bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental health need of students at entry to university: Baseline findings from the U‐Flourish Student Well‐Being and Academic Success Study
Authors: King Nathan , Pickett William , McNevin Steven H. , Bowie Chris R. , Rivera Daniel , Keown‐Stoneman Charlie , Harkness Kate , Cunningham Simone , Milanovic Melissa , Saunders Kate E. A. , Goodday Sarah , Duffy Anne ,   U‐Flourish Student Well‐Being and Academic Success Research Group
Published: February 2020

Aim

Transition to university is associated with unique stressors and coincides with the peak period of risk for onset of mental illness. Our objective in this analysis was to estimate the mental health need of students at entry to a major Canadian university.

Methods

After a student‐led engagement campaign, all first year students were sent a mental health survey, which included validated symptom rating scales for common mental disorders. Rates of self‐reported lifetime mental illness, current clinically significant symptoms and treatment stratified by gender are reported. The likelihood of not receiving treatment among those symptomatic and/or with lifetime disorders was estimated.

Results

Fifty‐eight per cent of all first‐year students (n = 3029) completed the baseline survey, of which 28% reported a lifetime mental disorder. Moreover, 30% of students screened positive for anxiety symptoms, 28% for depressive symptoms, and 18% for sleep problems with high rates (≅45%) of associated impairment. Only 8.5% of students indicated currently receiving any form of treatment. Females were more likely to report a lifetime diagnosis, anxiety and depressive symptoms, as well as current treatment. Over 25% of students reported lifetime suicidal thoughts and 6% suicide attempt(s). Current weekly binge drinking (25%) and cannabis use (11%) were common, especially in males.

Conclusions

There is limited systematically collected data describing the mental health needs of young people at entry to university. Findings of this study underscore the importance of timely identification of significant mental health problems as part of a proactive system of effective student mental health care.
Long‐term follow‐up of Cladribine, high‐dose Cytarabine, and Idarubicin as salvage treatment for relapsed acute myeloid leukemia and literature review
Authors: Mayer Karin , Hahn‐Ast Corinna , Schwab Katjana , Schmidt‐Wolf Ingo G. H. , Brossart Peter , Glasmacher Axel , von Lilienfeld‐Toal Marie
Published: February 2020

Purpose

Outcome for relapsed acute myeloid leukemia (AML) is poor. Cladribine has activity in AML, and an enhancing effect on other cytostatic drugs thus may help overcome resistance. Here, we present the final analysis of our phase II trial evaluating safety and efficacy of cladribine, cytarabine, and idarubicin (CAI) in relapsed AML.

Methods

Patients with relapsed AML after at least 6 months remission received two courses of CAI. After 9 patients, prolonged neutropenia prompted protocol change (omission of idarubicin in 2nd course and dose‐reduction of cytarabine). Primary endpoints were remission rate and safety.

Results

Twenty patients received treatment, fourteen one, and six two courses CAI/CA. After first course, complete remission (CR/CRi) was achieved in 60%. Most frequent toxicity was infection. Median OS was 8.8 months in all patients and 21.1 months in those with CR. Nine patients (48%) proceeded to allogeneic stem cell transplantation (allo‐SCT), four of those are still alive and in CR, accounting for a 5‐year survival rate of 55% of transplanted patients.

Conclusion

Cladribine, cytarabine, and idarubicin in relapsed AML is feasible and induces good response rates. As expected, infections are the most important complication. However, combined with allo‐SCT, long‐term survival can be achieved in a substantial number of patients.
Impulse control and related behaviors in Parkinson’s disease with dementia
Authors: Martinez‐Martin P. , Wan Y. M. , Ray Chaudhuri K. , Schrag A. E. , Weintraub D.
Published: February 2020

Background and purpose

The objective was to determine the frequency, demographic and clinical correlates [such as age, sex, Parkinson’s disease (PD) severity and dopaminergic treatment] of impulse control disorder (ICD) symptoms and related behaviors in patients with PD with (PD‐D) and without (PD‐ND) dementia.

Methods

We analyzed historical data from a national, multi‐center, cross‐sectional database and assessed ICDs and related behaviors with the Scale for Evaluation of Neuropsychiatric Disorders in Parkinson’s Disease administered as a semi‐structured interview to patients with PD‐D (n = 85) and PD‐ND (n = 444) and their informants.

Results

Dopamine agonist therapy use was common and similar in the two groups (78.8% in PD‐D vs. 82.9% in PD‐ND), but ICDs (23.5% vs. 13.3%,P = 0.02), hobbyism‐punding (32.9% vs. 10.6%,P < 0.001) and dopaminergic medication abuse (8.2% vs. 3.2%,P = 0.03) were more common in the PD‐D group.

Conclusions

The finding that ICDs and related behaviors are more common in patients with PD frequently treated with dopamine agonists who also have comorbid dementia suggests that the neural substrates associated with PD dementia may also predispose to development of compulsive behaviors.
Nestling tree swallows (Tachycineta bicolor) alter begging behaviour in response to odour of familiar adults, but not their nests
Authors: Griebel Ilsa A. , Dawson Russell D.
Published: February 2020

Communication using chemical cues is important for many taxa, including birds, but the use of olfaction for intraspecific communication has been investigated only recently in passerines and is understudied in nestlings. To address this knowledge gap, we explored whether nestling tree swallows (Tachycineta bicolor) would recognize and respond to chemical cues of conspecifics, specifically testing begging responses to familiar and unfamiliar nest and adult odours. For the nest odour experiment, nests were treated with either orange essential oil or distilled water to create scented and unscented (control) odour environments, respectively. For the adult odour experiment, adults attending the nestlings were considered “familiar adults” and adults attending a different brood in the population were considered “unfamiliar adults.” We found that begging responses of nestlings did not differ in response to orange oil odour or water, but nestlings begged significantly longer and more intensely in response to odours of a familiar than an unfamiliar adult, regardless of adult sex. This provides evidence that tree swallows use chemical cues to alter their behaviour and opens up many exciting avenues of future research.
CEO influence on the board of directors: Evidence from corporate spinoffs
Authors: Pham Duong T.
Published: February 2020

We utilize a sample of spinoff firms that need to form a new board of directors, to shed light on the chief executive officer (CEO) influence hypothesis. We find spinoff boards with a CEO who was the parent firm CEO to be similarly structured to the boards of industry and size‐matched peers, whereas spinoff boards with nonparent CEOs are structured for greater monitoring. Consistent with our board structure results, the CEO compensation and replacement decisions of parent CEO spinoff boards are more lenient toward spinoff CEOs, whereas those of nonparent CEO spinoff boards are more consistent with protecting shareholder benefits.
Averaged strain energy density estimated rapidly from nodal displacements by coarse FE analyses: Cracks under mixed mode loadings
Authors: Campagnolo Alberto , Zuin Silvio , Meneghetti Giovanni
Published: February 2020

The strain energy density (SED) averaged over a structural volume allows to assess the fracture and fatigue behaviour of cracked components under mixed‐mode loadings. To rapidly estimate the averaged SED, two approaches have been previously proposed: (a) the direct approach; (b) the peak stress method (PSM) and nodal stress (NS) approach. In this paper, the nodal displacement (ND) approach is presented to rapidly estimate the averaged SED from the nodal displacements by FE analyses. This method combines the advantages of all previous approaches, ie, the use of coarse meshes able to capture the contributions of both stress intensity factors (SIFs) and higher order terms, without requiring geometrical modelling of the control volume. To validate the method, cracked plates and cracked bars under mixed‐mode loadings have been analysed. The averaged SED values estimated by the ND approach agree with those calculated by the direct approach, within a range of applicability.
Variations in trace elements, isotopes, and organic geochemistry during the Hangenberg Crisis, Devonian–Carboniferous transition, northeastern Vietnam
Authors: Shizuya Atena , Oba Masahiro , Ando Takuto , Ogata Yukari , Takashima Reishi , Nishi Hiroshi , Komatsu Toshifumi , Nguyen Phong D.
Published: February 2020

The Hangenberg Crisis at the Devonian–Carboniferous boundary is known as a polyphase extinction event that affected more than 45 % of marine and terrestrial genera. As the cause of this event is still debated, analyses were carried out on sedimentary samples from the Devonian–Carboniferous Pho Han Formation in northeastern Vietnam to reconstruct the paleoenvironment around the time of this event using stable carbon isotopes; total sulfur; manganese; vanadium; molybdenum; and sedimentary organic matter, such as dibenzothiophenes, cadalene, and regular steranes. These geochemical signatures provide a high‐resolution redox history for this section and show that transgression‐driven high primary productivity, possibly enhanced by terrestrial input, caused severe oxygen depletion along the continental margin of the South China block during the Hangenberg Crisis.
Low expression of miR‐204 is associated with expression of CD34 and poor performance status in denovo AML
Authors: Abdelhafiz Ahmed S. , Elsayed Ghada M. , Saber Magdy M. , Gameel Abdallah , Hamdy Nayera
Published: February 2020

Introduction

Acute myeloid leukemia (AML) is the most common acute leukemia in adults. There is growing evidence that microRNAs (miRNAs) provide prognostic information in AML. MiR‐204 has a tumor suppressor function, and several studies have proven its role in solid cancers. The aim of this work is to evaluate the level of expression of miR‐204 in adults newly diagnosed with AML with normal karyotype and to correlate its level of expression with disease outcome and different prognostic factors.

Patients and methods

The study included 87 adult patients newly diagnosed with AML. Detection of miR‐204 was done using RT‐PCR in patients and seven age‐matched controls.

Results

Acute myeloid leukemia patients showed significantly lower miR‐204 expression, compared to control group (P = .029). Low miR‐204 expression was significantly associated with positive CD34 (P = .017), with poor performance status (PS) (P = .009), and with the presence of diabetes mellitus (DM) (P = .014). Low expression of miR‐204 was also significantly associated with shorter overall survival (OS) (P = .020) and disease‐free survival (DFS) (P = .013). Low miR‐204 expression was identified as an independent prognostic factor for prediction of shorter OS (P = .034) and DFS (P = .027) in AML.

Conclusion

To the best of our knowledge; this is the first time to prove the correlation between miR‐204 expression and CD34 expression. Further study of this correlation is needed to confirm the role of miR‐204 in CD34‐positive cells, including leukemic stem cells. This correlation may have therapeutic implications. MiR‐204 can be used as a biomarker for PS in AML patients.
Effects of assertiveness and psychosocial work condition on workplace bullying among nurses: A cross‐sectional study
Authors: Fang Li , Hsiao Li‐Ping , Fang Shu‐Hui , Chen Bao‐ Chen
Published: February 2020

Aims: This study aims to explore nurses' demographic data, assertiveness, psychosocial work condition, and workplace bullying, and find the predictors of workplace bullying.

Methods: This study adopted a cross‐sectional design. A stratified sample comprising 241 nurses from a regi onal teaching hospitals in Taiwan was selected from the 10th to the 23rd September, 2018. Data were analysed by using the SPSS Statistics 17.0. Descriptive statistics (frequency, percentage, mean, and standard deviation), one‐way Anova, t test, Pearson's correlation, and multiple linear regressions were used.

Results: The results showed that the participants with “past bullying experience,” “lower self‐assertiveness,” “higher work psychological demands,” “lower workplace justice,” “lower labour participation,” and “lower overall social support” are more likely to experience workplace bullying.

Conclusions: Hospital managers should pay attention to the problem of nursing workplace bullying. First of all, hospital managers should encourage curriculum on nursing workplace bullying and incorporate nursing workplace bullying prevention training courses in curriculum planning.
Evaluation of dyadic changes of parent‐child weight loss patterns during a family‐based behavioral treatment for obesity
Authors: Kang Sim Dong‐Jin E. , Strong David R. , Manzano Michael A. , Rhee Kyung E. , Boutelle Kerri N.
Published: February 2020

Background

Family‐based treatment (FBT) for children with overweight and obesity is a package that includes nutrition and physical activity education, as well as parenting and behavior therapy skills. To date, the majority of research suggests that one of the best predictors of child weight loss is parent weight loss. However, the bidirectional processes facilitating parent‐child weight loss are not well understood.

Objective

To evaluate the strength and direction of parent‐child weight‐change patterns during a 6‐month intervention with FBT for childhood obesity.

Methods

Parent‐child weight change dynamics were evaluated using a bivariate multilevel approach.

Results

Significant positive weight reductions throughout treatment were observed among both parents and children (P's < .01 for both parent and child). In the model adjusting for the conditional influence of attendance over time, parents' initial weight loss was associated with subsequent weight loss by their child (B = 0.102, P < .05; d = 0.352) across the first 10 sessions. Child's weight loss also was associated with subsequent weight loss by their parent (B = 0.105, P < .01; d = 0.412) across the first 10 sessions. A small and negative effects of parents' weight loss on children and children's weight loss on parents from sessions 10 to 20 may have been reflective of slowed rates of weight loss as treatment progressed.

Conclusions

Together these data suggest that parent‐child dyads mutually influence weight loss in FBT. Future studies should leverage how to make best clinical use of these dynamic effects in the context of family‐based interventions.
Analysis of pharmacist-identified medication-related problems at two United Kingdom hospitals: a prospective observational study
Authors: Geeson Cathy , Wei Li , Franklin Bryony Dean
Published: February 2020

Objective

Hospital pharmacy is undergoing a period of rapid change, with pharmacists needing to focus where they add most value. Our aim was to identify where pharmacists have potential for greatest impact by analysing data on clinically relevant medication-related problems (MRPs).

Methods

We included consecutive admissions from adult medical wards at two UK hospitals between April and November 2016. MRPs were identified by pharmacists at the study sites as part of their routine daily patient assessments, validated and assessed for preventability and severity. Descriptive analyses were performed on clinically relevant (moderate or severe preventable) MRPs to establish the stage of inpatient stay where identified and their types/categories (overall and by stage of inpatient stay).

Key findings

Among 1503 eligible admissions, 2614 validated MRPs were identified, of which 1153 were moderate or severe, and preventable. Over 70% of these clinically relevant MRPs were identified during/before the first ward-based pharmacy review of patients. The most frequent MRP subcategory was ‘indication not treated/missing therapy’, accounting for 46% of clinically relevant MRPs. Dose selection issues were the next most common, accounting for 24%. The subcategory ‘indication not treated/missing therapy’ was identified more frequently at admission and discharge (53% and 45% of MRPs, respectively) compared with during the inpatient stay (14%), P < 0.001.

Conclusions

This research suggests patients are at greatest need of pharmacist input in terms of identification/resolution of clinically relevant MRPs during early stages of inpatient stay; however, clinically relevant MRPs continue to occur throughout their stay, suggesting need for ongoing pharmacy review.
Stabilities of infant behaviors and maternal responses to them
Authors: Bornstein Marc H. , Putnick Diane L. , Hahn Chun‐Shin , Tamis‐LeMonda Catherine S. , Esposito Gianluca
Published: February 2020

Consistency in the order of individuals in a group across substantial lengths of time—stability—is a central concept in developmental science for several reasons. Stability underscores the meaningfulness of individual differences in psychological phenomena; stability informs about the origins, nature, and overall developmental course of psychological phenomena; stability signals individual status and so affects the environment, experience, and development; stability has both theoretical and clinical implications for individual functioning; and stability helps to establish that a measure constitutes a consequential individual‐differences metric. In this three‐wave prospective longitudinal study (Ns = 40 infants and mothers), we examined stabilities of individual variation in multiple infant behaviors and maternal responses to them across infant ages 10, 14, and 21 months. Medium to large effect size stabilities in infant behaviors and maternal responses emerged, but both betray substantial amounts of unshared variance. Documenting the ontogenetic trajectories of infant behaviors and maternal responses helps to elucidate the nature and structure of early human development.
Development and validation of the Needs in Recovery Assessment (NiRA): A clinical tool for assessing the needs of individuals recovering from a first episode of mental illness
Authors: Davies Ellen L. , Hooper Kenneth J. , Pelentsov Lemuel J. , Gordon Andrea L. , Esterman Adrian J.
Published: February 2020

Recovering from a first episode of mental illness entails unique challenges and often includes experiencing unmet needs. The availability of a formal, structured and valid means of assessing the needs of individuals recovering from a first episode of mental illness may improve mental health service delivery. This article describes the development of a new needs assessment tool, the Needs in Recovery Assessment (NiRA), and presents the results of processes used to validate the tool. The NiRA was developed using data collected in a previous literature review and focus groups with mental health service users. It contains three sections for the identification, prioritization, planning and re‐evaluation of a broad array of needs. It was presented in two workshops, where mental health service users and clinicians evaluated its validity, acceptability and usability. Items of need and the format of the NiRA were evaluated using Likert‐scale questions, open‐ended short answer and closed questions. Each item of need was evaluated for its validity by a panel of experts via an online survey. Descriptive statistics were used to analyse data, including means, percentages and the Content Validity Index (CVI).Streiner and Kottner's scale development and testing guidelines were used in the reporting of this study. 48 items of need were evaluated as valid by mental health service users, clinicians and academics. Most items received an I‐CVI of greater than .93. The scale CVI/Avg was .96. The NiRA is perceived as a valid and acceptable tool for assessing the needs of people recovering from a first episode of mental illness.
Ireland's conundrum on union bargaining rights: assessing the Industrial Relations Amendment Act 2015
Authors: Dobbins Tony , Cullinane Niall , Sheehan Brian
Published: February 2020

Anglophone countries address the question of workplace‐level union bargaining rights via the mechanism of statutory recognition. Existing literature has evaluated such regimes as underpinned by several weaknesses. In contrast, Ireland presents an unusual case whereby the question of bargaining rights is resolved via collective dispute resolution procedures combining voluntary and statutory provisions. However, employer challenges and civil court rulings resulted in the weakening of these procedures from a trade union perspective. We assess the latest attempts to reform the Irish provisions via the Industrial Relations (Amendment) Act 2015, evaluating the implications for unions and their capacity to represent members' on pay and working conditions in comparison to Anglophone statutory recognition regimes.
Cross‐tolerance for drought, heat and salinity stresses in chickpea (Cicer arietinum L.)
Authors: Pushpavalli Raju , Berger Jens D. , Turner Neil C. , Siddique Kadambot H. M. , Colmer Timothy D. , Vadez Vincent
Published: February 2020

Chickpea crops are often exposed to a combination of drought, heat and salinity stresses during the reproductive stage. Previous efforts have largely focused on these stresses in isolation, such that we do not understand whether genotypes tolerant to one stress can withstand other stresses. Around 22–44 chickpea genotypes contrasting for tolerance to drought, salinity or heat in previous studies were exposed to terminal drought (TD, 3 experiments) and to salinity (SAL, 1 experiment). A priori stress tolerance to any of the listed stresses was generally reflected in drought and salinity tolerance in the present study. Thus, the drought‐, heat‐ and salt‐tolerant groups (DT, HT and ST) produced higher seed yield, had earlier phenology, higher harvest indices and seed yield transpiration efficiencies compared with sensitive groups (DS, HS and SS). However, tolerance did not select for prescriptive water use patterns. Despite our efforts to remove the confounding effects of phenology, 4–9 days variation in flowering time made a significant difference in productivity and differentiated tolerant from sensitive counterparts. In TD1, TD2 and SAL, all tolerant groups yielded similarly under stress conditions. This showed the existence of cross‐tolerance in chickpea where tolerant genotype selected for an individual stress can yield well under other stresses too.
Structural and thermal behavior of 45S5 Bioglass®‐based compositions containing alumina and strontium
Authors: Araujo Mariana S. , Silva Antonio C. , Bartolomé José F. , Mello‐Castanho Sonia
Published: February 2020

The present research exposes the influence of 2 mol% of Al2O3 and 2 mol% SrO in 45S5 Bioglass®‐based compositions. Four compositions were produced to elucidate the difference in how both oxides influence structure and thermal behavior separately and their synergy when together. Thermal properties, crystallization tendency, and sintering behavior was evaluated by differential scanning calorimetry, hot stage microscopy, and dilatometry. Changes of medium‐range structures were characterized by Qn distribution of Raman spectroscopy and evaluation of 31P, 27Al, 23Na, and 29Si environment obtained by magic angle spinning nuclear magnetic resonance. Despite Qn distribution was predominantly Q2 in all samples, the composition criteria used enabled improved processing and stabilibity characteristics. The addition of Al2O3 and SrO promoted larger sinterability parameter (Sc) which indicates better sintering behavior, the glass stability against crystallization doubled (KH) compared to 45S5 and the processing window enlarged from 106 to 171.
Left sinus of Valsalva—Electroanatomic basis and outcomes with ablation for outflow tract arrhythmias
Authors: Kapa Suraj , Mehra Nandini , Deshmukh Abhishek J. , Friedman Paul A. , Asirvatham Samuel J.
Published: February 2020

Introduction

The ablation of outflow tract premature ventricular contractions (PVCs) is generally safe and effective. In some patients, successful ablation sites may not correlate with the earliest activation. We sought to evaluate mechanistic and anatomic relevance of the region below the left sinus of Valsalva in variable morphology outflow tract ventricular arrhythmias.

Methods

PVC cases where ablation was in the region inferior to the left sinus of Valsalva were identified. Procedural and demographic information and long‐term outcomes were obtained. Cadaver dissections to evaluate regional anatomy were done as well.

Results

A total of 51 cases were included (age 53 ± 10; 37 [73%] males). Ablation was done for high PVC burden (>20%; mean 27% ± 8%) and presence of symptoms (73%) or ejection fraction less than 50% (78%). QRS morphology included either R wave (8; 16%), Rs (9; 18%), or rS (67%) in lead I, no precordial transition (40; 78%), V2 transition, (7; 14%), or V3 transition (4; 8%). In 31 (61%), the site just below the left coronary cusp was the earliest site, while the remainder had another site earlier. Ablation was acutely successful in 50 of 51 (98%). After 3 months, success was noted in 48 of 51 (94%). In two patients, repeat ablation in the same region resulted in durable suppression.

Conclusion

The cases presented emphasize the importance of a region centered below the left sinus of Valsalva, where multivariable morphology QRS may be successfully ablated. Consideration of mapping and ablation even when signals are late in this region may be warranted in previously failed ablation attempts or first‐line evaluation.
Concomitant leadless pacemaker implantation and lead extraction during an active infection
Authors: Chang David , Gabriels James K. , Soo Kim Beom , Ismail Haisam , Willner Jonathan , Beldner Stuart J. , John Roy M. , Epstein Laurence M.
Published: February 2020

Introduction

The need for transvenous lead extractions due to cardiac implantable electronic device (CIED)‐related infections continues to rise. Current guidelines recommend complete device removal in the setting of an active infection, which can be challenging in pacemaker‐dependent patients.

Methods

We retrospectively reviewed all leadless pacemaker implants between January 2018 and November 2019 and identified a subset of patients who had undergone a concomitant CIED extraction in the setting of an active infection. Baseline characteristics, procedural details, and clinical follow‐ups were recorded.

Results

Seventeen patients received a leadless pacemaker during the same procedure as the CIED extraction. There were no procedural complications. All patients were being treated for an active CIED infection at the time of the procedure. Fourteen patients (82.4%) were completely pacemaker‐dependent and four patients (23.5%) had positive blood cultures at the time of the leadless pacemaker implantation. During a median follow‐up of 143 days (interquartile range: 57, 181 days), there were no recurrent infections.

Conclusion

Simultaneous leadless pacemaker implantation and CIED extraction are safe and feasible in the setting of an active infection. This strategy may be particularly useful in patients that are pacemaker‐dependent.
Association of impaired arterial wall properties with the presence of coronary artery disease in patients with abdominal aortic aneurysms
Authors: Rafouli‐Stergiou Pinelopi , Ikonomidis Ignatios , Katsiki Niki , Kadoglou Nikolaos P. E. , Vlachos Stefanos , Thymis John , Parissis John , Moulakakis Konstantinos G. , Kakisis John D.
Published: February 2020

Pulse wave velocity (PWV) is a valid, clinically feasible marker of arterial stiffening, and a strong predictor of outcomes. The present study aimed to compare aortic elastic properties in patients with abdominal aortic aneurysms (AAA), with or without coronary artery disease (CAD), as well as healthy individuals. A total of 130 patients with AAA, eligible for interventional repair, and 30 healthy individuals, comprising the control group (HC), were enrolled. Presence of CAD was identified by coronary angiography. Aortic PWV (aPWV) was measured using the Arteriograph. aPWV was found considerably higher in AAA patients compared with HC group (11.5 ± 2.9 vs 7.3 ± 1.6 m/s, P < .001). Importantly, among patients with AAA, those with concomitant CAD (n = 41) had greater aPWV than those without CAD (12.5 ± 2.9 vs 11.0 ± 3.0 m/s, P = .03). In receiver operator curve (ROC) analysis, a value of aPWV above 12.8 m/s was identified to correlate with the presence of CAD in the AAA patient population. After adjustment for confounders, including hypertension which is one of the major risk factors for abdominal aneurysms, multivariate logistic regression analysis revealed that this aPWV cutoff remained independently associated with presence of CAD [odds ratio = 1.64, 95% confidence interval =1.19‐4.08, P = .03]. The coexistence of CAD and AAA is characterized by a greater arterial stiffness. This finding should be taken into consideration when selecting endovascular stents with more favorable elastic properties. Moreover, AAA patients with high aPWV (>12.8 m/s) are more likely to also have CAD, and this may be considered by vascular surgeons when evaluating patients' cardiovascular risk.
Aortic blood pressure and arterial stiffness in patients with controlled resistant and non‐resistant hypertension
Authors: Cai Anping , Siddiqui Mohammed , Judd Eric K. , Oparil Suzanne , Calhoun David A.
Published: February 2020

The purpose of the current study was to determine whether aortic blood pressure (BP) and arterial stiffness are greater in patients with controlled resistant hypertension (RHTN) than controlled non‐resistant hypertension (non‐RHTN) despite similar clinic BP level. Participants were recruited from University of Alabama at Birmingham (UAB) Hypertension Clinic. Controlled hypertension was defined as automated office BP measurement with BP < 135/85 mm Hg. A total of 141 participants were evaluated by pulse wave analysis (PWA) and carotid‐femoral pulse wave velocity (cf‐PWV). Among them, 75 patients had controlled RHTN with use of 4 or more antihypertensive medications and 56 patients had controlled non‐RHTN with use of 3 or less antihypertensive medications. Compared to patients with controlled non‐RHTN, those with controlled RHTN were more likely to be African American and had a higher prevalence of diabetes mellitus and congestive heart failure. The mean number of antihypertensive medications was greater in patients with controlled RHTN (4.4 ± 0.8 vs 2.3 ± 0.7,P < .001). Clinic brachial BP, aortic BP, augmentation pressure (AP), augmentation index normalized for heart rate of 75 beats per minute (AIx@75) and cf‐PWV were similar in both groups. In summary, there was no significant difference in central BP or arterial stiffness between patients with controlled RHTN and controlled non‐RHTN. These findings suggest that the higher residual cardiovascular risk observed in patients with RHTN after achieving BP control compared to patients with more easily controlled hypertension is not likely attributable to persistent differences in central BP and arterial stiffness.
PCAT‐1 promotes cell growth by sponging miR‐129 via MAP3K7/NF‐κB pathway in multiple myeloma
Authors: Shen Xianjuan , Kong Shan , Yang Qian , Yin Qingqing , Cong Hui , Wang Xudong , Ju Shaoqing
Published: February 2020

Loss of one or some specific miRNA‐mediated regulation is closely associated with malignant progression of multiple myeloma (MM). But how these miRNAs work and what role the specific miRNA plays in this process of malignant progression remain unclear. It was found in this study that the expression of miR‐129 was decreased in both MM cell lines and newly diagnosed MM patients. Further clinicopathological statistics showed that miR‐129 was correlated with the isotype of MM patients. MiR‐129 overexpression disturbed cell proliferation, cell cycle evolution and spurred apoptosis both in vitro and in vivo. MAP3K7, a kinase able to activate NF‐κB circuit, was found to be up‐regulated in MM and contain a binding target of miR‐129. In addition, lncRNA PCAT‐1 functioned to sponge miR‐129 and thereby lowered its expression. PCAT‐1 knockdown eliminated the tumour‐promoting effect caused by miR‐129 inhibition, probably through repressing MAP3K7 and subsequent NF‐κB activation. To the best of our knowledge, this is the first study to have discovered that increased expression of PCAT‐1 could augment cell proliferation and cycle procession and inhibit apoptosis by down‐regulating miR‐129 via the MAP3K7/NF‐κB pathway in MM.
A cautionary tale of multiple‐dose drug products: Fluticasone and salmeterol combination inhaler waste
Authors: Aeng Elissa S. Y. , Dhaliwal Maninder M. , Tejani Aaron M.
Published: February 2020

Rationale

Some drugs can only be dispensed in multiple‐dose containers. Multiple‐dose packaging may pose a problem for hospitals in terms of drug wastage and cost. Oral inhalers, such as fluticasone propionate and salmeterol combination inhalers, are only available as multiple‐dose formats in Canada.

Objectives

The objectives of this study are to quantify the amount of fluticasone propionate and salmeterol combination inhaler waste and to assess possible factors that could be contributing to waste.

Methods

A retrospective chart review of 189 patients was conducted. Patients were included if they had received an order for fluticasone propionate and salmeterol combination inhaler at one of the 12 acute hospital sites of Fraser Health Authority. The primary outcome was the proportion of patients who were dispensed one or more inhalers unnecessarily. The number of inhalers dispensed was compared with the number of inhalers needed to complete a patient's order duration. The chart was also reviewed for possible factors that could have contributed to extra inhalers being dispensed unnecessarily.

Results

Thirty‐seven patients (19.6%) had at least one inhaler dispensed unnecessarily and thus wasted. About 17.4% of the total amount of inhalers dispensed were dispensed unnecessarily, and 76.3% of doses dispensed were wasted. The cost of inhalers wasted for our sample was $5151.12 (CAD). The most common factors that contributed to inhaler waste appeared to be loss of medication during patient transfers and storage of inhalers as wardstock.

Conclusions

The use of drugs that are only available in multiple‐dose formats results in significant drug wastage and unnecessary health care expenditure. To minimize wastage of drug product, procedures could be implemented to ensure that drugs are properly transferred with the patient when a patient transfers locations in the hospital. As well, a review of wardstock inventory may minimize waste. Further assessment of multiple‐dose drug product waste and evaluations of methods to mitigate waste are encouraged.
The environmental impacts of operating an Antarctic research station
Authors: Crossin Enda , Verghese Karli , Lockrey Simon , Ha Hieu , Young Gordon
Published: February 2020

We present a life cycle assessment (LCA) of the operation of Casey Station in Antarctica. The LCA included quantifying material and energy flows, modeling of elementary flows, and subsequent environmental impacts. Environmental impacts were dominated by emissions associated with freight operations and electricity cogeneration. A participatory design approach was used to identify options to reduce environmental impacts, which included improving freight efficiency, reducing the temperature setpoint of the living quarters, and installing alternative energy systems. These options were then assessed using LCA, and have the potential to reduce environmental impacts by between 2% and 19.1%, depending on the environmental indicator.
Comparison of three reversible injectable chemical restraint protocols in Spix´s Owl monkeys (Aotus vociferans) using ketamine, xylazine and midazolam
Authors: Alfonso Jessy , Lescano Jesús , Quevedo Miryam , Fernández Víctor
Published: February 2020

Background

There is scarce information detailing clinical and physiological effects of reversible injectable protocols of chemical restraint on Neotropical primates.

Methods

Nineteen captive Spix´s Owl monkeys (Aotus vociferans) were assessed in a double‐blind randomized crossover study using the following: ketamine/xylazine [KX], ketamine/midazolam [KM] and ketamine/xylazine/midazolam [KXM]. During immobilization, respiratory and pulse rates, rectal temperature, haemoglobin oxygen saturation and arterial blood pressure were recorded at 5‐minute intervals during a 20‐minute period; afterwards, antagonist drugs (yohimbine for xylazine and flumazenil for midazolam) were, respectively, administered. Quality and duration of induction, immobilization and recovery periods were recorded.

Results

Ketamine/xylazine increased manipulation sensitivity and produced poor muscle relaxation. KM maintained all assessed parameters within physiological ranges. KXM produced depressant cardiorespiratory effects and hypotension. All protocols produced hypothermia.

Conclusions

Based on its adequate anaesthetic depth and minimum effects on physiological parameters, KM is suitable for immobilizing A vociferans and performing short‐term procedures lasting around 20 minutes.
Platelet regulates neuroinflammation and restores blood–brain barrier integrity in a mouse model of traumatic brain injury
Authors: Gao Cheng , Wang Haochen , Wang Tao , Luo Chengliang , Wang Zufeng , Zhang Mingyang , Chen Xiping , Tao Luyang
Published: February 2020

Neuroinflammation accompanied by microglial activation triggers multiple cell death after traumatic brain injury (TBI). The secondary injury caused by inflammation may persist for a long time. Recently, platelet C‐type lectin‐like 2 receptor (CLEC‐2) has been shown to regulate inflammation in certain diseases. However, its possible effects on TBI remain poorly understood. Here, we aimed to investigate the role of platelet CLEC‐2 in the pathological process of neuroinflammation after TBI. In this study, mice were subjected to sham or controlled cortical impact injury, and arbitrarily received recombinant platelet CLEC‐2. In parallel, BV2 cells were treated with lipopolysaccharide (LPS) to mimic microglial activation after TBI. Primary endothelial cells were also subjected to LPS in order to replicate the inflammatory damage caused by TBI. We used western blot analysis, reverse transcription polymerase chain reaction (RT‐PCR), and immunostaining to evaluate the role of platelet CLEC‐2 in TBI. In conditional knock out platelet CLEC‐2 mice, trauma worsened the integrity of the blood–brain barrier and amplified the release of inflammatory cytokines. In wild type mice subjected to controlled cortical impact injury, recombinant platelet CLEC‐2 administration altered the secretion of inflammatory cytokines, reduced brain edema, and improved neurological function. In vitro, the polarization phenotype of microglia induced by LPS was transformed by recombinant platelet CLEC‐2, and this conversion depended on the mammalian target of rapamycin (mTOR) pathway. Endothelial cell injury by LPS was ameliorated when microglia expressed mostly M2 phenotype markers. In conclusion, platelet CLEC‐2 regulates trauma‐induced neuroinflammation and restores blood–brain barrier integrity.

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Hypnotic prescription by GPs is associated with their personal drug consumption but not by their insomnia status
Authors: Chambe Juliette , Kobayashi Frisk Mio , Charton Lea , Lefebvre François , Will Sandrine , Rat Cédric , Bourgin Patrice
Published: February 2020

French general practitioners (GPs) are known to widely prescribe medications to treat insomnia despite their negative effects. GPs’ easy access to self‐medication may affect their mental representation of sleep and hypnotics, and subsequently their professional behaviour. Our aim was to examine the association between GPs’ personal hypnotic drug consumption habits and their management of patients with sleep disturbances. A randomized sample of Alsatian GPs participated in a survey based on questionnaires including the Pittsburgh Sleep Quality Index, the Dysfunctional Beliefs About Sleep in 10 questions to characterize sleep, and an evaluation of their management strategies regarding sleep for both patients and themselves. Two‐hundred and forty‐nine GPs were included (response rate of 51%). Demographics of the GPs’ samples were representative of those of the Alsatian GP population. Fifteen percent of the survey respondents met insomnia criteria. For the management of their own sleep disturbances, 14.3% of GPs were taking hypnotic drugs and 8.7% were taking anxiolytics, with greater drug consumption in the insomnia group. In a multivariate analysis, GPs who personally consumed these medications prescribed significantly more of them to patients, whereas their insomnia status had less impact. Other factors such as gender and type of practice were not associated with a higher prescription rate. Our results indicate that GPs’ personal drug consumption can have a significant impact on the management of their patients, therefore suggesting that actions towards GPs’ health improvement may also benefit their patients and the public.
Optimal drug administration manner would rescue partial virological response in chronic hepatitis B patients with entecavir or tenofovir treatment
Authors: Tao Ya‐Chao , Wang Meng‐Lan , Zhang Dong‐Mei , Wu Dong‐Bo , Wang Yong‐Hong , Liao Juan , Tang Hong , Chen En‐Qiang
Published: February 2020

Not all treatment‐naïve patients receiving entecavir (ETV) or tenofovir disoproxil fumarate (TDF) therapy can achieve complete virological response, and many factors may be related with the outcome of partial virological response. This study aimed to determine whether the manner of drug administration affects the antiviral efficacy of ETV/TDF monotherapy. All eligible patients were divided into complete or partial response cohorts based on their virological response following 24‐week therapy. Factors related with partial response were evaluated. Patients with partial response were further grouped depending on whether they later adjusted the manner of drug administration, and the antiviral efficacy was compared between the two groups during prolonged treatment. A total of 518 patients were enrolled. Suboptimal drug administration (OR 77.511, P = .000), positive‐HBeAg (OR 3.191, P = .000) and ETV treatment (OR 2.537, P = .001) were identified as independent risk factors for partial response. Among patients with partial response, 213 were in the adjusted group and 76 were in the unadjusted group. The percentages of patients with undetectable serum HBV DNA (78.9% vs 31.6%, P < .001) and with normal alanine aminotransferase (ALT) (88.7% vs 68.4%, P < .001) were both higher in the adjusted group than that in unadjusted group following a further 6‐month therapy. In conclusion, the manner of drug administration is an important factor influencing the efficacy of ETV/TDF therapy, and optimal drug administration manner can help to increase antiviral efficacy and rescue patients with partial response.
Patient and provider‐level barriers to hepatitis C screening and linkage to care: A mixed‐methods evaluation
Authors: Higashi Robin T. , Jain Mamta K. , Quirk Lisa , Rich Nicole E. , Waljee Akbar K. , Turner Barbara J. , Lee Simon Craddock , Singal Amit G.
Published: February 2020

Achieving practice change can be challenging when guidelines shift from a selective risk‐based strategy to a broader population health strategy, as occurred for hepatitis C (HCV) screening (2012‐2013). We aimed to evaluate patient and provider barriers that contributed to suboptimal HCV screening and linkage‐to‐care rates after implementation of an intervention to improve HCV screening and linkage‐to‐care processes in a large, public integrated healthcare system following the guidelines change. As part of a mixed‐methods study, we collected data through patient surveys (n = 159), focus groups (n = 9) and structured observation of providers and staff (n = 9). We used these findings to then inform domains for the second phase, which consisted of semi‐structured interviews with patients across the screening‐treatment continuum (n = 24) and providers and staff at primary care and hepatology clinics (n = 21). We transcribed and thematically analysed interviews using an integrated inductive and deductive framework. We identified lack of clarity about treatment cost, treatment complications and likelihood of cure as ongoing patient‐level barriers to screening and linkage to care. Provider‐level barriers included scepticism about establishing HCV screening as a quality metric given competing clinical priorities, particularly for patients with multiple comorbidities. However, most felt positively about adding HCV as a quality metric to enhance HCV screening and linkage to care. Provider engagement yielded suggestions for process improvements that resulted in increased stakeholder buy‐in and real‐time enhancements to the HCV screening process intervention. Systematic data collection at baseline and during practice change implementation may facilitate adoption and adaptation to improve HCV screening guideline implementation. Findings identified several key opportunities and lessons to enhance the impact of practice change interventions to improve HCV screening and treatment delivery.
The impact of civil conflict on infant and child malnutrition, Nigeria, 2013
Authors: Howell Embry , Waidmann Timothy , Birdsall Nancy , Holla Nikhil , Jiang Kevin
Published: February 2020

The new millennium brought renewed attention to improving the health of women and children. In this same period, direct deaths from conflicts have declined worldwide, but civilian deaths associated with conflicts have increased. Nigeria is among the most conflict‐prone countries in Sub‐Saharan Africa, especially recently with the Boko Haram insurgency in the north. This paper uses two data sources, the 2013 Demographic and Health Survey for Nigeria and the Social Conflict Analysis Database, linked by geocode, to study the effect of these conflicts on infant and young child acute malnutrition (or wasting). We show a strong association in 2013 between living close to a conflict zone and acute malnutrition in Nigerian children, with larger effects for rural children than urban children. This is related to the severity of the conflict, measured both in terms of the number of conflict deaths and the length of time the child was exposed to conflict. Undoubtedly, civil conflict is limiting the future prospects of Nigerian children and the country's economic growth. In Nigeria, conflicts in the north are expected to continue with sporadic attacks and continued damaged infrastructure. Thus, Nigerian children, innocent victims of the conflict, will continue to suffer the consequences documented in this study.
Life history parameters and diet of Risso's dolphins, Grampus griseus, from southeastern South Africa
Authors: Plön Stephanie , Heyns‐Veale Elodie R. , Smale Malcolm J. , Froneman P. William
Published: February 2020

The life history of Risso's dolphins (Grampus griseus) remains poorly known and data from strandings can help provide important information. Data from 126 Risso's dolphins stranded or bycaught along the southeastern coastline of South Africa between 1958 and 2017 were analyzed in relation to their sex, age structure, and diet. Mean estimated length at birth was 146.9 cm, while maximum length was 325 cm for males and 313 cm for females; small sample sizes precluded detailed examination of sexual dimorphism. Age estimates for 33 individuals (14 males, 17 females, 2 unknown sex) indicated a maximum age of 13 years (males) and 17 years (females), respectively; the oldest animal was 19 years (unknown sex). Mean length and age at attainment of sexual maturity were estimated at 280 cm and 7.1 years in males and at 282 cm and 7.7 years in females. Stomach contents from 27 individuals showed that diets of immature and mature males and females overlapped and consisted predominantly of cephalopods. Reported strandings decreased between 2000 and 2017, possibly due to a lack of reporting associated with a ban on driving on beaches or related to the collapse of the local “chokka” squid (Loligo reynaudii) fishery in 2014–2015.