bluuebunny/crossref_metadata_2025 huggingface dataset:
Social dilemmas with manifest and unknown networks
Authors: Razo Armando
Published: February 2020

Scholarly consensus that social ties resolve social dilemmas is largely predicated on common knowledge of networks. But what happens when people do not know all relevant social ties? Does network uncertainty translate into worse outcomes? I address these concerns by advancing the notion of a Network Estimation Bayesian Equilibrium to examine cooperative behavior under different epistemic conditions. When networks are common knowledge, I find that all possible outcomes of an original cooperation game can be realized in equilibrium, albeit with a higher likelihood of defection for more connected players. Variable knowledge of the network also has a distributional impact. With incomplete network knowledge, it’s possible to observe reversed equilibrium behavior when more connected players actually cooperate more often than less connected ones. In fact, aggregate network uncertainty in some social contexts incentivizes more mutual cooperation than would be the case with common knowledge of all social ties.
Testing structural and relational embeddedness in collaboration risk
Authors: Song Minsun , Jung Kyujin , Ki Namhoon , Feiock Richard C
Published: February 2020

The study investigates the effect of embeddedness, defined as a property of interdependent relations in which organizations are integrated in a network, on collaboration risk emerging from relational uncertainty. Despite efforts to understand the structural effects of network governance, embedded relationships and their influence on collaboration remain relatively unexplored. A case of intergovernmental collaboration for emergency management is used as a test bed to examine the role of embeddedness in disaster networks and to extend the knowledge of collaboration risk within the institutional collective action framework. We hypothesize and test the effect of relational and structural embeddedness on the level of collaboration risk that an organization perceives. Our analysis of 69 organizations engaged in emergency management operations in the Seoul Metropolitan Area, South Korea reveals that both structural and relational embeddedness facilitate organizations to mitigate perceived collaboration risk. The results suggest that reachability secures relief of relational risk, and that commitment relationships bind participants.
Acknowledging Student Behavior: A Review of Methods Promoting Positive and Constructive Feedback
Authors: Whitney Todd , Ackerman Kera B.
Published: February 2020

Positive and constructive feedback is a form of positive reinforcement essential to effective instruction and classroom management. This article provides practitioners with a range of realistic positive and constructive feedback strategies and descriptions of how such feedback can be implemented in schools and classrooms, with a special focus on the reinforcement of students with emotional and behavioral disorders.
Different Reasons for Different Responses: A Review of Incumbents’ Adaptation in Carbon-Intensive Industries
Authors: Sump Franziska , Yi Sangyoon
Published: February 2020

Organizations often respond in different ways to common external shocks. To advance theories on organizational adaptation and performance heterogeneity, it is essential to understand different reasons for different organizational responses. We examine how incumbents in carbon-intensive industries adapt to heightened environmental pressure to reduce carbon emissions. Based on a review of the literature, we propose three dimensions along which diverse organizational responses can be efficiently mapped out: goal, timing, and scope. Building on our proposed dimensions, we develop a typology of five different organizational responses. With this, we show that organizational responses are more diverse than a one-dimensional scale could show but that the heterogeneity is somehow limited as the positions on the dimensions are not independent but correlated. To understand this observed limited heterogeneity, we proceed by identifying reasons behind different organizational responses. Furthermore, we discuss the theoretical implications of our findings for research on organizational adaptation and sustainability.
Does Scientific Publication Inform Public Discourse? A Case Study Observing Social Media Engagement Around Vaccinations
Authors: Nelon Jordan L. , Moscarelli Michael , Stupka Payton , Sumners Christina , Uselton Taylor , Patterson Megan S.
Published: February 2020

In the early 2000s, there was a shift in the use of the internet. Individuals on the internet began seeking information from other creators and creating their own content. These online communities allowed individuals to communicate across the globe, gravitating toward people like them or those who shared similar beliefs. Conversations around vaccinations have been particularly polarizing across social media even though scientific literature continually validates their safety and effectiveness. This study will explore whether online public discourse about vaccinations changes before and after major scientific publications, and will measure what is related to social engagement around vaccinations on Twitter. In September 2018, two weeks’ worth of Twitter posts ( n = 2,919) discussing vaccinations were collected, coded, and analyzed before and after two major 2014 scientific publications. Linear regression analyses examined variables related to engagement with vaccination-related Tweets pre- and postpublication. Antivaccine-related Tweets decreased by over 25% after scientific publications, while provaccine Tweets increased by 16.6%. Regression models suggest verification status and number of followers were the strongest predictors of Twitter engagement. Findings indicate that scientific publications might affect what people public health information people share online, and how people engage with online content. In a time when false information is easily spread online, this study suggests the need for continual scientific publication on “hot topics,” and urges researchers to partner with influential individuals on social media to disseminate effective, evidence-based, and user-friendly public health information to the public.
Qigong Mind-Body Exercise as a Biopsychosocial Therapy for Persistent Post-Surgical Pain in Breast Cancer: A Pilot Study
Authors: Osypiuk Kamila , Ligibel Jennifer , Giobbie-Hurder Anita , Vergara-Diaz Gloria , Bonato Paolo , Quinn Roxanne , Ng Winnie , Wayne Peter M.
Published: February 2020

Purpose: To assess the feasibility, safety, and preliminary effectiveness of a 12-week multimodal Qigong Mind-Body Exercise (QMBE) program for breast cancer survivors with persistent post-surgical pain (PPSP). Methods: This was a single-arm mixed-methods pilot study. Primary outcome measures were feasibility (recruitment, adherence) and safety. Validated self-report questionnaires were used to evaluate a constellation of interdependent symptoms, including pain, fatigue, mood, exercise, interoceptive awareness, and health-related quality of life at baseline and 12 weeks. A subset of the instruments was administered 6 months postintervention. Shoulder range of motion and grip strength were objectively assessed at baseline and 12 weeks. Qualitative interviews were conducted at baseline and 12 weeks. Results: Twenty-one participants were enrolled; 18 and 17 participants, respectively, completed the 12-week and 6-month outcome assessment. No serious adverse events were reported. Statistically significant improvements were observed at 12 weeks in pain severity and interference, fatigue, anxiety, depression, perceived stress, self-esteem, pain catastrophizing, and several subdomains of quality of life, interoceptive awareness, and shoulder range of motion. Changes in pain, fatigue, pain catastrophizing, anxiety, depression, and quality of life were clinically meaningful. Postintervention effects were sustained at 6 months. Conclusions: QMBE is a safe and gentle multimodal intervention that shows promise in conferring a broad range of psychosocial and physical benefits for breast cancer survivors with PPSP. Results support the value of future studies evaluating the impact of QMBE on multiple outcomes relevant to breast cancer survivors with PPSP.
Paratesticular Mesenchymal Malignancies: A Single-Center Case Series, Clinical Management, and Review of Literature
Authors: Gatto Lidia , Del Gaudio Massimo , Ravaioli Matteo , Cescon Matteo , Tonini Valeria , Cervellera Maurizio , Franceschelli Alessandro , Pirini Maria Giulia , Di Scioscio Valerio , Buia Francesco , Niro Fabio , Capizzi Elisa , Fiorentino Michelangelo , Astolfi Annalisa , Indio Valentina , Nannini Margherita , Pantaleo Maria Abbondanza , Saponara Maristella
Published: February 2020

Background: Primary soft tissue sarcomas arising from the male urinary and genital tract are rare tumors, only accounting for 1% to 2% of all malignancies of the genitourinary tract. Clinical management of advanced disease is lacking in standardized recommendations due to the rarity of the disease. To date, complete and extensive surgery represents the only curative and standardized approach for localized disease, while the impact of retroperitoneal lymphadenectomy and adjuvant treatments on clinical outcomes are still unclear. Similarly, a standardized systemic treatment for advanced metastatic disease is still missing. Cases Presentation: Four out of 274 patients have been identified in our sarcoma population. The mean age was 54 years (range = 45-73). The histotypes showed liposarcoma in 2 cases and leiomyosarcoma in the remaining 2 cases. In all 4 cases, the disease was localized at presentation, patients underwent complete surgery, and no adjuvant treatments were done. Three cases presented a recurrence of disease at a mean follow-up of 86 months (range = 60-106 months), more than 7 years. Two cases were treated with a second surgery and chemotherapy and 1 case only with chemotherapy. Discussion and Conclusions: Sharing data about clinical management of paratesticular mesenchymal tumors is a key issue due to the rarity of this tumor’s subtype. In this article, we report the clinical history of 4 patients affected by paratesticular mesenchymal tumor. In particular, main issues of interest are the decision of postoperative treatment and systemic treatment at time of disease recurrence.
Cell Wall Membrane Fraction of Chlorella sorokiniana Enhances Host Antitumor Immunity and Inhibits Colon Carcinoma Growth in Mice
Authors: Ishiguro Susumu , Robben Nicole , Burghart Riley , Cote Paige , Greenway Sarah , Thakkar Ravindra , Upreti Deepa , Nakashima Ayaka , Suzuki Kengo , Comer Jeffrey , Tamura Masaaki
Published: February 2020

A colon cancer growth inhibitor partially purified from the isolated cell wall membrane fraction of Chlorella sorokiniana, here referred to as Chlorella membrane factor (CMF), was evaluated for its antitumor and immunomodulatory effects in cell culture and in a colon carcinoma mouse model. The CMF treatment dose- and time-dependently inhibited colon carcinoma cell growth in 2-dimensional cultures. Treatment with CMF also significantly inhibited the growth of colon carcinoma spheroids in 3-dimensional cell culture in coculture with T lymphocytes. In a mouse CT26 colon carcinoma peritoneal dissemination model, intraperitoneal injection of CMF (10 or 30 mg dry weight/kg body weight, every other day) dose-dependently and significantly attenuated the growth of tumor nodules via induction of tumor cell apoptosis. Evaluation of immune cell populations in ascites showed that CMF treatment tended to increase T lymphocytes but lower granulocyte populations. The present study suggests that the cell wall membrane fraction of Chlorella sorokiniana contains a bioactive material that inhibits colon carcinoma growth via direct cell growth inhibition and stimulation of host antitumor immunity. Hence, it is suggested that the Chlorella cell wall membrane extract or a bioactive substance in the extract is an attractive complementary medicine for cancer therapy.
Validation of a Novel Needle Holder to Train Advanced Laparoscopy Skills to Novices in a Simulator Environment
Authors: Oussi Ninos , Georgiou Konstantinos , Larentzakis Andreas , Thanasas Dimitrios , Castegren Markus , Georgiou Evangelos , Enochsson Lars
Published: February 2020

Background. Our aim was to determine if a newly designed Najar needle holder (NNH) shortens the time for novices to improve advanced laparoscopy (AL) techniques (suturing/knot tying), compared with a conventional macro needle holder (MNH) in a simulator. Furthermore, we aimed to validate a new video scoring system determining AL skills. Methods. Forty-six medical students performed identical surgical tasks in a prospective, crossover study evaluating AL skills (NNH vs MNH). All subjects performed a double-throw knot, 2 single-throw knots following 3 running sutures in the Simball Box (SB) simulator. After resting, subjects switched needle holders. All tasks were videotaped and analyzed using SB software and by 2 independent reviewers using the Objective Video Evaluation Scoring Table (OVEST). Trial performance expressed as SB Overall Score (SBOS) and OVEST. Results. In the group starting with NNH (followed by MNH) OVEST was consistently high during both trials (median = 12.5, range = 6.5-18.0, and median = 13.5, range = 6.5-21.0; P = .2360). However, in the group starting with MNH, OVEST improved significantly when the participants changed to NNH (median = 10.0, range = 2.5-19.5, vs median = 14.5, range = 4.5-18.0; P = .0003); an improvement was also found with SBOS (median = 37%, range = 27% to 92%, vs median = 48%, range = 34% to 70%; P = .0289). In both trials, both independent reviewers’ OVEST measures correlated well: Trial 1: β = 0.97, P < .0001; and Trial 2: β = 0.95, P < .0001. A correlation also existed between SBOS and OVEST in both trials (β = 2.1, P < .0001; and β = 1.9, P = .0002). Conclusions. This study indicates a significantly higher improvement in laparoscopic suturing skills in novices training AL skills using NNH compared with MNH. Starting early, AL training in novices using NNH is a feasible option. Furthermore, OVEST used in experimental settings as an evaluation tool is comparable with the validated SBOS.
Single-Port Sleeve Gastrectomy Compared With Conventional Laparoscopic Sleeve Gastrectomy: 5-Year Follow-up of Weight Loss, Comorbidity Resolution, and Cost
Authors: Khidir Nesreen , Gagner Michel , El Matbouly Moamena , El Ansari Walid , Billy Helmuth , Karam Mohsen , Sargsyan Davit , Alkuwari Mohammed , Bashah Moataz
Published: February 2020

Background. The Single-Port Instrument Delivery Extended Reach (SPIDER) surgical system is a safe revolutionary technology that defeated difficulties of single-incision surgery. We assessed the long-term outcomes of SPIDER sleeve gastrectomy (SPIDER SG) versus conventional laparoscopic sleeve gastrectomy (LSG) in morbidly obese patients. Methods. Retrospective review of patients who underwent SPIDER SG or LSG in our center matched by the date of surgery (2012-2013). We reviewed weight loss results up to 5 years, complication rates, procedure and hospitalization durations, financial cost, and effect on comorbidities. Results. Patients underwent 200 SPIDER SG and 220 LSG. At baseline, SPIDER SG versus LSG patients had a mean body mass index of 43.8 ± 5.6 and 48.6 ± 8.1 kg/m2, respectively. At 1 year, both groups had comparable percentage of excess weight loss (%EWL). At 5 years, SPIDER SG had %EWL of 54.6 ± 24.8 compared with 57.8 ± 29.9 in LSG ( P = .4). Nine SPIDER SG (4.5%) required conversion to LSG. Complications occurred in both groups: 4% versus 4.1% ( P = .95). At 2-year follow-up, diabetes mellitus was reversed in 43% of SPIDER SG and 62% LSG. Despite a shorter hospital stay in SPIDER SG, the total cost was significantly higher ($2 041 477) compared with LSG ($1 773 834). The mean score of scar satisfaction was significantly more in SPIDER SG. Conclusions. SPIDER SG was safe with long-term effects on weight loss comparable to LSG. Despite the higher cost of SPIDER SG, a shorter hospital stay and better cosmesis were observed.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Disease or Symptom? Current Perspectives on Diagnosis, Treatment, and Prognosis
Authors: Zhang Jianzhong , Liang ChaoZhao , Shang Xuejun , Li Hongjun
Published: February 2020

Definitive diagnosis and selection of effective treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are frustrations encountered frequently by urology care providers in their practice. Knowledge of etiology and pathophysiology is not sufficient and therapeutic guidelines have not yielded acceptable outcomes and prognoses for both patients and care providers. The authors present updated perspectives on CP/CPPS, including definition, diagnosis, treatment, and prognosis, based on literature review and clinical experience. A key point is to shift the diagnostic and therapeutic focus from a single entity of disease toward associated symptoms of CP/CPPS. An individualized multimodal treatment approach to cope with the course of the disorder is proposed. Communications and personal/family/community supports are emphasized as an important component in the therapeutic regime and rehabilitation of patients with CP/CPPS. The purpose is to improve comprehension on CP/CPPS and to help care providers and patients to achieve the goal of medical intervention—relieving associated symptoms of CP/CPPS and improving the quality of life.
Unplanned Reoperation and Implant Revision After Total Wrist Arthroplasty
Authors: Pong Taylor M. , van Leeuwen Wouter F. , Oflazoglu Kamil , Blazar Philip E. , Chen Neal
Published: February 2020

Background: Total wrist arthroplasty (TWA) is a treatment option for many debilitating wrist conditions. With recent improvements in implant design, indications for TWA have broadened. However, despite these improvements, there are still complications associated with TWA, such as unplanned reoperation and eventual implant removal. The goal of this study was to identify risk factors for an unplanned reoperation or implant revision after a TWA at 2 academic medical centers between 2002 and 2015. Methods: In this retrospective study, 24 consecutive TWAs were identified using CPT codes. Medical records were manually reviewed to identify demographic, patient- or disease-related, and surgery-related risk factors for reoperation and implant removal after a primary TWA. Results: Forty-six percent of wrists (11 of 24 TWAs performed) had a reoperation after a median of 3.4 years, while 29% (7 of 24) underwent implant revision after a median of 5 years. Two patients had wrist surgery prior to their TWA, both eventually had their implant removed ( P = .08). There were no risk factors associated with reoperation or implant removal. Conclusion: Unplanned reoperation and implant removal after a primary TWA are common. Approximately 1 in 3 wrists are likely to undergo revision surgery. We found no factors associated with reoperation or implant removal; however, prior wrist surgery showed a trend toward risk of implant removal after TWA.
Using Data and Research to Heal the Future
Authors: Maughan Erin D.
Published: February 2020

This invited testimony was given during a Robert Wood Johnson Foundation and Campaign for Action meeting held in New Orleans, LA. The meeting was held in conjunction with the Future of Nursing Town Hall in Chicago that focused on social determinants of health. The focus of the meeting was school health and social determinants of health. The author, serving as Director of Research for NASN, was asked to specifically focus on NASN’s efforts related to data and research, as well as social determinants of health.
Advocating for Students and School Nursing: NASN Contributions to the Future of Nursing 2020-2030
Authors: Maughan Erin D. , Combe Laurie G. , Mazyck Donna , Mendonca Linda
Published: February 2020

The Future of Nursing (FON) 2020-2030 will be an important roadmap for advancing the profession of nursing. The final FON document is meant to address nursing as a whole—not specific specialties—as well as address changes needed in the entire healthcare system that would facilitate patient safety and care. To ensure inclusion of the needs of school-age children and nurses employed outside the traditional hospital setting in the proceedings, the NASN offered comments at the first public meeting of the Committee on the Future of Nursing in March 2019 (Figure 1) and followed the other town hall meetings carefully. NASN submitted the following observations and suggestions in the form of a memo to the FON 2020-2030 Committee for consideration in the final report.
Does Every Student Count! in Your State? Update on the National School Nurse Dataset
Authors: Maughan Erin D.
Published: February 2020

The NASN launched a new data initiative in 2018 called: The National School Health Data Set: Every Student Counts! The initiative includes three distinct foci or prongs. This article reports on the progress of states participating in Every Student Counts! For more information on NASN’s initiative and to learn how school nurses can join the data revolution, go to http://nasn.org/everystudentcounts .
The Internal Realities of Individuals With Type 2 Diabetes: Mediators Influencing Self-Management Beliefs via Grounded Theory Approach
Authors: Swarna Nantha Yogarabindranath , Haque Shamsul , Paul Chelliah Azriel Abisheg , Md Zain Anuar Zaini , Kim Yen Gan
Published: February 2020

Background: There has been an unabated rise in the prevalence of type 2 diabetes (T2D) worldwide. Although T2D is highly preventable, these trends suggest that a paradigm change is much needed in the way both clinicians and policy makers view what effective T2D strategies conventionally entail. Hence, it is becoming increasingly clear that T2D patients require more than just a pharmacological approach to their disease. Evidence indicate that culturally specific mediators can help foster better self-management practices. We intend to discover psychosocial mediators that influence and support self-management beliefs in T2D patients. Methods: We adopted the grounded theory approach to guide in-depth interviews with T2D patients and health care professionals (HCP) at a regional primary care clinic in Malaysia. Twenty-four T2D patients and 10 HCPs were recruited through purposive sampling method to examine the inner psychological narratives about how they perceive and what they believe beliefs about the disease. Two focus group discussions were also were conducted for data triangulation. Results: A functional framework for the psychosocial mediators influencing self-management beliefs in T2D patients was designed and characterized by 4 major processes: (1) health promotion, (2) personal expectations, (3) person-centered care, and (4) psychosocial support. The fulfillment of patients’ personal expectations is central to better self-management beliefs. Conclusions: Positive emotional states are important in providing a positive environment to nurture self-management practices. A person-centered consultation that focuses on empathy and cultural sensitivities has the potential to foster behavioral change required to sustain self-care practices.
Making the Random the Usual: Appreciative Inquiry/Boot Camp Translation—Developing Community-Oriented Evidence That Matters
Authors: Nease Donald E , Simpson Matthew J. , Zittleman Linda , Holtrop Jodi Summers , Hall Tristen L. , Fisher Mary , Felzien Maret , Westfall John M.
Published: February 2020

Background: The evidence underlying clinical guidelines arising from typical scientific inquiry may not always match the needs and concerns of local communities. Our High Plains Research Network Community Advisory Council (HPRN CAC) identified a need for evidence regarding how to assist members of their community suffering from mental health issues to recognize their need for help and then obtain access to mental health care. The lack of evidence led our academic team to pursue linking Appreciative Inquiry with Boot Camp Translation (AI/BCT). This article describes the development and testing of this linked method. Method: We worked with the HPRN CAC and other communities affiliated with the State Networks of Colorado Ambulatory Practices and Partners (SNOCAP) practice-based research networks to identify 5 topics for testing of AI/BCT. For each topic, we developed AI interview recruitment strategies and guides with our community partners, conducted interviews, and analyzed the interview data. Resulting themes for each topic were then utilized by 5 groups with the BCT method to develop community relevant messages and materials to communicate the evidence generated in each AI set of interviews. At each stage for each topic, notes on adaptations, barriers, and successes were recorded by the project team. Results: Each topic successfully led to generation of community specific evidence, messages, and materials for dissemination using the AI/BCT method. Beyond this, 5 important lessons emerged regarding the AI/BCT method: Researchers must (1) first ensure whether the topic is a good fit for AI, (2) maintain a focus on “what works” throughout all stages, (3) recruit one or more experienced qualitative analysts, (4) ensure adequate time and resources for the extensive AI/BCT process, and (5) present AI findings to BCT participants in the context of existing evidence and the local community and allow time for community partners to ask questions and request additional data analyses to be done. Conclusions: AI/BCT represents an effective way of responding to a community’s need for evidence around a specific topic where standard evidence and/or guidelines do not exist. AI/BCT is a method for turning the “random” successes of individuals into “usual” practice at a community level.
Acquisition of Cholera Within the United States
Authors: Maniam Ganesh , Nguyen Emily N. , Milton John Scott
Published: February 2020

Cholera has been woven into human history through numerous pandemics, with the most recent ongoing since 1961. Global rates of cholera continue to decline, but outbreaks continue to pose diagnostic challenges for clinicians, which delays initiation of treatment and prolongs the disease course. Despite millions of infections and thousands of deaths worldwide each year, cholera remains rare in the United States, with the few cases each year usually being the result of pathogen acquisition while the patient traveled abroad. This article presents a unique case of cholera acquired in the United States, which emphasizes the necessary vigilance of symptom recognition, in the context of appropriate clinical investigation, in ensuring that the patient had a full recovery. Cholera in the United States is exceedingly rare, yet effective diagnosis with early initiation of treatment is known to reduce mortality and shorten disease course. While other more common diagnoses must definitely be excluded first, it is important for cholera to be kept on the differential for patients presenting with treatment refractory, watery diarrhea causing hypotension. This case of a patient with a recent travel history to Hawaii and infection with cholera underscores the importance of investigative medicine and clinical expertise in optimizing patient care, even when presented with rare illnesses.
Teaching History Through Theater: The Effects of Arts Integration on Students’ Knowledge and Attitudes
Authors: Kisida Brian , Goodwin Laura , Bowen Daniel H.
Published: February 2020

Faced with accountability pressures and limited resources, education policymakers make difficult choices regarding school curricula. In recent years, studies have documented a decreased emphasis in arts and humanities instruction. One potential way for schools to fill this gap includes partnering with arts and cultural organizations to provide arts learning opportunities through arts integration, yet there is limited evidence on the effectiveness of such programs. We examine one such partnership by evaluating the efficacy of a program that infuses history content with theater. By randomly assigning school groups to participate in this program, we are able to draw causal conclusions about its effects. We find that students demonstrate increases in historical content knowledge, enthusiasm for learning about history, historical empathy, and interest in the performing arts as a result of this program. These findings suggest that there are valuable educational benefits from arts-integrated learning opportunities provided through school partnerships with arts organizations.
Detecting Prefrailty: Comparing Subjective Frailty Assessment and the Paulson–Lichtenberg Frailty Index
Authors: Hu Yi-Ling , Patel Pragnesh , Fritz Heather
Published: February 2020

We examined the level of agreement between subjective frailty assessments (SFA) and frailty classifications derived from the validated Paulson–Lichtenberg Frailty Index (PLFI). Clinic patients ( n = 202) were classified as healthy, prefrail, or frail first by screening using the PLFI and later by two geriatric nurses and two geriatricians according to SFA. Of the 202 participants (mean age = 76.7 ± 8.6), 52 (26%) were prefrail and 57 (28%) were frail based on the PLFI. Geriatrician SFA aligned with the PLFI in 43.0% of prefrail and 65.7% of frail cases. Nurse SFA aligned with the PLFI in 43.9% of prefrail and 17.0% of frail cases. There was slight-to-fair agreement between SFA and PLFI (geriatrician: Cohen’s κ = .23; 95% confidence interval (CI) = [.11, .35], p < .001; nurse: Cohen’s κ = .20; 95% CI = [.08, .33], p = .001). Clinician SFA did not align well with PLFI classifications.
CD49d promotes disease progression in chronic lymphocytic leukemia: new insights from CD49d bimodal expression
Authors: Tissino Erika , Pozzo Federico , Benedetti Dania , Caldana Chiara , Bittolo Tamara , Rossi Francesca Maria , Bomben Riccardo , Nanni Paola , Chivilò Hillarj , Cattarossi Ilaria , Zaina Eva , Norris Kevin , Polesel Jerry , Gentile Massimo , Tripepi Giovanni , Moia Riccardo , Santinelli Enrico , Innocenti Idanna , Olivieri Jacopo , D’Arena Giovanni , Laurenti Luca , Zaja Francesco , Pozzato Gabriele , Chiarenza Annalisa , Di Raimondo Francesco , Rossi Davide , Pepper Chris , Hartmann Tanja Nicole , Gaidano Gianluca , Del Poeta Giovanni , Gattei Valter , Zucchetto Antonella
Published: February 2020

CD49d is a remarkable prognostic biomarker of chronic lymphocytic leukemia (CLL). The cutoff value for the extensively validated 30% of positive CLL cells is able to separate CLL patients into 2 subgroups with different prognoses, but it does not consider the pattern of CD49d expression. In the present study, we analyzed a cohort of 1630 CLL samples and identified the presence of ∼20% of CLL cases (n = 313) characterized by a bimodal expression of CD49d, that is, concomitant presence of a CD49d+ subpopulation and a CD49d− subpopulation. At variance with the highly stable CD49d expression observed in CLL patients with a homogeneous pattern of CD49d expression, CD49d bimodal CLL showed a higher level of variability in sequential samples, and an increase in the CD49d+ subpopulation over time after therapy. The CD49d+ subpopulation from CD49d bimodal CLL displayed higher levels of proliferation compared with the CD49d− cells; and was more highly represented in the bone marrow compared with peripheral blood (PB), and in PB CLL subsets expressing the CXCR4dim/CD5bright phenotype, known to be enriched in proliferative cells. From a clinical standpoint, CLL patients with CD49d bimodal expression, regardless of whether the CD49d+ subpopulation exceeded the 30% cutoff or not, experienced clinical behavior similar to CD49d+ CLL, both in chemoimmunotherapy (n = 1522) and in ibrutinib (n = 158) settings. Altogether, these results suggest that CD49d can drive disease progression in CLL, and that the pattern of CD49d expression should also be considered to improve the prognostic impact of this biomarker in CLL.
Effect of moonseed vine (Triclisia gilletii Staner) on ethane-1,2-diol-induced urolithiasis and its renotoxicity in Wistar albino rats
Authors: Olayeriju O. S. , Crown O. O. , Elekofehinti O. O. , Akinmoladun A. C. , Olaleye M. T. , Akindahunsi A. A.
Published: February 2020

Background

Moonseed vine (Triclisia gilletiiStaner) in the family Menispermaceae is a robust creeper of up to 10 cm diameter, of the lowland dense rain forest. In Ondo State, located in the South Western part of Nigeria, the plant which is usually called Peshe is used for the management of renal-related ailments. The present study was undertaken to explore the efficacy ofTriclisia gilletii, a folkloric therapy in the management of renal-related ailment.

Results

Phenols, steroids, saponins, and flavonoids are present in the TGME with a total antioxidant capacity of (30.36 ± 1.90 (mg GAE/g extract), LD50greater than 5000 mg/kg b.w., and in vitro anti-nucleation activity (iC50 = 7.09 mg/mL). Calcium oxalate stone formation as a result of oxalate from ethane-1,2-diol was evident by hypocalcemia, and further electrolyte imbalance and decreased glomerular filtration rate. The enhanced oxidative milieu in hyperoxaluria was evident by increased MDA and PC and decreased enzymatic and non-enzymatic antioxidants as well as renal membrane enzymes activities. The renal histopathological study further emphasized oxalate-induced damage and the ameliorative potential of TGME.

Conclusion

The abnormal biochemical, redox electrolyte, membrane integrity, and histological alterations were attenuated by TGME which affirms its usage as nephroprotectant.
A microcarrier-based spheroid 3D invasion assay to monitor dynamic cell movement in extracellular matrix
Authors: Liu Hui , Lu Tao , Kremers Gert-Jan , Seynhaeve Ann L. B. , ten Hagen Timo L. M.
Published: February 2020

Background

Cell invasion through extracellular matrix (ECM) is a critical step in tumor metastasis. To study cell invasion in vitro, the internal microenvironment can be simulated via the application of 3D models.

Results

This study presents a method for 3D invasion examination using microcarrier-based spheroids. Cell invasiveness can be evaluated by quantifying cell dispersion in matrices or tracking cell movement through time-lapse imaging. It allows measuring of cell invasion and monitoring of dynamic cell behavior in three dimensions. Here we show different invasive capacities of several cell types using this method. The content and concentration of matrices can influence cell invasion, which should be optimized before large scale experiments. We also introduce further analysis methods of this 3D invasion assay, including manual measurements and homemade semi-automatic quantification. Finally, our results indicate that the position of spheroids in a matrix has a strong impact on cell moving paths, which may be easily overlooked by researchers and may generate false invasion results.

Conclusions

In all, the microcarrier-based spheroids 3D model allows exploration of adherent cell invasion in a fast and highly reproducible way, and provides informative results on dynamic cell behavior in vitro.
scHaplotyper: haplotype construction and visualization for genetic diagnosis using single cell DNA sequencing data
Authors: Yan Zhiqiang , Zhu Xiaohui , Wang Yuqian , Nie Yanli , Guan Shuo , Kuo Ying , Chang Di , Li Rong , Qiao Jie , Yan Liying
Published: February 2020

Background

Haplotyping reveals chromosome blocks inherited from parents to in vitro fertilized (IVF) embryos in preimplantation genetic diagnosis (PGD), enabling the observation of the transmission of disease alleles between generations. However, the methods of haplotyping that are suitable for single cells are limited because a whole genome amplification (WGA) process is performed before sequencing or genotyping in PGD, and true haplotype profiles of embryos need to be constructed based on genotypes that can contain many WGA artifacts.

Results

Here, we offer scHaplotyper as a genetic diagnosis tool that reconstructs and visualizes the haplotype profiles of single cells based on the Hidden Markov Model (HMM). scHaplotyper can trace the origin of each haplotype block in the embryo, enabling the detection of carrier status of disease alleles in each embryo. We applied this method in PGD in two families affected with genetic disorders, and the result was the healthy live births of two children in the two families, demonstrating the clinical application of this method.

Conclusion

Next generation sequencing (NGS) of preimplantation embryos enable genetic screening for families with genetic disorders, avoiding the birth of affected babies. With the validation and successful clinical application, we showed that scHaplotyper is a convenient and accurate method to screen out embryos. More patients with genetic disorder will benefit from the genetic diagnosis of embryos. The source code of scHaplotyper is available at GitHub repository:https://github.com/yzqheart/scHaplotyper.
The effect of preoperative anxiety level on mean platelet volume and propofol consumption
Authors: Uysal Ali İhsan , Altıparmak Başak , Korkmaz Toker Melike , Dede Gülseda , Sezgin Çiğdem , Gümüş Demirbilek Semra
Published: February 2020

Background

The mean platelet volume (MPV) is an important indicator of platelet function with large platelets showing higher enzymatic and metabolic activity than other platelets. There can be a relationship between increased platelet activity and anxiety and depression. Our primary hypothesis was that patients with high anxiety scores would have higher MPV, and the secondary hypothesis was that propofol induction time and total propofol consumption within the first 30 min of surgery would be higher in patients with higher anxiety scores.

Methods

The Beck Anxiety Inventory (BAI) was administered to the participating patients 1 day before surgery to evaluate the level of anxiety. Based on the scores from the BAI, 40 patients with an anxiety score of < 8 were assigned to the non-anxious group (Group NA) and 40 patients with an anxiety score of ≥8 were assigned to the anxious group (Group A). At the anesthesia induction the mean time to achieve an entropy value below 60 (T1) was recorded. The total intraoperative propofol consumption within the first 30 min was recorded.

Results

There was a statistically significant difference between the groups in terms of preoperative MPV and demographic data, including age and sex. The mean total propofol consumption at 30 min after induction in the groups was statistically significant. The cut-off value for MPV was calculated as 9.65.

Conclusions

The preoperative MPV values and propofol consumption at 30 min among patients with high preoperative anxiety scores were high. We suggest that MPV is helpful in the clinical practice in predicting the amount of anesthetic agents required for the 30 mins of anesthesia.
Written patient information materials used in general practices fail to meet acceptable quality standards
Authors: Posch Nicole , Horvath Karl , Wratschko Kerstin , Plath Jasper , Brodnig Richard , Siebenhofer Andrea
Published: February 2020

Background

Patient information materials and decision aids are essential tools for helping patients make informed decisions and share in decision-making. The aim of this study was to investigate the quality of the written patient information materials available at general practices in Styria, Austria.

Methods

We asked general practitioners to send in all patient information materials available in their practices and to answer a short questionnaire. We evaluated the materials using the Ensuring Quality Information for Patients (EQIP-36) instrument.

Results

A total of 387 different patient information materials were available for quality assessment. These materials achieved an average score of 39 out of 100. The score was below 50 for 78% of all materials. There was a significant lack of information on the evidence base of recommendations. Only 9 % of the materials provided full disclosure of their evidence sources. We also found that, despite the poor quality of the materials, 89% of general practitioners regularly make active use of them during consultations with patients.

Conclusion

Based on international standards, the quality of patient information materials available at general practices in Styria is poor. The vast majority of the materials are not suitable as a basis for informed decisions by patients. However, most Styrian general practitioners use written patient information materials on a regular basis in their daily clinical practice. Thus, these materials not only fail to help raise the health literacy of the general population, but may actually undermine efforts to enable patients to make shared informed decisions. To increase health literacy, it is necessary to make high quality, evidence-based and easy-to-understand information material available to patients and the public. For this, it may be necessary to set up a centralized and independent clearinghouse.
Does long-term recreational gymnastics prevent injurious falls in older women? A prospective 20-year follow-up
Authors: Uusi-Rasi Kirsti , Karinkanta Saija , Kannus Pekka , Tokola Kari , Sievänen Harri
Published: February 2020

Background

Exercise interventions focusing on balance and strength training have been shown to be effective for falls prevention. The aim of this 20-year register-based follow-up was to examine whether long-term participation in recreational female gymnastics is associated with a lower risk of medically-attended injurious falls.

Methods

Health care register data of 187 women (103 recreational gymnasts and 84 sedentary controls) from the original cohort of 243 women were assessed. The mean age (sd) at baseline was 62.8 (5.4) years and the mean follow-up time was 19.4 (2.7) years (range from 5.6 to 21.0 years).

Injurious falls were scrutinized from medical records. An injurious fall was defined as an event in which falling was mentioned as a reason for making contact with health-care professionals. Negative binomial regression was used to estimate incidence rate ratios (IRR) for injurious falls, and Cox-regression models for calculating hazard ratios (HR) for injured fallers with the control group as reference.

Results

Recreational gymnasts had about 30% less injurious falls compared to controls, the mean IRR (95% CI) being 0.71 (0.51 to 0.96). The HR for injured fallers was 0.73 (0.52 to 1.02) favoring the recreational gymnasts. There were no statistically significant between-group differences for fractures.

Conclusions

Long-term recreational gymnastics appears to reduce the risk of injurious falls in old age.
Multiplex bacterial polymerase chain reaction in a cohort of patients with pleural effusion
Authors: Franchetti Léo , Schumann Desiree M. , Tamm Michael , Jahn Kathleen , Stolz Daiana
Published: February 2020

Background

The identification of the pathogens in pleural effusion has mainly relied on conventional bacterial culture or single species polymerase chain reaction (PCR), both with relatively low sensitivity. We investigated the efficacy of a commercially available multiplex bacterial PCR assay developed for pneumonia to identify the pathogens involved in pleural infection, particularly empyema.

Methods

A prospective, monocentric, observational study including 194 patients with pleural effusion. Patients were evaluated based on imaging, laboratory values, pleura ultrasound and results of thoracentesis including conventional microbiology studies during hospitalisation. Multiplex bacterial PCR (Curetis Unyvero p55) was performed in batch and had no influence on therapeutic decisions.

Results

Overall, there were 51/197 cases with transudate and 146/197 with exudate. In 42% (n = 90/214) there was a clinical suspicion of parapneumonic effusion and the final clinical diagnosis of empyema was made in 29% (n = 61/214) of all cases. The most common microorganisms identified in the cases diagnosed with empyema were anaerobes [31] followed by gram-positive cocci [10] and gram-negative rods [4]. The multiplex PCR assay identified more of the pathogens on the panel than the conventional methods (23.3% (7/30) vs. 6.7% (2/30), p = 0.008).

Conclusion

The multiplex PCR-based assay had a higher sensitivity and specificity than conventional microbiology when only the pathogens on the pneumonia panel were taken into account. A dedicated pleural empyema multiplex PCR panel including anaerobes would be needed to cover most common pathogens involved in pleural infection.
Variables associated with use of symptomatic medication during a headache attack in individuals with tension-type headache: a European study
Authors: Fernández-de-las-Peñas César , Palacios-Ceña Maria , Castaldo Matteo , Wang Kelun , Guerrero-Peral Ángel , Catena Antonella , Arendt-Nielsen Lars
Published: February 2020

Background

Pharmacological treatment of patients with tension-type headache (TTH) includes symptomatic (acute) and prophylactic (preventive) medication. No previous study has investigated variables associated to symptomatic medication intake in TTH. Our aim was to assess the association of clinical, psychological and neurophysiological outcomes with the use and timing of the use of symptomatic medication in TTH.

Methods

A longitudinal observational study was conducted. One hundred and sixty-eight (n = 168) patients with TTH participated. Pain features of the headache (intensity, frequency, duration), burden of headache (Headache Disability Inventory), sleep quality (Pittsburgh Sleep Quality Index), anxiety/depression (Hospital Anxiety and Depression Scale), trait/state anxiety levels (State-Trait Anxiety Inventory), and bilateral pressure pain thresholds on the temporalis, C5-C6 joint, second metacarpal and tibialis anterior were assessed. Symptomatic medication intake was also collected for a 6-months follow-up period. Differences between patients using or not using symptomatic medication, depending on self-perceived effectiveness, and time (early during an attack, i.e., the first 5 min, or when headache attack is intense) when the symptomatic medication was taken were calculated.

Results

One hundred and thirty-six (n = 136, 80%) reported symptomatic medication intake for headache (73% NSAIDs). Sixteen (12%) reported no pain relief, 81 (59%) experienced moderate relief and 39 (29%) total pain relief. Fifty-eight (43%) took ‘early medication’ whereas 78 (57%) took ‘late medication’. Patients taking symptomatic medication in general showed lower headache frequency and lower depressive levels than those patients not taking medication. Symptomatic medication was more effective in patients with lower headache history, frequency, and duration, and lower emotional burden. No differences in pressure pain sensitivity were found depending on the self-perceived effectiveness of medication. Patients taking ‘late symptomatic’ medication exhibited more widespread pressure pain sensitivity than those taking ‘early medication’.

Conclusions

This study found that the effectiveness of symptomatic medication was associated with better headache parameters (history, frequency, or duration) and lower emotional burden. Further, consuming early symptomatic medication at the beginning of a headache attack (the first 5 min) could limit widespread pressure pain sensitivity.