cardiovascular disease (ASCVD) risk across heterogeneous populations is needed for effective primary prevention. Little is known about the performance of standard cardiovascular risk factors in older adults.

OBJECTIVE

To evaluate the performance of the American College of Cardiology/American Heart Association Pooled Cohort Equations (PCE) risk model, as well as the underlying cardiovascular risk factors, among adults older than 65 years.

DESIGN AND SETTING

Retrospective cohort derived from a regional referral system's electronic medical records.

PARTICIPANTS

A total of 25 349 patients who were 65 years or older at study baseline (date of the first outpatient lipid panel taken between 2007 and 2010).

MEASUREMENTS

Exposures of interest were traditional cardiovascular risk factors, as defined by inclusion in the PCE model. The primary outcome was major ASCVD events, defined as a composite of myocardial infarctions, stroke, and cardiovascular death.

RESULTS

The PCE and internally estimated models produced similar risk distributions for white men aged 65 to 74 years. For all other groups, PCE predictions were generally lower than those of the internal models, particularly for African Americans. Discrimination of the PCE was poor for all age groups, with concordance index (95% confidence interval) estimates of 0.62 (0.60‐0.64), 0.56 (0.54‐0.57), and 0.52 (0.49‐0.54) among patients aged 65 to 74, 75 to 84, and 85 years and older, respectively. Reestimating relationships within these age groups resulted in better calibration but negligible improvements in discrimination. Blood pressure, total cholesterol, and diabetes either were not associated at all or had inverse associations in the older age groups.

CONCLUSION

Traditional clinical risk factors for cardiovascular disease failed to accurately characterize risk in a contemporary population of Medicare‐aged patients. Among those aged 85 years and older, some traditional risk factors were not associated with ASCVD events. Better risk models are needed to appropriately inform treatment decision making for the growing population of older adults. J Am Geriatr Soc 68:754–761, 2020
Lower urinary symptoms, resilience, and post‐traumatic stress symptoms among rectal cancer patients after surgery
Authors: Lin Yu‐Hua , Kao Chia‐Chan , Pan I‐Ju , Liu Yi‐Hui
Published: January 2020

Aim

Disturbance of urinary function is a common complication after rectal cancer surgery, and it may affect patients' psychological well‐being, consequently may develop post‐traumatic stress disorder. Personal resilience might increase people's ability to manage life's challenges. However, limited study to explore their relationships. This study examined the relationships among lower urinary symptoms, resilience, and post‐traumatic stress symptoms (PTSS) in post‐surgery patients with rectal cancer.

Methods

A cross‐sectional study design was used and included 188 patients with diagnosed rectal cancer who had undergone surgery over 24 months and were recruited from a hospital in southern Taiwan. The outcome measurements included a resilience scale, International Prostate Symptom Score (IPSS), the Chinese Davidson Trauma Scale, personal characteristics, and disease‐related variables.

Results

There were significant relationships among age at diagnosed, self‐reported physical status, perceived satisfied with recovery, urinary tract symptoms, resilience, and overall PTSS. The stepwise regression demonstrated that five factors, self‐reported physical status, resilience, urinary tract symptoms, age at diagnosed and gender, and together explained 27.7% of overall PTSS variance (10.7, 6.7, 3.7, 4.8 and 1.8% of variance, respectively).

Conclusion

The study demonstrates that patients with diagnosed rectal cancers long‐term outcomes of PTSS, urinary tract symptoms, and resilience after surgery; in addition, self‐reported physical status, resilience, urinary tract symptoms, age at diagnosed and gender are the major predictors of PTSS. A better understanding of the long‐term outcomes of post‐surgery in rectal cancer patients and its related factors may help to decreasing the PTSS after surviving cancer.
Incorporating an Equity Agenda into Health Professions Education and Training to Build a More Representative Workforce
Authors: Effland Kristin J. , Hays Karen , Ortiz Felina M. , Blanco Brittni A.
Published: January 2020

Efforts to achieve health equity goals in the United States require the recruitment, retention, and graduation of an increasingly diverse student body of aspiring health professionals. Improving access to health care providers who are culturally congruent with the populations served is a related ethical priority that has the potential to improve the health inequities faced by communities of color and others in the United States. Midwifery education program administrators and faculty have responded to this need by acknowledging that creation of a more representative midwifery workforce starts with midwifery education. The Equity Agenda Guideline, related conceptual model, and website resources were developed for the purpose of supporting health professions educators and institutions who recognize a need for change and are seeking answers about how to train and graduate more health care providers from communities that are currently underrepresented. Using a systems approach to outline the transformative multilevel changes required, these resources offer a roadmap for how to address the underlying problems of racism and other differentisms that have limited the growth and diversification of the health and helping professions. This article addresses how health education programs interested in making an impact on this complex and persistent problem can adopt or adapt the Equity Agenda Guideline, originally developed for midwifery education programs in the United States.
Angiopoietin‐1/Tie‐2 signal after focal traumatic brain injury is potentiated by BQ788, an ETB receptor antagonist, in the mouse cerebrum: Involvement in recovery of blood–brain barrier function
Authors: Michinaga Shotaro , Tanabe Ayami , Nakaya Ryusei , Fukutome Chihiro , Inoue Anna , Iwane Aya , Minato Yukiko , Tujiuchi Yu , Miyake Daisuke , Mizuguchi Hiroyuki , Koyama Yutaka
Published: January 2020

Angiopoietin‐1, an angiogenic factor, stabilizes brain microvessels through Tie‐2 receptor tyrosine kinase. In traumatic brain injury, blood–brain barrier (BBB) disruption is an aggravating factor that induces brain edema and neuroinflammation. We previously showed that BQ788, an endothelin ETB receptor antagonist, promoted recovery of BBB function after lateral fluid percussion injury (FPI) in mice. To clarify the mechanisms underlying BBB recovery mediated by BQ788, we examined the involvements of the angiopoietin‐1/Tie‐2 signal. When angiopoietin‐1 production and Tie‐2 phosphorylation were assayed by quantitative reverse transcription polymerase chain reaction and western blotting, increased angiopoietin‐1 production and Tie‐2 phosphorylation were observed in 7–10 days after FPI in the mouse cerebrum, whereas no significant effects were obtained at 5 days. When BQ788 (15 nmol/day, i.c.v.) were administered in 2–5 days after FPI, increased angiopoietin‐1 production and Tie‐2 phosphorylation were observed. Immunohistochemical observations showed that brain microvessels and astrocytes contained angiopoietin‐1 after FPI, and brain microvessels also contained phosphorylated Tie‐2. Treatment with endothelin‐1 (100 nM) decreased angiopoietin‐1 production in cultured astrocytes and the effect was inhibited by BQ788 (1 μM). Five days after FPI, increased extravasation of Evans blue dye accompanied by reduction in claudin‐5, occludin, and zonula occludens‐1 proteins were observed in mouse cerebrum while these effects of FPI were reduced by BQ788 and exogenous angiopoietin‐1 (1 μg/day, i.c.v.). The effects of BQ788 were inhibited by co‐administration of a Tie‐2 kinase inhibitor (40 nmol/day, i.c.v.). These results suggest that BQ788 administration after traumatic brain injury promotes recovery of BBB function through activation of the angiopoietin‐1/Tie‐2 signal.

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Synucleinopathies: Where we are and where we need to go
Authors: Brás Inês Caldeira , Dominguez‐Meijide Antonio , Gerhardt Ellen , Koss David , Lázaro Diana F. , Santos Patrícia I. , Vasili Eftychia , Xylaki Mary , Outeiro Tiago Fleming
Published: January 2020

Synucleinopathies are a group of disorders characterized by the accumulation of inclusions rich in the a‐synuclein (aSyn) protein. This group of disorders includes Parkinson's disease, dementia with Lewy bodies (DLB), multiple systems atrophy, and pure autonomic failure (PAF). In addition, genetic alterations (point mutations and multiplications) in the gene encoding for aSyn (SNCA) are associated with familial forms of Parkinson's disease, the most common synucleinopathy. The Synuclein Meetings are a series that has been taking place every 2 years for about 12 years. The Synuclein Meetings bring together leading experts in the field of Synuclein and related human conditions with the goal of discussing and advancing the research. In 2019, the Synuclein meeting took place in Ofir, a city in the outskirts of Porto, Portugal. The meeting, entitled "Synuclein Meeting 2019: Where we are and where we need to go", brought together >300 scientists studying both clinical and molecular aspects of synucleinopathies. The meeting covered a many of the open questions in the field, in a format that prompted open discussions between the participants, and underscored the need for additional research that, hopefully, will lead to future therapies for a group of as of yet incurable disorders. Here, we provide a summary of the topics discussed in each session and highlight what we know, what we do not know, and what progress needs to be made in order to enable the field to continue to advance. We are confident this systematic assessment of where we stand will be useful to steer the field and contribute to filling knowledge gaps that may form the foundations for future therapeutic strategies, which is where we need to go.

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When Family Property Becomes Individual Property: Intrahousehold Property Ownership and Women's Well‐Being in China
Authors: Zang Emma
Published: January 2020

Objective

This study examines the impact of the 2011 judicial interpretation to the Chinese Marriage Law, which altered property rights, on the well‐being of husbands and wives.

Background

Although the focus on macro‐level gender inequality continues, relatively few studies have focused on intrahousehold gender inequality in China.

Method

Using data from the China Family Panel Studies (80,162 observations of 22,541 individuals), a nationally representative survey of Chinese households, this study uses a difference‐in‐differences strategy to compare the outcomes of spouses in households where only the husband's name is on the deed with those where the spouses have equal homeownership status.

Results

In the short term, the 2011 judicial interpretation to the Marriage Law led to diminished well‐being for women in a typical Chinese household where the deed to the marital home is in the husband's name only. However, in the long term, the adverse effect for women weakened, which is likely because couples turned to adaptive behaviors more in line with premarital agreements and traditional practices, nullifying any effects caused by the reform. No significant effects of the reform were found for men living households where only the wife's name is on the deed.

Conclusion

This study demonstrates how a seemingly gender‐neutral policy can generate gendered consequences. It is therefore critical that policy makers consider the implications of intrahousehold inequality.
Paternity Leave and Fathers' Responsibility: Evidence From a Natural Experiment in Canada
Authors: Wray Dana
Published: January 2020

Objective

This study uses a natural experiment in Canada to examine whether reserved paternity leave policy can increase fathers' involvement with their children.

Background

Although a growing body of research suggests that paternal leave‐taking is associated with increased father involvement, the causality of this relationship is unclear. Furthermore, leave‐taking may differently impact multiple dimensions of father involvement, including engagement (direct interaction with children), accessibility (time in children's presence), and responsibility (solo parenting time).

Method

Using two cross‐sectional waves of time diary data from the 2005 and 2010 Canadian General Social Survey, this study exploits the natural experiment of the reserved paternity leave policy introduced in the province of Quebec in 2006 compared to the shared parental leave benefits offered in the rest of Canada. Difference‐in‐differences methods are used to estimate the causal effect of the policy on multiple measures of father involvement.

Results

The reserved paternity leave policy led to a direct increase in fathers' responsibility time—2.2 additional hours of solo parenting time per week—but no direct effect on fathers' engagement or accessibility time. The findings also suggest that there may be indirect, contextual effects of the policy that have shifted the norms in Quebec regarding fathering.

Conclusion

This study concludes that reserved paternity leave can increase fathers' responsibility for children in ways that may benefit family well‐being and gender equality more broadly.
Nothing going on? Exploring the role of missed events in changes in subjective well‐being and the Big Five personality traits
Authors: Luhmann Maike , Buecker Susanne , Kaiser Till , Beermann Mira
Published: January 2020

Objective

Missed events are defined as the nonoccurrence of expected major life events within a specified time frame. We examined whether missed events should be studied in research on growth by exploring the role of missed events for changes in subjective well‐being (SWB) and the Big Five personality traits.

Method

The samples were selected from two nationally representative panel studies, the German Socioeconomic Panel Innovation Sample (SOEP‐IS, total N = 6,638) and the Dutch Longitudinal Internet Studies for the Social Sciences panel (LISS, Ns between 4,262 and 5,749). Rank‐order stability and mean‐level change were analyzed using regression and mixed models. Type I error probability was reduced by using conservative thresholds for level of significance and minimal effect size.

Results

Expected but missed events were more frequent than actually experienced events. For SWB, rank‐order stability tended to be lower among those who experienced a missed event than among those who did not. For the Big Five personality traits, significant differences between those who did and those who did not experience a missed event were rare and unsystematic.

Conclusion

Missed events merit more attention in future research on growth and personality change, but the effects are probably weak.
Mental health nurses in non‐uniform: Facilitator of recovery process?
Authors: Chu Lok Yan , Chang Tin Wai , Dai Tsz Yuet , Hui Lok , Ip Hei Tung , Kwok San Yuet , Ying Kin Long , Chan Fung Man , Bressington Daniel
Published: January 2020

Accessible summary

What is known on the subject?

Many Western countries have abandoned the wearing of nurse uniforms on inpatient mental health wards. The adoption of a non‐uniform policy in Hong Kong was recently introduced in select rehabilitation units to align with the philosophy of the recovery model.

What the paper adds to existing knowledge?

The findings suggest that nurses perceived wearing non‐uniform might help to reduce the self‐stigma of service users and develop better self‐esteem.

The perceived potential benefits of the introduction of a non‐uniform policy seemed to outweigh the perceived drawbacks.

What are the implications for practice?

The results further acknowledge the potential positive effects of nurses wearing non‐uniform on facilitating psychiatric service users' recovery process. However, further research on service users' perspectives is required.

The wearing of non‐uniform may be considered to be extended to other psychiatric wards in Hong Kong and other similar Asian settings in order to potentially help promote patient's recovery and to reduce emotional distance between staff and service users.

Introduction

A non‐uniform policy was recently adopted in selected Hong Kong rehabilitation wards to align with the philosophy of the recovery model. The change in policy is relatively novel in Asia, where no previous studies have reported how this may influence nursing care and service users' recovery.

Aim

To explore Hong Kong Mental Health Nurses' views about wearing non‐uniform within an inpatient rehabilitation unit in regard to facilitating service users' recovery process.

Method

A qualitative descriptive study was conducted, utilizing individual in‐depth semi‐structured research interviews.

Results

A total of 12 interviews were conducted with nurse participants. The analysis process identified 3 main themes and 9 subthemes. Main themes were “building up rapport with service users,” “non‐uniform helps deinstitutionalization” and “different approaches to maximize the benefit and to minimize the risk.”

Discussion

Despite some concerns, the majority of nurse participants positively viewed the policy of wearing non‐uniform and felt it was potentially beneficial to service users' recovery process.

Implications for practice

Nurses perceived that wearing non‐uniform may facilitate meaningful therapeutic engagement, and may help to reduce the self‐stigma and develop the self‐esteem of service users. Other inpatient units in Hong Kong and similar Asian settings might consider adopting the policy.
Genomic and phenotypic effects of inbreeding across two different hatchery management regimes in Chinook salmon
Authors: Waters Charles D. , Hard Jeffrey J. , Fast David E. , Knudsen Curtis M. , Bosch William J. , Naish Kerry A.
Published: January 2020

Genomic approaches permit direct estimation of inbreeding and its effect on fitness. We used genomic‐based estimates of inbreeding to investigate their relationship with eight adult traits in a captive‐reared Pacific salmonid that is released into the wild. Estimates were also used to determine whether alternative broodstock management approaches reduced risks of inbreeding. Specifically, 1,100 unlinked restriction‐site associated (RAD) loci were used to compare pairwise relatedness, derived from a relationship matrix, and individual inbreeding, estimated by comparing observed and expected homozygosity, across four generations in two hatchery lines of Chinook salmon that were derived from the same source. The lines are managed as “integrated” with the founding wild stock, with ongoing gene flow, and as “segregated” with no gene flow. While relatedness and inbreeding increased in the first generation of both lines, possibly due to population subdivision caused by hatchery initiation, the integrated line had significantly lower levels in some subsequent generations (relatedness: F2–F4; inbreeding F2). Generally, inbreeding was similar between the lines despite large differences in effective numbers of breeders. Inbreeding did not affect fecundity, reproductive effort, return timing, fork length, weight, condition factor, and daily growth coefficient. However, it delayed spawn timing by 1.75 days per one standard deviation increase in F (~0.16). The results indicate that integrated management may reduce inbreeding but also suggest that it is relatively low in a small, segregated hatchery population that maximized number of breeders. Our findings demonstrate the utility of genomics to monitor inbreeding under alternative management strategies in captive breeding programs.
Language as raw material, scripts as tools and conversations as product: effects of linguistic production on job categories in outsourced call centres
Authors: Alarcón Amado , Ubalde Josep , Mc. Heyman Josiah
Published: January 2020

The article shows how linguistic criteria have become central when defining job categories in the outsourced call centre sector in Spain. Language occupies a central role in the production processes of informational capitalism: in call centres, language functions as the raw material, scripts as tools and conversations as a product. Yet the ways in which linguistic production affects key elements of job categories have received little attention. Drawing on in‐depth interviews in the call centre sector, the analysis of scripts and collective agreements, this article shows how trade unions and workers are pushing to adapt Fordist arguments based on job autonomy to informational production, arguing that job categories may depend on linguistic autonomy from the scripts during the labour process.
Religiosity, spirituality, and the quality of life of patients with sequelae of head and neck cancer
Authors: dos Reis Liliane Braga Monteiro , Leles Cláudio Rodrigues , Freire Maria do Carmo Matias
Published: January 2020

Objectives

To investigate associations between religiosity, spirituality and quality of life (QoL) in patients with visible sequelae due to head and neck cancer surgery.

Subject and Methods

Cross‐sectional study in 202 patients in a cancer hospital in Brazil. Psychosocial, demographic and clinical conditions were collected through interviews, clinical examinations and from the medical records. The outcome was QoL, measured by the Functional Assessment of Cancer Therapy‐Head and Neck (FACT‐HN) and the University of Washington QoL Questionnaire for patients with head and neck cancer (UW‐QOL). The explanatory variables were religiosity (Duke University Religiosity Index—DUREL) and spirituality (Functional Assessment of Chronic Illness Therapy‐Spiritual Well‐Being Scale—FACIT‐Sp12). Pearson's correlation and linear regression were used for data analysis.

Results

Religiosity and spirituality were associated with both measures of the patients' QoL. After adjustment, higher scores of QoL (FACT‐HN and UW‐QOL) were found in patients with higher levels of religiosity and of spirituality. Other significant covariates were gender (male), those living with their families, with sequelae not involving the cervical region, longer post‐surgical time and who had no chemotherapy or radiation.

Conclusion

Religiosity and spirituality were associated with the patients' QoL, regardless of their sociodemographic and cancer‐related clinical conditions and behaviours.
Nanoscale adhesion forces of glucosyltransferase B and C genes regulated Streptococcal mutans probed by AFM
Authors: Wang Rui , Deng Ling , Lei Zixue , Wu Peiyao , Wang Yigan , Hao Liying , Li Tianjiao , Jiang Li
Published: January 2020

Glucosyltransferases (Gtfs), represented by GtfB and GtfC, are important virulence factors of Streptococcus mutans and the major etiologic pathogens of tooth decay. However, the individual roles of gtfB and gtfC in the initial attachment of S. mutans are not known. We used atomic force microscopy to explore the contribution of gtfB and gtfC, as well as enamel‐surface roughness, on the initial attachment of S. mutans. Adhesion forces of four S. mutans strains (wild‐type, ΔgtfB, ΔgtfC, and ΔgtfBC), onto etched enamel surfaces, were determined. Force curves showed that, with increasing etching time from 0 to 10 s, the forces of all strains increased accordingly with acid‐exposure time, the adhesion forces of wild‐type strains were significantly greater than those of mutant strains (p < .05), and the forces of the three mutants were similar (p < .05). When the etching time was increased from 10 to 30 s, difference in force between 20 and 30 s was not observed, and adhesion forces among ΔgtfB, ΔgtfC, and wild‐type strains were not significantly different when the etching time was >20 s (p > .05). These data suggest that the roughness and morphology of enamel surfaces may have a significant influence upon the initial attachment of bacteria, and that gtfB and gtfC are essential for the adhesion activity of bacteria. Furthermore, gtfB seems to be more important than gtfC for bacterial‐biofilm formation, and gtfB inactivation is an effective strategy to inhibit the virulence of cariogenic biofilms.
Tinea capitis: A single‐institution retrospective review from 2010 to 2015
Authors: Nguyen Cuong V. , Collier Sigrid , Merten Ashley H. , Maguiness Sheilagh M. , Hook Kristen P.
Published: January 2020

Background/Objective

Tinea capitis is a common infection of scalp hair in children. The prevalent etiologic organism has changed significantly over time, which may reflect the complex interaction of environmental factors, genetic predisposition, and movement of populations. We evaluate the prevalence of different infectious organisms causing tinea capitis and describe the clinical characteristics.

Methods

A retrospective chart review of patients diagnosed with tinea capitis with tissue culture confirmation, who were seen in pediatric dermatology at a tertiary care center from 2010 to 2015. Patient demographics, culture data, and clinical characteristics were evaluated. Inflammatory pattern, characterized by presence of pustules, bogginess, or lymphadenopathy, was noted.

Results

Forty‐six patients with culture‐positive tinea capitis were identified. In the 18 (42.9%) patients who were infected with either Trichophyton violaceum or Trichophyton soudanenese, all were of African ethnicity. In contrast, Trichophyton tonsurans was identified in a minority of African patients (3.8%), revealing a statistically significant difference between ethnicity and infective species (P‐value < 0.001). T tonsurans was significantly more likely than T violaceum to exhibit an inflammatory pattern (68% vs 22%, P value < 0.027).

Conclusions

While T tonsurans remained the most common cause of tinea capitis, T violaceum and T soudanense have increased in prevalence. As these latter agents are less inflammatory, clinical diagnosis may be delayed. Studying changes in the infectious cause of tinea capitis can help us create a snapshot to better understand the evolution of our population make‐up, allowing us to provide crucial quality health care to all.
Basosquamous carcinoma and melanoma collision tumor in a child with xeroderma pigmentosum
Authors: Bostanci Seher , Akay Bengü Nisa , Kirmizi Ayca , Okcu Heper Aylin , Farabi Banu
Published: January 2020

Xeroderma pigmentosum (XP) is a rare autosomal recessive genodermatosis associated with hypersensitivity to ultraviolet radiation (UVR), being due to defects involving the nucleotide excision repair pathway. Patients with XP are prone to develop multiple cutaneous neoplasms including non‐melanoma skin cancers and melanoma. Collision tumors in patients with XP have been reported in the literature including the following lesions, actinic keratosis, basal cell carcinoma, squamous cell carcinoma, and in situ melanoma. Herein, we present a rare collision tumor composed of melanoma and basosquamous carcinoma in a 13‐year‐old XP patient and describe the dermoscopic features.
Hoarse cry in a newborn with epidermolysis bullosa simplex, generalized severe
Authors: Diociaiuti Andrea , Giancristoforo Simona , Pisaneschi Elisa , Condorelli Angelo Giuseppe , Boldrini Renata , Zambruno Giovanna , El Hachem May
Published: January 2020

Hoarse cry and respiratory stridor are the signs of potentially life‐threatening laryngeal involvement in selected severe and frequently early lethal subtypes of inherited epidermolysis bullosa (EB). We present a newborn with generalized skin blistering and onychodystrophy who developed a hoarse cry and inspiratory stridor. Ultrastructural skin examination revealed tonofilament clumping in basal keratinocytes and genetic testing identified the de novo missense mutation p.Arg125Cys in the KRT14 gene, consistent with EB simplex generalized severe, which is characterized by major morbidity in infancy but a favorable long‐term prognosis. The present case underlines the importance to consider EB simplex generalized severe in the differential diagnosis of EB infants presenting hoarseness and stridor.
Celiac disease and hematological abnormalities in children with recurrent aphthous stomatitis
Authors: Yılmaz Songül , Tuna Kırsaçlıoğlu Ceyda , Şaylı Tülin Revide
Published: January 2020

Background

Recurrent aphthous stomatitis (RAS) is one of the most common diseases of the oral mucosa and may be related to vitamin deficiencies or systemic diseases such as celiac disease (CD). The aim of this study was to investigate the frequency of hematinic deficiency and CD in children with RAS.

Methods

The medical records of patients diagnosed with RAS were reviewed for the presence of hematinic deficiencies (hemoglobin, mean corpuscular volume, ferritin, vitamin B12, folic acid), and CD. The study group included 108 children with RAS and 57 healthy children who were evaluated for hematological abnormalities in routine evaluation.

Results

The frequency of a family history of RAS was significantly higher in the RAS group compared to the control group (34.2% vs 7%, respectively; P < 0.001). A hematological abnormality was detected in 32.4% of the RAS group and 10.5% of the control group (P = 0.02). The prevalence of iron deficiency anemia was significantly higher in the RAS group (P = 0.037). Three (2.7%) patients with RAS were diagnosed with CD, which is a significantly higher frequency than that observed in healthy children in Turkey (P < 0.01; OR 6.03, 95% CI [2.37, 4.56]). These children had mild malnutrition, iron deficiency, and iron deficiency anemia.

Conclusions

Children with RAS should be evaluated for nutritional status and hematological indices, and in the case of hematological abnormalities and malnutrition screening for CD should be considered.
Serum concentrations of leptin in pregnant and non‐pregnant bitches
Authors: Troisi Alessandro , Cardinali Lucia , Menchetti Laura , Speranza Roberto , Verstegen John P. , Polisca Angela
Published: January 2020

Leptin regulates body weight and several physiological processes including reproduction. We evaluated the circulating levels of leptin in pregnant and non‐pregnant bitches as well as their correlation with body weight, food intake and number of foetuses. Nineteen healthy German shepherd bitches were used and divided in two groups (pregnant n = 12 and non‐pregnant n = 7). Blood samples were collected every 15 days starting from ovulation (Day 0) throughout pregnancy (pregnant group, P) or throughout luteal phase (non‐pregnant group, NP) In pregnant bitches, leptin concentrations increased from the day of ovulation (1.32 ± 0.06 ng/ml) up to day 45 (1.51 ± 0.06 ng/ml; p < .01) and returned to baseline values from day 60 post‐ovulation. In non‐pregnant bitches, leptin concentrations remained constant throughout the whole observation period (estimated marginal mean ± SE=1.33 ± 0.38 ng/ml). Pairwise comparisons showed significant differences between P and NP at day 45 post‐ovulation (p < .05). Multivariable models indicated that, controlling for time and litter size, there was a positive relationship between leptin concentration and BW (p < .05) although Pearson coefficients showed that the correlation between BW and leptin was only significant in NP animals at day 45 (r = 0.76, p < .05). The multivariable approach also suggested that, holding BW and time constant, leptin concentrations tend to increase as the number of puppies increased (p = .06). Our study supports indirectly the contribution of the feto‐placental unit to the circulating maternal leptin concentration.
Semisupervised Inference for Explained Variance in High Dimensional Linear Regression and its Applications
Authors: Tony Cai T. , Guo Zijian
Published: January 2020

The paper considers statistical inference for the explained variance βTΣβ under the high dimensional linear model Y = Xβ + ε in the semisupervised setting, where β is the regression vector and Σ is the design covariance matrix. A calibrated estimator, which efficiently integrates both labelled and unlabelled data, is proposed. It is shown that the estimator achieves the minimax optimal rate of convergence in the general semisupervised framework. The optimality result characterizes how the unlabelled data contribute to the estimation accuracy. Moreover, the limiting distribution for the proposed estimator is established and the unlabelled data have also proved useful in reducing the length of the confidence interval for the explained variance. The method proposed is extended to semisupervised inference for the unweighted quadratic functional ‖β‖22. The inference results obtained are then applied to a range of high dimensional statistical problems, including signal detection and global testing, prediction accuracy evaluation and confidence ball construction. The numerical improvement of incorporating the unlabelled data is demonstrated through simulation studies and an analysis of estimating heritability for a yeast segregant data set with multiple traits.
Monitoring of prenatal patients using a combined antibody titre for Rh and non‐Rh antibodies
Authors: Farrell Michael , Clarke Gwen , Barr Gerri , Hannon Judith
Published: January 2020

Objectives

This was a laboratory exercise designed to determine whether combined antibody titrations in the presence of multiple antibodies achieve a critical level earlier or at the same time as antibodies having individual antibody titrations.

Background

Management of haemolytic disease of the fetus and newborn involves monitoring maternal antibody concentration by antibody titration. Separate titrations are generally performed for each antibody.

Method

Thirty‐one samples containing combinations of two different Rh and/or non‐Rh antibodies were examined with separate titres for each antibody and one single combined titration.

Results

Of 31 samples, 19 (61.3%) showed an increased combined titre. Of 12 samples that showed no increase, 10 contained a separate titre of <1 for either one or both antibodies. Where both antibodies had a separate titre of ≥1, 15 of 17 (88.2%) showed an increased combined titre. In contrast to the separate titration method, no decrease in titre level was observed using the combined method.

Conclusion

Where two antibodies are present, titrations performed by a combined method will produce titre levels equal to or higher than antibodies titred individually. Therefore, a combined titration can be expected to reach a critical titre level as early as, or earlier in gestation than, antibodies monitored by a single titration method. Further studies relating fetal outcomes to titration methodology would be valuable in determining the validity of this approach for prenatal management. Cost‐effectiveness of this approach to prenatal screening should also be assessed.