bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative efficacy and safety of low‐intensity warfarin therapy in preventing unprovoked recurrent venous thromboembolism: A systematic review and meta‐analysis
Authors: Jiang Rong , Shi Yu , Zhang Rui , Pudasain Bigyan , Wang Lan , Zhao Qin‐Hua , Yuan Ping , Guo Jian , Zhu Chang‐Tai , Liu Jin‐Ming
Published: March 2018

Background

Although there exists potential risk of bleeding, extended ‘lifelong’ conventional‐intensity [international normalized ratio (INR): 2.0‐3.0] warfarin anticoagulation is recommended for unprovoked venous thromboembolism (VTE) patients because of risk of recurrent VTE. Whether long‐term low‐intensity (INR: 1.5‐2.0) warfarin therapy reduced the risk of major bleeding without substantially lowered antithrombotic efficacy is not well understood. The aim of this study was to perform a systematic review and meta‐analysis to evaluate the risk‐benefits of low‐intensity warfarin therapy.

Methods

We conducted a comprehensive search of electronic databases and included randomized control trials (RCTs) that reported efficacy (recurrent VTE) and safety (bleeding episodes) of low‐intensity warfarin therapy compared with conventional‐intensity warfarin or placebo from inception through Jun 2016.

Results

Four RCTs reporting high GRADE quality evidence were included. Although the relative risk of recurrent VTE with low‐intensity therapy was significantly increased [2.96 (95% CI: 1.40 to 6.24), P < .004] compared to conventional‐intensity warfarin, there was significant decrease of relative risk when compared with placebo [0.37 (95% CI: 0.24 to 0.56), P < .00001]. As per included publications, no significant major bleeding episodes were observed in low‐intensity warfarin group.

Conclusions

Although less effective than conventional‐intensity warfarin therapy this meta‐analysis indicates that long‐term low‐intensity warfarin therapy is highly effective for preventing recurrent VTE than placebo, along with reduced risks of major bleeding and minimizing potential complications.
Supervised physical exercise improves clinical, anthropometric and biochemical parameters in adult cystic fibrosis patients: A 2‐year evaluation
Authors: Elce Ausilia , Nigro Ersilia , Gelzo Monica , Iacotucci Paola , Carnovale Vincenzo , Liguori Renato , Izzo Viviana , Corso Gaetano , Castaldo Giuseppe , Daniele Aurora , Zarrilli Federica
Published: March 2018

Objective

Cystic fibrosis (CF) is the most common inherited, life limiting condition among Caucasians. No healing therapy is currently available for patients with CF. The aim of the study was to define clinical, anthropometric and biochemical effects of regular, supervised physical exercise in a large cohort of patients with CF.

Materials and Methods

Fifty‐nine adult patients with CF that performed regularly supervised physical exercise in the last 3 years in comparison to 59 sex and age matched sedentary patients with CF were included in the study.

Results

Physical exercise had significantly beneficial effects on: (a) FEV1% decline; (b) anthropometric parameters (lower number of cases with altered BMI, waist and arm circumferences); (c) lipid and glucose metabolism; (d) vitamin D serum levels. Of course, some of this improvement may be because of the better adherence to therapy typical of patients with CF that perform physical activity.

Conclusions

Such clinical and metabolic effects make supervised physical activity one of the hubs in managing patients with CF.
Phenotypes, genotypes, and the management of paroxysmal movement disorders
Authors: Silveira‐Moriyama Laura , Kovac Stjepana , Kurian Manju A , Houlden Henry , Lees Andrew J , Walker Matthew C , Roze Emmanuel , Paciorkowski Alex R , Mink Jonathan W , Warner Thomas T
Published: March 2018

As a consequence of the genomic revolution, a large number of publications describing paroxysmal movement disorders have been published in the last few years, shedding light on their molecular pathology. Routine gene testing is not necessary to guide treatment for typical forms of paroxysmal kinesigenic dyskinesia (PKD), paroxysmal nonkinesigenic dyskinesia (PNKD), and episodic ataxia type 1 or 2. It can, however, be helpful in the management of atypical or complex cases, especially for genetic counselling, treatment strategies, and the offer of preimplantation genetic diagnosis. Antiepileptic drugs remain the treatment of choice for PKD and episodic ataxia type 1, benzodiazepines are often useful for PNKD, and episodic ataxia type 2 benefits from acetazolamide regardless of the genetic etiology.

What the paper adds

A growing number of genes have been associated with classic and newly described paroxysmal movement disorders.

Paroxysmal movement disorders share common mechanisms and clinical features with other neurological paroxysmal phenomena including epilepsy and migraine.
Speckle tracking analysis in intensive care unit: A toy or a tool?
Authors: D'Andrea Antonello , Radmilovic Juri , Mele Donato , D'Ascenzi Flavio , Agricola Eustachio , Carbone Andreina , Lo Iudice Francesco , Novo Giuseppina , Ancona Francesco , Righini Francesca Maria , Mondillo Sergio , Bossone Eduardo , Galderisi Maurizio ,   the Working Group on Echocardiography of the Italian Society of Cardiology
Published: March 2018

The use of conventional echocardiography in the intensive care unit (ICU) is today established to assess left and right ventricular systolic function, for preload determination and procedural guidance. Next step in ICU echocardiography could be the use of novel ultrasound techniques such as strain echocardiography to assist in the management of patients with acute coronary syndrome, heart failure, or pulmonary embolism. This review has gathered the available evidence supporting the incremental value of strain in the diagnostic workup of cardiac diseases treated in ICU.
Acute aortic regurgitation following fibrous strand rupture of aortic valve successfully diagnosed by transesophageal echocardiography
Authors: Nishida Hidefumi , Suenaga Etsuro , Ishii Katsuhisa
Published: March 2018

Fibrous strand rupture is a rare cause of acute aortic regurgitation, but is a serious condition because of acute massive regurgitation. Therefore, prompt and accurate diagnosis is required. We saw a 53‐year‐old man who presented with acute dyspnea without evidence of infection. Transesophageal echocardiography revealed severe aortic regurgitation because of fibrous strand rupture. We performed surgery and found that the fibrous strand of the right coronary leaflet was ruptured. In cases of acute aortic regurgitation, the rupture of fibrous strand should be considered and transesophageal echocardiography would be very useful to diagnose it.
Dose‐dependent modulation of the visually evoked N1/N170 by perceptual surprise: a clear demonstration of prediction‐error signalling
Authors: Robinson Jonathan E. , Breakspear Michael , Young Andrew W. , Johnston Patrick J.
Published: March 2018

Prediction‐error checking processes play a key role in predictive coding models of perception. However, neural indices of such processes have yet to be unambiguously demonstrated. To date, experimental paradigms aiming to study such phenomena have relied upon the relative frequency of stimulus repeats and/or ‘unexpected’ events that are physically different from ‘expected’ events. These features of experimental design leave open alternative explanations for the observed effects. A definitive demonstration requires that presumed prediction error‐related responses should show contextual dependency (rather than simply effects of frequency or repetition) and should not be attributable to low‐level stimulus differences. Most importantly, prediction‐error signals should show dose dependency with respect to the degree to which expectations are violated. Here, we exploit a novel experimental paradigm specifically designed to address these issues, using it to interrogate early latency event‐related potentials (ERPs) to contextually expected and unexpected visual stimuli. In two electroencephalography (EEG) experiments, we demonstrate that an N1/N170 evoked potential is robustly modulated by unexpected perceptual events (‘perceptual surprise’) and shows dose‐dependent sensitivity with respect to both the influence of prior information and the extent to which expectations are violated. This advances our understanding of perceptual predictions in the visual domain by clearly identifying these evoked potentials as an index of visual surprise.
Plant controls on Late Quaternary whole ecosystem structure and function
Authors: Jeffers Elizabeth S. , Whitehouse Nicki J. , Lister Adrian , Plunkett Gill , Barratt Phil , Smyth Emma , Lamb Philip , Dee Michael W. , Brooks Stephen J. , Willis Katherine J. , Froyd Cynthia A. , Watson Jenny E. , Bonsall Michael B.
Published: March 2018

Plants and animals influence biomass production and nutrient cycling in terrestrial ecosystems; however, their relative importance remains unclear. We assessed the extent to which mega‐herbivore species controlled plant community composition and nutrient cycling, relative to other factors during and after the Late Quaternary extinction event in Britain and Ireland, when two‐thirds of the region's mega‐herbivore species went extinct. Warmer temperatures, plant–soil and plant–plant interactions, and reduced burning contributed to the expansion of woody plants and declining nitrogen availability in our five study ecosystems. Shrub biomass was consistently one of the strongest predictors of ecosystem change, equalling or exceeding the effects of other biotic and abiotic factors. In contrast, there was relatively little evidence for mega‐herbivore control on plant community composition and nitrogen availability. The ability of plants to determine the fate of terrestrial ecosystems during periods of global environmental change may therefore be greater than previously thought.
Cantharidin world in air: Spatiotemporal distributions of flying canthariphilous insects in the forest interior
Authors: Horiuchi Kaho , Hashimoto Kosei , Hayashi Fumio
Published: March 2018

The natural community in which the members interact using a toxic terpenoid cantharidin is named the “cantharidin world.” In previous studies, however, the members of this world have been surveyed only on the forest floor by setting pitfall traps with cantharidin as an attractant. In this study, we set cantharidin traps at various heights above the forest floor to investigate the structure and functional diversity of the canthariphilous flying insect community in the forest above‐ground space. A total of 3,168 arthropods were collected by the traps; among them, six species were more attracted to cantharidin than to control traps. Pseudopyrochroa brevitarsis and P. laticollis (Colecoptera: Pyrochroidae) both appeared for a short time during spring, but the latter species tended to use a lower layer of the forest. Clavicollis fugiens (Coleoptera: Anthicidae) also appeared in spring and flew near the ground. In these beetles, the attracted individuals were mostly males; they may use the obtained cantharidin for nuptial gifts to the female. Atrichopogon femoralis, A. insularis and Atrichopogon sp. (Diptera: Ceratopogonidae) were collected widely in the forest above‐ground space. These midges were almost females, probably because only females of these insects use chemical cues, including cantharidin, for searching for arthropods from which to suck hemolymph.
SCN1A variants associated with sudden infant death syndrome
Authors: Brownstein Catherine A. , Goldstein Richard D. , Thompson Christopher H. , Haynes Robin L. , Giles Emma , Sheidley Beth , Bainbridge Matthew , Haas Elisabeth A. , Mena Othon J. , Lucas Jonathan , Schaber Bethann , Holm Ingrid A. , George Alfred L. , Kinney Hannah C. , Poduri Annapurna H.
Published: March 2018

We identified SCN1A variants in 2 infants who died of sudden infant death syndrome (SIDS) with hippocampal abnormalities from an exome sequencing study of 10 cases of SIDS but no history of seizures. One harbored SCN1A G682V, and the other had 2 SCN1A variants in cis: L1296M and E1308D, a variant previously associated with epilepsy. Functional evaluation in a heterologous expression system demonstrated partial loss of function for both G682V and the compound variant L1296M/E1308D. Our cases represent a novel association between SCN1A and SIDS, extending the SCN1A spectrum from epilepsy to SIDS. Our findings provide insights into SIDS and support genetic evaluation focused on epilepsy genes in SIDS.
Outcome prediction in patients with acute repetitive seizures: Application of the Status Epilepticus Severity Score
Authors: Szklener Sebastian , Godek Magdalena , Korchut Agnieszka , Balicka‐Adamik Luiza , Rejdak Robert , Rossetti Andrea O. , Rejdak Konrad
Published: March 2018

Acute repetitive seizures (ARS) pose a risk of hospital admission with status epilepticus and a mortality threat, which underscores the need for the early prediction of a clinical course. Unfortunately, little attention has been given to ARS in this context, even though we possess the appropriate predictive tools for the stages of status epilepticus. Therefore, the main aim of this study was to assess the prognostic value of the Status Epilepticus Severity Score (STESS) in the population of patients with ARS. The study included a population of 200 patients. Almost half of the patients had achieved seizure cessations after diazepam administration, whereas 19.5% progressed to status epilepticus despite antiepileptic drug treatment. Mortality reached 10.5% of the total population. The receiver operating characteristic (ROC) curve for prediction of death by the STESS had an area under the curve (AUC) of 0.901, with an optimal cutoff point for discrimination ≥2 (sensitivity 0.95, specificity 0.71, and Youden index 0.66). Hosmer‐Lemeshow indicated good calibration of the STESS (chi‐square goodness‐of‐fit test = 3.24; P = .919). The study shows excellent effectiveness of the STESS in the prognosis of the clinical course in patients with ARS. STESS may be a valuable tool for the proper planning of diagnostic and therapeutic activities in this population.
Neuromuscular disease detection by neural networks and fuzzy entropy on time‐frequency analysis of electromyography signals
Authors: Vallejo Marcela , Gallego Carlos J. , Duque‐Muñoz L. , Delgado‐Trejos Edilson
Published: March 2018

Analysis of electromyography (EMG) signals is a necessary step in the diagnosis of neuromuscular diseases. Automatic classification systems can assist specialists and optimize the diagnostic process by applying time‐frequency analysis, fuzzy entropy, and neural networks to EMG signals in order to identify the presence of characteristics of a specific disorder, such as myopathy and amyotrophic lateral sclerosis. The performance of a decision support system depends on three important issues: the correct estimation of features from the EMG signal, the proper criteria for relevance analysis, and the learning process of the classification algorithm. In this paper, Discrete Wavelet Transform and Fuzzy Entropy are used to extract and select features from EMG signals, whereas Artificial Neural Networks are used to give the recognition result. The database used in this study is available for public use in EMGLAB, which is a website for sharing data, software, and information related to EMG decomposition. Results using the combination of these techniques show an accuracy around 98% for identifying EMG signals from three classes: healthy, patients with myopathy, or evidence of amyotrophic lateral sclerosis.
Sexuality, space, gender, and health: Renewing geographical approaches to well‐being in lesbian, gay, bisexual, transgender, and queer populations
Authors: Davies Megan , Lewis Nathaniel M. , Moon Graham
Published: March 2018

Research on sexual orientation and gender identities, such as lesbian, gay, bisexual, transgender, and queer (LGBTQ), has been limited in health geography compared with other sub‐fields of the discipline. The reasons for this gap include both the logistical limitations of data on sexual orientation and the historical dominance of visible, measurable infectious, and chronic disease outcomes in medical geography research. While medical geographers were among the first to research HIV/AIDS diffusion among gay men, there is now something of a divide between qualitative geographers studying experience and embodiment and health science researchers examining the socio‐spatial determinants of LGBTQ health outcomes. In the following article, we review the LGBTQ health inequalities research, emerging geographies of mental health and substance use among those identified as LGBTQ, and potential avenues for health geographers to re‐engage with this field of study.
Executive capacity to control legislatures and presidential choice of cabinet ministers in East Asian democracies
Authors: Lee Don S.
Published: March 2018

How do presidents in new democracies choose cabinet ministers to accomplish their policy goals? Contrary to existing studies explaining the partisan composition of the cabinet with institutional characteristics, such as formal authority, we argue that the broader political context surrounding the president's ability to control the legislature can affect cabinet partisanship. By analyzing original data on cabinet formation in all presidential systems in East Asia since democratization, we find that when presidents are more likely to be dominant in executive–legislative relations, they have less concern about legislative support and more leeway to focus on policy performance by appointing nonpartisan cabinet members. This analysis suggests that understanding cabinet partisanship requires a view of cabinet appointments as a trade‐off between securing legislative support and managing policy performance, and the scope of this compromise depends on the strength of the president vis‐à‐vis the legislature.
Administrative (de)centralization, performance equity, and outcome achievement in rural contexts: An empirical study of U.S. child welfare systems
Authors: Elgin Dallas J. , Carter David P.
Published: March 2018

Whether public services are better delivered through centralized or decentralized administrative systems is one of the most enduring debates in public administration. This article contributes to the debate with a study of program outcome achievement in U.S. child welfare services. We examine whether centralized state‐administered or decentralized county‐administered systems are more successful at realizing desired outcomes, which exhibit greater performance equity, and which are more successful at securing program outcomes in rural settings. Using a coarsened exact matching approach to quasi‐experimental research, we find that centralized child welfare systems exhibit greater success at achieving desired outcomes—in both rural contexts and overall. No discernible difference is found in centralized and decentralized systems' performance equity; outcome disparities exist under both structures. The study thus lends credence to centralization arguments, but at the same time cautions that centralized administration is not a structural panacea.
The politics of state compliance with international “soft law” in finance
Authors: Quaglia Lucia
Published: March 2018

Why do jurisdictions comply (or not) with international soft law in finance? This research systematically links international and domestic explanations of compliance by highlighting the “disjuncture” between the international standard‐setting process and the process of domestic compliance. Two causal mechanisms that affect compliance are identified. In the uploading stage, elected officials delegate the making of international soft law to domestic regulators; large, internationally active financial institutions mobilize extensively and, to a large extent, successfully. In the downloading stage, domestic interest groups team up with elected officials in order to resist compliance with international soft law that has negative distributional implications for domestic constituencies. These arguments are illustrated through a structured, focused comparison, and process tracing of the mixed record of compliance of the two main jurisdictions worldwide—the United States and the European Union—with the main international banking standards, the Basel Accords.
Cost‐utility of a six‐month programmed sports therapy (PST) in patients with haemophilia
Authors: Koeberlein‐Neu J. , Runkel B. , Hilberg T.
Published: March 2018

Introduction

Recurrent musculoskeletal haemorrhages in people with haemophilia (PwH) lead to restrictions in the locomotor system and, as a result, in physical performance, too. Due to its physical and psychological benefits, sport is increasingly re‐commended for haemophilic patients. Evidence on the cost‐effectiveness of sports therapy is still lacking.

Aim

The aim of this study was to determine the cost‐effectiveness of a 6‐month programmed sports therapy (PST).

Methods

The cost‐effectiveness of the 6‐month PST was assessed from a societal perspective alongside a RCT using cost‐utility analysis. The analysis included 50 PwH with moderate‐to‐severe haemophilia A and B and a training period over 6 months. The health‐related quality of life was measured with the EuroQoL‐domain questionnaire. Resource utilization was assessed by questionnaire before and after the intervention. A cost‐effectiveness acceptability curve was constructed, and sensitivity analyses were performed.

Results

During the 6‐month study period, mean adjusted total healthcare costs were lower (mean difference: −22 805 EUR; 95%‐CI: −73 944‐48 463; P = .59) and the number of QALYs was higher in the intervention group (mean difference: 0.3733; 95%‐CI: 0.0014‐0.0573; P = .04). The probability of an incremental cost‐effectiveness ratio <50 000 EUR per QALY was 71%. The performed sensitivity analysis confirmed these results.

Conclusion

Results showed that the PST is effective in terms of a significant gain of QALYs. Furthermore, results weakly indicate the potential of the PST to reduce healthcare costs. Future studies should expand the observation period to have a closer look at the influence of PST on lifetime costs.
Recurrence rates of pruritus after the stop of nalfurafine hydrochloride in chronic liver disease: Preliminary prospective confirmatory trial
Authors: Akuta Norio , Kumada Hiromitsu , Fujiyama Shunichiro , Kawamura Yusuke , Sezaki Hitomi , Hosaka Tetsuya , Kobayashi Masahiro , Kobayashi Mariko , Saitoh Satoshi , Suzuki Yoshiyuki , Suzuki Fumitaka , Arase Yasuji , Ikeda Kenji
Published: March 2018

Aim

The recurrence rates of pruritus after stopping nalfurafine hydrochloride are unknown in chronic liver disease.

Methods

A prospective confirmatory trial was carried out to determine the recurrence rates of pruritus after cessation of nalfurafine hydrochloride in chronic liver disease. After pretreatment with nalfurafine hydrochloride for 4 weeks or more, 15 consecutive Japanese patients, who confirmed the improvement of pruritus (decrease in the visual analogue scale (VAS) of ≥50 mm), were enrolled in the present study. Patients were classified to the continuous group (continuation of nalfurafine hydrochloride for 4 weeks) or the discontinuous group (cessation of nalfurafine hydrochloride) at the time of consent to study protocol, by self‐determination.

Results

The recurrence rates (increase in VAS of ≥25 mm after stopping nalfurafine hydrochloride) were 100% (5 of 5 patients) and 0% (0 of 10) in the discontinuous and continuous groups, respectively. In the discontinuous group, 3 patients selected retreatment with nalfurafine hydrochloride as salvage therapy, and they generally recovered to the levels of VAS at the discontinuation of treatment.

Conclusion

The present prospective trial showed the high recurrence rates of pruritus after the stop of nalfurafine hydrochloride in chronic liver disease.
Diet with linseed oil and organic selenium yields low n‐6/n‐3 ratio pork Semimembranosus meat with unchanged volatile compound profiles
Authors: Wojtasik‐Kalinowska Iwona , Guzek Dominika , Górska‐Horczyczak Elżbieta , Brodowska Marta , Sun Da‐Wen , Wierzbicka Agnieszka
Published: March 2018

The aim of this was to improve n‐6/n‐3 ratio without affecting the volatile compounds profiles of pork. Different feeding strategies were designed for 60 Polish Landrace pigs with the goal to enhance the health attributes of Polish pork. Composition, colour, hardness, fatty acid contents and volatile compound profiles of the semimembranosus muscles were determined. Results showed that with the basic diet with the addition 3% of linseed oil, 100 mg kg−1 of vitamin E and 1 mg kg−1 of organic selenium, the level of polyunsaturated fatty acids (PUFA) in the meat samples was increased by 26% (P ≤ 0.05) as compared to the control. Principal component analysis (PCA) demonstrated that the aroma profile of semimembranosus muscles from pigs fed with the diet supplemented with 3% of linseed oil and 1 mg kg−1 of organic selenium was close to that of control. Results demonstrated that healthy functional meats could be produced by designing feeding strategies.
Carbohydrate composition of Slovenian bee pollens
Authors: Bertoncelj Jasna , Polak Tomaž , Pucihar Tina , Lilek Nataša , Kandolf Borovšak Andreja , Korošec Mojca
Published: March 2018

Bee pollen is a source of nutrients that are important for humans. There is growing interest in bee pollen, mainly due to consumers wishing to use natural products for a healthy diet or for their therapeutic effects. The composition of bee pollen varies according to botanical and geographical origin. The aim was to define for the first time the carbohydrate composition of bee pollen from Slovenia. A total of twenty‐eight samples of bee pollens were analysed for botanical origins and contents of water, sugars and soluble and insoluble dietary fibre. From the bee pollen samples analysed, ten were recognised as monofloral. Monosaccharides represented 96% of the sugar fraction, with ranges 13.2–27.8 g per 100 g dry weight for fructose and 10.6–28.5 g per 100 g dry weight for glucose. Levels of sucrose, maltose and melezitose were low. Total dietary fibre was 10.0–21.4 g per 100 g dry weight bee pollen, with 73–82% insoluble fibre. Bee pollen can thus provide a good source of dietary fibre. This study supports further nutritional proposals for Slovenian bee pollen.
Promoting active ageing in older people with mental disorders living in the community: An integrative review
Authors: Kenbubpha Kedsaraporn , Higgins Isabel , Chan Sally Wai‐Chi , Wilson Amanda
Published: March 2018

Aim

To critically synthesize the evidence in relation to the promotion of active ageing in older people, including those with mental disorders.

Background

Approximately 15% of older people aged 60 and above are experiencing a mental disorder. However, they are commonly unrecognized from health care providers.

Design

This study is an integrative review. Articles published between January 2002 and March 2017 in English and in Thai were identified through searches of the databases CINAHL, MEDLINE, EMBASE, PsycINFO, and Thai LIS, as well as through manual searching. Methodologically high‐quality research articles were included if they addressed the promotion of active ageing and related concepts, the impact of mental disorders on active ageing and related concepts, the perspective of older people regarding active ageing, and issues related to working with older people with mental health problems living in the community.

Results

A total of 18 articles were included. The findings show that there is little evidence regarding the promotion of active ageing in older people with mental disorders. Older people with mental disorders were less likely to achieve successful ageing compared with those without mental disorders, suggesting they need support from health care providers. However, there are several barriers to care and working with older people with mental disorders at the community level.

Conclusion

Of concern is that health professionals focus on the physical health of older people while mental health issues are overlooked.
Does a blended learning environment suit advanced practice training for pharmacists in a Middle East setting?
Authors: Wilbur Kerry , Taylor Andrea D J
Published: March 2018

Objectives

The transfer of pedagogies and instructional techniques outside their contexts of origin may not be always be suitable for intended learners. The aim of this study was to explore the experiences of Middle East pharmacists enrolled in advanced pharmacy practice courses delivered through a blended learning environment (BLE).

Methods

Seventeen students and graduates from a BLE in Qatar participated in focus group interviews. A topic guide was developed to elicit these pharmacists’ perspectives on perceived barriers to completing the courses and facilitating factors for content engagement and overall satisfaction. Discussions were recorded, transcribed verbatim and text analysed using thematic content analysis.

Key findings

We identified three predominant themes in our analysis of these discussions: (1) relevance, (2) motivation and (3) communication. Participants favourably endorsed any programme aspect that linked with their workplace care responsibilities, but found it challenging to adapt to high-fidelity testing environments. The on-campus sessions were key for sustaining motivation and recommitting to time management and organisation with the distance-based content. Although these students expressed difficulty in understanding posted assignment instructions and feedback and occasionally faced technological issues, they were overwhelmingly satisfied with how the programme contributed to advancing their practice capabilities.

Conclusions

Pharmacists enrolled in BLE advanced pharmacy practice courses in Qatar identified barriers and facilitators like those experienced by professional learners elsewhere. However, we found that instructional design and communication approaches merit some special consideration for Arab students for optimal engagement in BLE.
Statistical analysis of factors affecting re‐operative times in paediatric patients with scar deformity after deep second‐degree burn injury
Authors: Chen Baoguo , Yue Xiaotong , Zhang Ruijuan , Song Huifeng
Published: March 2018

Deep second‐degree burn injuries pose a challenge for treating scar deformity in developing paediatric patients. Some patients underwent several re‐operations during their development. There was no literature reporting which factors affect re‐operative times. In this article, we intend to analyse possible influential factors that are responsible for re‐operative times in paediatric patients with scar deformity after deep second‐degree burn injuries. From 2010 to 2016, 177 paediatric cases with a history of deep second‐degree burn injury who underwent re‐operation once, twice, and equal to or more than thrice were recruited to this study, with age ranging from 0 to 18 years. The following factors were analysed: age, gender, size of scar, method for reconstruction, location, postoperative anti‐scar treatment, preschool group, school group, combined deformity, and combined method for reconstruction. One‐way ANOVA and multi‐way ANOVA analysis were used as statistical tools to analyse the above factors and re‐operative times. There were 83 male cases and 94 female cases, with an average age of 7.47 years. Statistical significance was achieved for the size of scar (P = 0.000), operation method (P = 0.001), and combined deformity (P = 0.026) under 1‐way ANOVA in different re‐operative times. The operation methods for the head and neck area (P < 0.05) and the lower extremities (P < 0.05) are critical factors for multi‐factor variance analysis in different re‐operative times. Multivariate logistic regression analysis also demonstrated that the size of scar was an independent risk factor for the number of operations. Combined operative method was a protective risk factor for the number of operations. There was no statistical significance obtained for other factors. Size of scar, operation method, and combined operation method are the risk factors for re‐operative times, while operation methods for the head and neck area and lower extremities are the critical factors for re‐operative times. We can use the combined method to resolve scar‐related problems in order to reduce re‐operative times.
An electrical plasma dissection tool for surgical treatment of chronic ulcers: Results of a prospective randomised trial
Authors: Marangi Giovanni F , Pallara Tiziano , Lamberti Daniela , Perrella Eleonora , Serra Raffaele , Stilo Francesco , De Caridi Giovanni , Onetti Muda Andrea , Persichetti Paolo
Published: March 2018

Cutaneous ulceration is a difficult medical problem and a major source of morbidity for patients. In the surgical treatment of ulcers, debridement is the first step, and it can be carried out using several surgical tools. Recently, new surgical devices have emerged using plasma‐mediated electrical discharges with a lower peak temperature. A prospective single‐blind trial was conducted on chronic ulcers not responsive to common non‐surgical management. Patients were randomly separated into 2 groups: Group A received surgical debridement with conventional electrocautery, and Group B received surgical debridement using the plasma‐mediated device. Histological samples were collected intraoperatively to evaluate the thermal damage during the surgical procedure and 2 weeks after surgery to evaluate the inflammatory response and collagen deposition. The width of coagulation necrosis at the incision margins in Group B was significantly shorter compared with Group A (P = .001). The inflammatory cell infiltration showed a cellular distribution percentage that was quite equal between the 2 groups. The granulation tissue showed an abundant deposition of dense and mature collagen in Group B, compared with Group A, where the mature collagen appeared in small quantities (P < .001). Microbial culture showed a lower incidence of postoperative infections in Group B compared with the control group (P < .05). The study demonstrated, based on the results, that the new technology with the use of a lower temperature electrosurgical device represents an effective therapeutic weapon for the surgical treatment of skin ulcers, both vascular and extravascular types.
Successful treatment of enteroatmospheric fistulas in combination with negative pressure wound therapy: Experience on 3 cases and literature review
Authors: Wirth Ulrich , Renz Bernhard W , Andrade Dorian , Schiergens Tobias S , Arbogast Helmut , Andrassy Joachim , Werner Jens
Published: March 2018

Enteroatmospheric fistulas (EAF) are rare but challenging and morbid complications of abdominal surgery and require time‐ as well as resource‐consuming management. Furthermore, they severely affect patients' quality of life. Several treatment modalities for EAF management are described in the literature. We describe 3 consecutive cases of EAF treatment by employing negative pressure wound therapy (NPWT) along with either a special silicone fistula adapter or a Silo‐Vac‐like system in another case to isolate the fistula from the remaining abdominal wound. Spontaneous fistula closure was achieved in 2 of the 3 cases, and surgical resection of the small bowel segment harbouring EAF opening was possible in a third case after wound conditioning. The rate of fistula closure was 100% (n = 3/3). Compartmentalisation of the contaminated area using NPWT accelerated healing of the open abdominal wound remarkably. In summary, we present a useful tool for the challenging management of EAF and review the literature on different treatment options of EAF available today.
Are body perceptions and perceived appearance judgments by others linked to stress and depressive symptoms?
Authors: Sabik Natalie J. , Lupis Sarah B. , Geiger Ashley M. , Wolf Jutta M.
Published: March 2018

Body dissatisfaction has consistently been linked to depressive symptoms. We posit stress as a pathway, with differential links to two aspects of body esteem, including body dissatisfaction and evaluations attributed to others about one's body and appearance. The Trier Social Stress Test was administered, and cortisol responses to acute psychosocial stress and survey data (perceived chronic stress, self‐reported body esteem, and depressive symptoms) were assessed in 57 undergraduates (28F). Chronic stress mediated the association between body image and depressive symptoms. These findings support stress as a pathway by which poor self‐image gets “under the skin” to negatively affect health.
Perinatal substance use, residential instability, and negative behavioral outcomes among adolescents: Lessons from the maternal lifestyle study
Authors: Cotton Brandi P. , Lohman Matthew C. , Brooks Jessica M. , LaGasse Linda L.
Published: March 2018

Problem

Both housing instability and prenatal substance use are known risk factors for behavioral problems among adolescents.

Methods

The purpose of this study was to investigate the association between residential instability (residential mobility and homelessness) and delinquent behaviors among adolescents enrolled in the maternal lifestyle study (MLS), a 16‐year research study that explored short‐term and long‐term effects of in‐utero exposure to cocaine and/or opiates (N = 736). Logistic regression was used to measure the association between housing problems with youth crimes, school delinquency, and substance use at 11, 15, and 16 years of age.

Findings

Both high‐frequency residential mobility and homelessness were associated with deviant behaviors across the entire sample of children born with in‐utero cocaine/opiate exposure and those without.

Conclusions

Psychiatric nursing care of youth should include a comprehensive assessment of residential instability to identify risk and target potential interventions.
Tim‐3 blockade promotes iNKT cell function to inhibit HBV replication
Authors: Xu Yong , Wang Zehua , Du Xianhong , Liu Yuan , Song Xiaojia , Wang Tixiao , Tan Siyu , Liang Xiaohong , Gao Lifen , Ma Chunhong
Published: March 2018

Increased expression of T cell immunoglobulin and mucin domain‐3 (Tim‐3) on invariant natural killer T (iNKT) cells is reported in chronic hepatitis B virus (HBV) infection. However, whether Tim‐3 regulates iNKT cells in chronic HBV condition remains unclear. In this study, our results showed that the expression of Tim‐3 was up‐regulated on hepatic iNKT cells from HBV‐transgenic (Tg) mice or iNKT cells stimulated with α‐galactosylceramide (α‐Galcer). Compared with Tim‐3−iNKT cells, Tim‐3+iNKT cells expressed more IFN‐γ, IL‐4 and CD107a, indicating a strong relationship between Tim‐3 and iNKT cell activation. Constantly, treatment of Tim‐3 blocking antibodies significantly enhanced the production of IFN‐γ, TNF‐α, IL‐4 and CD107a in iNKT cells both in vivo and in vitro. This Tim‐3− mediated suppression of iNKT cells was further confirmed in Tim‐3 knockout (KO) mice. Moreover, Tim‐3 blockade promoted α‐Galcer‐triggered inhibition of HBV replication, displaying as the decreased HBV DNA and HBsAg level in serum, and down‐regulated pgRNA expression in liver tissues. Collectively, our data, for the first time, demonstrated the potential role of Tim‐3 blockade in promoting iNKT cell‐mediated HBV inhibition. Therefore, combination of α‐Galcer with Tim‐3 blockade might be a promising approach in chronic hepatitis B therapy.
LncRNA NR2F1‐AS1 regulates hepatocellular carcinoma oxaliplatin resistance by targeting ABCC1 via miR‐363
Authors: Huang Hai , Chen Jie , Ding Cheng‐Ming , Jin Xin , Jia Ze‐Ming , Peng Jian
Published: March 2018

Emerging evidence has validated the vital role of long non‐coding RNA (lncRNA) in the chemoresistance of cancer treatment. In the present study, we investigate the function of lncRNA NR2F1‐AS1 on oxaliplatin (OXA) resistance of hepatocellular carcinoma (HCC) and discover the underlying molecular mechanism. Results revealed that lncRNA NR2F1‐AS1 was up‐regulated in oxaliplatin‐resistant HCC tissue and cells using microarray analysis and RT‐PCR. Meanwhile, ABCC1 protein was overexpressed in OXA‐resistant HCC cells (Huh7/OXA and HepG2/OXA). In vitro, NR2F1‐AS1 knockdown reduced the invasion, migration, drug‐resistant gene (MDR1, MRP5, LRP1) and IC50 value in Huh7/OXA and HepG2/OXA cells. In vivo, NR2F1‐AS1 knockdown decreased the tumour weight of HCC cells. Bioinformatics tools and luciferase reporter assay confirmed miR‐363 targeted the 3′‐UTR of NR2F1‐AS1 and ABCC1 mRNA, presenting that NR2F1‐AS1 promoted ABCC1 expression through endogenous sponging miR‐363. In summary, results conclude that NR2F1‐AS1 regulates HCC OXA resistance through targeting miR‐363‐ABCC1 pathway, providing a vital theoretic mechanism and therapeutic target for HCC chemoresistance.
Alterations of polyunsaturated fatty acid metabolism in ovarian tissues of polycystic ovary syndrome rats
Authors: Huang Rong , Xue Xinli , Li Shengxian , Wang Yuying , Sun Yun , Liu Wei , Yin Huiyong , Tao Tao
Published: March 2018

The metabolism of polyunsaturated fatty acids (PUFAs) remains poorly characterized in ovarian tissues of patients with polycystic ovary syndrome (PCOS). This study aimed to explore alterations in the levels of PUFAs and their metabolites in serum and ovarian tissues in a PCOS rat model treated with a high‐fat diet and andronate. Levels of PUFAs and their metabolites were measured using gas/liquid chromatography‐mass spectrometry after the establishment of a PCOS rat model. Only 3 kinds of PUFAs [linoleic acid, arachidonic acid (AA) and docosahexaenoic acid] were detected in both the circulation and ovarian tissues of the rats, and their concentrations were lower in ovarian tissues than in serum. Moreover, significant differences in the ovarian levels of AA were observed between control, high‐fat diet‐fed and PCOS rats. The levels of prostaglandins, AA metabolites via the cyclooxygenase (COX) pathway, in ovarian tissues of the PCOS group were significantly increased compared to those in the controls. Further studies on the mechanism underlying this phenomenon showed a correlation between decreased expression of phosphorylated cytosolic phospholipase A2 (p‐cPLA2) and increased mRNA and protein expression of COX2, potentially leading to a deeper understanding of altered AA and prostaglandin levels in ovarian tissues of PCOS rats.
NEFA‐induced ROS impaired insulin signalling through the JNK and p38MAPK pathways in non‐alcoholic steatohepatitis
Authors: Gao Wenwen , Du Xiliang , Lei Lin , Wang Heyuan , Zhang Min , Wang Zhe , Li Xiaobing , Liu Guowen , Li Xinwei
Published: March 2018

The aim of this study was to investigate the changes in hepatic oxidative phosphorylation (OXPHOS) complexes (COs) in patients and cows with non‐alcoholic steatohepatitis (NASH) and to investigate the mechanism that links mitochondrial dysfunction and hepatic insulin resistance induced by non‐esterified fatty acids (NEFAs). Patients and cows with NASH displayed high blood NEFAs, TNF‐α and IL‐6 concentrations, mitochondrial dysfunction and insulin resistance. The protein levels of peroxisome proliferator‐activated receptor‐γ coactivator‐1α (PGC‐1α), mitofusin‐2 (Mfn‐2) and OXPHOS complexes (human: COI and COIII; cow: COI‐IV) were significantly decreased in patients and cows with NASH. NEFA treatment significantly impaired mitochondrial function and, increased reactive oxygen species (ROS) production, and excessive ROS overactivated the JNK and p38MAPK pathways and induced insulin resistance in cow hepatocytes. PGC‐1α and Mfn‐2 overexpression significantly decreased the NEFA‐induced ROS production and TNF‐α and IL‐6 mRNA expressions, reversed the inhibitory effect of NEFAs on mitochondrial function and attenuated the overactivation of the ROS‐JNK/p38MAPK pathway, alleviated insulin resistance induced by NEFAs in cow hepatocytes and HepG2 cells. These findings indicate that NEFAs induce mitochondrial dysfunction and insulin resistance mediated by the ROS‐JNK/p38MAPK pathway. PGC‐1α or Mfn‐2 overexpression reversed the lipotoxicity of NEFAs on mitochondrial dysfunction and insulin resistance. Our study clarified the mechanism that links hepatic mitochondrial dysfunction and insulin resistance in NASH.
ElevatedCRB3 expression suppresses breast cancer stemness by inhibiting β‐catenin signalling to restore tamoxifen sensitivity
Authors: Li Pingping , Feng Chen , Chen He , Jiang Yina , Cao Fang , Liu Jie , Liu Peijun
Published: March 2018

Tamoxifen is a first‐line drug for hormone therapy (HT) in oestrogen receptor‐positive breast cancer patients. However, 20% to 30% of those patients are resistant to tamoxifen treatment. Cancer stem cells (CSCs) have been implicated as one of the mechanisms responsible for tamoxifen resistance. Our previous study indicated that decreased expression of theCRB3 gene confers stem cell characteristics to breast cancer cells. In the current investigation, we found that most of the breast cancer patient tissues resistant to tamoxifen were negative forCRB3 protein and positive for β‐catenin protein, in contrast to their matched primary tumours by immunohistochemical analysis. Furthermore, expression ofCRB3mRNAand protein was low, while expression of β‐cateninmRNAand protein was high in tamoxifen resistance cells (LCC2 and T47D TamR) contrast to their corresponding cell linesMCF7 and T47D. Similarly,CRB3 overexpression markedly restored the tamoxifen sensitivity of TamR cells by theMTTviability assay. Finally, we found thatCRB3 suppressed the stemness of TamR cells by inhibiting β‐catenin signalling, which may in turn lead to a decrease in the breast cancer cell population. Furthermore, these findings indicate thatCRB3 is an important regulator for breast cancer stemness, which is associated with tamoxifen resistance.
The role of septin 7 in physiology and pathological disease: A systematic review of current status
Authors: Wang Xinlu , Fei Fei , Qu Jie , Li Chunyuan , Li Yuwei , Zhang Shiwu
Published: March 2018

Septins are a conserved family of cytoskeletal GTPases present in different organisms, including yeast, drosophila, Caenorhabditis elegans and humans. In humans, septins are involved in various cellular processes, including exocytosis, apoptosis, leukemogenesis, carcinogenesis and neurodegeneration. Septin 7 is unique out of 13 human septins. Mammalian septin 6, septin 7, septin 2 and septin 9 coisolate together in complexes to form the core unit for the generation of the septin filaments. Physiological septin filaments are hetero‐oligomeric complexes consisting of core septin hexamers and octamers. Furthermore, septin 7 plays a crucial role in cytokinesis and mitosis. Septin 7 is localized to the filopodia and branches of developing hippocampal neurons, and is the most abundant septin in the adult rat forebrain as well as a structural component of the human and mouse sperm annuli. Septin 7 is crucial to the spine morphogenesis and dendrite growth in neurons, and is also a structural constituent of the annulus in human and mouse sperm. It can suppress growth of some tumours such as glioma and papillary thyroid carcinoma. However, the molecular mechanisms of involvement of septin 7 in human disease, especially in the development of cancer, remain unclear. This review focuses on the structure, function and mechanism of septin 7 in vivo, and summarizes the role of septin 7 in cell proliferation, cytokinesis, nervous and reproductive systems, as well as the underlying molecular events linking septin 7 to various diseases, such as Alzheimer's disease, schizophrenia, neuropsychiatric systemic lupus erythematosus, tumour and so on.