bluuebunny/crossref_metadata_2025 huggingface dataset:
Campanometry The Statistics of Bells
Authors: de Wet Tertius , Teugels Jef , van Deventer Pieta
Published: November 2019

For the past decade, Tertius de Wet, Jef Teugels and Pieta van Deventer have been documenting bells found in South Africa's Western Cape Province. But while some bells come with a rich and detailed history, others are more of a mystery. Can the statistical analysis of sound help trace their origins?
DDX49 is a novel biomarker and therapeutic target for lung cancer metastases
Authors: Lian Xiaojuan , Xiang Debing , Peng Chunfang , Chen Jiangyan , Liao Maojun , Sun Guiyin , Zhang Zhimin
Published: November 2019

The identification of lymph node metastases is important for the diagnosis, treatment and prognosis of patients with lung cancer. We found DDX49 was associated with the lymph node metastases in lung cancer by the Akt/β‐catenin pathway. Transcriptome sequencing, bioinformatics analysis, quantitative RT‐PCR, cell transfection and the Cancer Genome Atlas (TCGA) data set were used to identify DDX49 responsible for lymph node metastases. A Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was used to explore the possible molecular mechanism in experimental cell. The DDX49 gene was correlated significantly with lymph node metastases of lung cancer. The knockdown of DDX49 inhibited the cell proliferation and migration in PC‐9 and H460 cells. The mechanism research found downexpression of DDX49 decreased the Akt/β‐catenin pathway in lung cancer cell. In vivo experiments showed that DDX49 promoted the proliferation and metastases of lung cancer cells by increasing the Akt/β‐catenin pathway. These findings suggested that DDX49 may be useful as a novel biomarker of lymph node metastases and therapeutic target for lung cancer metastasis.
LncRNA ACART protects cardiomyocytes from apoptosis by activating PPAR‐γ/Bcl‐2 pathway
Authors: Wu Hao , Zhu Haixia , Zhuang Yuting , Zhang Jifan , Ding Xin , Zhan Linfeng , Luo Shenjian , Zhang Qi , Sun Fei , Zhang Mingyu , Pan Zhenwei , Lu Yanjie
Published: November 2019

Cardiomyocyte apoptosis is an important process occurred during cardiac ischaemia‐reperfusion injury. Long non‐coding RNAs (lncRNA) participate in the regulation of various cardiac diseases including ischaemic reperfusion (I/R) injury. In this study, we explored the potential role of lncRNA ACART (anti‐cardiomyocyte apoptosis‐related transcript) in cardiomyocyte injury and the underlying mechanism for the first time. We found that ACART was significantly down‐regulated in cardiac tissue of mice subjected to I/R injury or cultured cardiomyocytes treated with hydrogen peroxide (H2O2). Knockdown of ACART led to significant cardiomyocyte injury as indicated by reduced cell viability and increased apoptosis. In contrast, overexpression of ACART enhanced cell viability and reduced apoptosis of cardiomyocytes treated with H2O2. Meanwhile, ACART increased the expression of the B cell lymphoma 2 (Bcl‐2) and suppressed the expression of Bcl‐2‐associated X (Bax) and cytochrome‐C (Cyt‐C). In addition, PPAR‐γ was up‐regulated by ACART and inhibition of PPAR‐γ abolished the regulatory effects of ACART on cell apoptosis and the expression of Bcl‐2, Bax and Cyt‐C under H2O2 treatment. However, the activation of PPAR‐γ reversed the effects of ACART inhibition. The results demonstrate that ACART protects cardiomyocyte injury through modulating the expression of Bcl‐2, Bax and Cyt‐C, which is mediated by PPAR‐γ activation. These findings provide a new understanding of the role of lncRNA ACART in regulation of cardiac I/R injury.
CYP2J2/EET reduces vulnerability to atrial fibrillation in chronic pressure overload mice
Authors: Li Xuguang , Zhu Feng , Meng Weidong , Zhang Feng , Hong Jiang , Zhang Guobing , Wang Fang
Published: November 2019

Growing evidence has well established the protective effects of CYP2J2/EET on the cardiovascular system. The aim of the present study was to determine whether CYP2J2/EET has a preventive effect on atrial fibrillation (AF) and to investigate the underlying mechanisms. Wild‐type mice were injected with or without AAV9‐CYP2J2 before abdominal aortic constriction (AAC) operation. After 8 weeks, compared with wild‐type mice, AAC mice display higher AF inducibility and longer AF durations, which were remarkably attenuated with AAV9‐CYP2J2. Also, AAV9‐CYP2J2 reduced atrial fibrosis area and the deposit of collagen‐I/III in AAC mice, accompanied by the blockade of TGF‐β/Smad‐2/3 signalling pathways, as well as the recovery in Smad‐7 expression. In vitro, isolated atrial fibroblasts were administrated with TGF‐β1, EET, EEZE, GW9662, SiRNA Smad‐7 and pre‐MiR‐21, and EET was demonstrated to restrain the differentiation of atrial fibroblasts largely dependent on Smad‐7, due to the inhibition of EET on MiR‐21. In addition, increased inflammatory cytokines, as well as activated NF‐κB pathways induced by AAC surgery, were also significantly blunted by AAV9‐CYP2J2 treatment. These effects of CYP2J2/EET were partially blocked by GW9662, the antagonist of PPAR‐γ. In conclusion, this study revealed that CYP2J2/EET ameliorates atrial fibrosis through modulating atrial fibroblasts activation by disinhibition of MiR‐21 on Smad‐7, and attenuates atrial inflammatory response by repressing NF‐κB pathways, reducing the vulnerability to AF, and CYP2J2/EET exerts its role at least partially through PPAR‐γ activation. Our findings might provide a novel upstream therapeutic strategy for AF.
Trust and world view in shared decision making with indigenous patients: A realist synthesis
Authors: Groot Gary , Waldron Tamara , Barreno Leonzo , Cochran David , Carr Tracey
Published: November 2019

Introduction

How shared decision making (SDM) works with indigenous patient values and preferences is not well understood. Colonization has affected indigenous peoples' levels of trust with institutions, and their world view tends to be distinct from that of nonindigenous people. Building on a programme theory for SDM, the present research aims to refine the original programme theory to understand how the mechanisms of trust and world view might work differently for indigenous patients.

Design

We used a six‐step iterative process for realist synthesis: preliminary programme theory development, search strategy development, selection and appraisal of literature, data extraction, data analysis and synthesis, and formation of a revised programme theory.

Data Sources

Searches were through Medline, CINAHL, and the University of Saskatchewan iPortal for grey literature. Medline and CINAHL searches included the University of Alberta Canada‐wide indigenous peoples search filters.

Data synthesis

Following screening 731 references, 90 documents were included for data extraction (53 peer reviewed and 37 grey literature). Documents from countries with similar colonization experiences were included.

Results

A total of 518 context‐mechanism‐outcome (CMO) configurations were identified and synthesized into 21 CMOs for a revised programme theory. Demographics, indigenous world view, system and institutional support, language barriers, and the macro‐context of discrimination and historical abuse provided the main contexts for the programme theory. These inspired mechanisms of reciprocal respect, perception of world view acceptance, and culturally appropriate knowledge translation. In turn, these mechanisms influenced the level of trust and anxiety experienced by indigenous patients. Trust and anxiety were both mechanisms and intermediate outcomes and determined the level of engagement in SDM.

Conclusion

This realist synthesis provides clinicians and policymakers a deeper understanding of the complex configurations that influence indigenous patient engagement in SDM and offers possible avenues for improvement.
Patient safety culture in Oman: A national study
Authors: Al Nadabi Waleed , Faisal Muhammad , Mohammed Mohammed Amin
Published: November 2019

Rational, aim, and objectives

A positive patient safety culture in maternity units is linked to higher quality of care and better outcomes for mothers. However, safety culture varies across maternity units. Analyses of variation in safety culture using statistical process control (SPC) methods may help provider units to learn from each other's performance. This study aims to measure patient safety culture across maternity units in Oman using SPC methods.

Methods

The 36‐item Safety Attitude Questionnaire (SAQ) was distributed to all doctors, nurses, and midwifes working in ten maternity care units in Oman's hospitals and analysed using SPC methods. The SAQ considers six domains: job satisfaction, perception of management, safety climate, stress recognition, teamwork, and work condition.

Results

Of the 892 targeted participants, 735 (82%) questionnaires were returned. The overall percentage of positive safety responses in all hospitals ranged from 53% to 66%, but no hospital had the targeted response of above 75%. Job satisfaction had the highest safety score (4.10) while stress recognition was the lowest (3.17). SPC charts showed that the overall percentage of positive responses in three maternity units (H1, H7, and H10) was above and one (H4) was below the control limits that represent special cause variation that merits further investigation.

Conclusion

Generally, the safety culture in maternity units in Oman is below target and suggests that considerable work is required to enhance safety culture. Several maternity units showed evidence of high/low special cause variation that may offer a useful starting point for understanding and enhancing safety culture.
Dengue hepatitis with acute liver failure: Clinical, biochemical, histopathological characteristics and predictors of outcome
Authors: Devarbhavi Harshad , Ganga Deepak , Menon Mahesh , Kothari Ksheetij , Singh Rajvir
Published: November 2019

Background

Hepatitis infection from non‐hepatotropic viruses such as dengue virus (DENV) is increasing worldwide. There is increasing recognition of the changing epidemiology and atypical presentations of DENV infection including acute liver failure (ALF). There is paucity of data regarding incidence, disease characteristics, and markers of prognosis in patients who develop DENV‐related ALF.

Methods

We aimed to study the incidence, clinical features, laboratory characteristics, and determinants of outcome in patients of DENV presenting with ALF. We reviewed all patients with DENV infection and focused on DENV‐related ALF from 2014 to 2017. Diagnosis of DENV and ALF was confirmed by serological tests and standard criteria, respectively.

Results

Thirty‐six patients (20 men, mean age 32.3) developed ALF among 10 108 patients with DENV infection (0.35%). Twenty‐one patients died (58.3%). Although bilirubin, aspartate and alanine aminotransferase, and international normalized ratio were markedly elevated in all patients with DENV ALF, there was no statistically significant difference between survivors and non‐survivors. Lactate levels, pH at admission, and model for end‐stage liver disease (MELD) score were the only predictors of mortality. Lactate levels were significantly higher in non‐survivors (11.5 ± 4.2 mmol/L) than survivors (6.3 ± 3.6 mmol/L) (P < 0.001). MELD score in non‐survivors (26.7 ± 10.2) was significantly higher than in survivors (20 ± 7.2) (P = 0.039). Receiver operator characteristic curve showed lactate or pH to be a superior prognostic marker than MELD with an area under the curve of 0.80, 0.79, and 0.70, respectively.

Conclusion

Dengue hepatitis progressed to ALF in 0.35%. Development of ALF was associated with a high mortality (> 50%). Lactate level, pH, and MELD score at admission were significant determinants of outcome.
MiR‐342‐3p inhibition promotes cell proliferation and invasion by directly targeting ID4 in pre‐eclampsia
Authors: Han Xiuhua , Niu Chuanzhen , Zuo Zhongli , Wang Yuanmin , Yao Lanlan , Sun Lili
Published: November 2019

Aim

This study aimed to explore the miR‐342‐3p expression in pre‐eclampsia (PE) placentas and confirm whether miR‐342‐3p exerts effects on proliferation and migration of HTR‐8/SVneo trophoblastic cells.

Methods

The PE placentas (n = 8) were taken from gravidas complicated by PE and delivered after 34 weeks. The chorionic plates and the basal plates were separately taken from the placenta disc near the position of umbilical cord insertion. RT‐qPCR was used to measure the expression of miR‐342‐3p in the chorionic plates and the basal plates. Cell invasion assay and MMT assay were used to assess the effects of miR‐342‐3p on proliferation and migration of HTR‐8/SVneo trophoblastic cells. Luciferase reporter assay and Western blotting were used to analyze the target of miR‐342‐3p and investigate the detailed mechanisms.

Results

The expression of miR‐342‐3p was upregulated in both basal plates and chorionic plates in patients with PE compared with healthy pregnant individuals. MiR‐342‐3p inhibitor suppressed the cell viability and invasion, and induced apoptosis in trophoblast cells. Furthermore, inhibitor of DNA binding (ID)‐4 (ID4) was a direct target of miR‐342‐3p, and knockdown of ID4 abrogated the regulation effect of miR‐342‐3p on cell viability, apoptosis and invasion.

Conclusion

Inhibition of miR‐342‐3p expression may suppress the occurrence of PE by targeting ID4 in vitro.
Cross‐cultural Protective Effects of Neighborhood Collective Efficacy on Antisocial Behaviors: Mediating Role of Social Information Processing
Authors: Yoshizawa Hiroyuki , Yoshida Toshikazu , Park Hyun‐Jung , Nakajima Makoto , Ozeki Miki , Harada Chika
Published: November 2019

Studies on the prevention of antisocial behavior in neighborhoods through efficacious social control have focused on collective efficacy as the theoretical mechanism by which children at the community level can be successfully socialized to develop an aversion to antisocial behaviors. We hypothesized that the effect of collective efficacy within communities on antisocial behaviors could be mediated by social‐information‐processing biases and tested the generality of these mediation effects for undergraduates (N = 929) in Japan, China, South Korea, and the United States, countries with widely varying cultures and political systems. Structural equation modeling revealed that the effects of collective efficacy on antisocial behaviors were perfectly mediated by social‐information‐processing biases. Findings also confirmed the generality of these mediational effects in all four countries investigated.
The modification of three vulnerability theories to assist nursing practice for school‐age children with severe asthma
Authors: Lack Sharon , Kinser Patricia A.
Published: November 2019

Purpose

Severe asthma is an inflammatory illness associated with adverse health outcomes and behaviors in children, such as decreased quality of life, impaired sleep, and increased medical costs and morbidity.

Conclusions

Children with severe asthma frequently exhibit a cycle of health and behaviors which contribute to these adverse health outcomes, consisting of decreased physical activity, increased stress, and increased airway inflammation and asthma exacerbations. School‐age children, in particular, are a vulnerable population because they not only rely on others for their care but also suffer from a chronic illness and are at risk for unequal healthcare access and health outcomes.

Practice Implications

Currently, there is no one nursing theory that adequately addresses the vulnerability, cycle of health and behaviors, and adverse health outcomes of children with severe asthma. By integrating key concepts from three vulnerability theories and presenting a modified conceptual framework, this paper aims to demonstrate how the use of this new conceptual framework may assist nurses in evaluating the unique needs of school‐age children with severe asthma to provide best practices and develop appropriate interventions.
Nurse case management to improve the hepatitis C care continuum in HIV co‐infection: Results of a randomized controlled trial
Authors: Starbird Laura E. , Budhathoki Chakra , Han Hae‐Ra , Sulkowski Mark S. , Reynolds Nancy R. , Farley Jason E.
Published: November 2019

The opportunity to eliminate hepatitis C virus (HCV) is at hand, but challenges remain that negatively influence progress through the care continuum, particularly for persons co‐infected with HIV who are not well engaged in care. We conducted a randomized controlled trial to test the effect of nurse case management (NCM) on the HCV continuum among adults co‐infected with HIV compared to usual care (UC). Primary outcomes included linkage to HCV care (attendance at an HCV practice appointment within 60 days) and time to direct‐acting antiviral (DAA) initiation (censored at 6 months). Sixty‐eight participants were enrolled (NCM n = 35; UC n = 33). Participants were 81% Black/African American, 85% received Medicaid, 46% reported illicit drug use, 41% alcohol use, and 43% had an undetectable HIV viral load. At day 60, 47% of NCM participants linked to HCV care compared to 25% of UC participants (P = .031; 95% confidence bound for difference, 3.2%‐40.9%). Few participants initiated DAAs (12% NCM; 25% UC). There was no significant difference in mean time to treatment initiation (NCM = 86 days; UC = 110 days; P = .192). Engagement in HCV care across the continuum was associated with drinking alcohol, knowing someone who cured HCV and having a higher CD4 cell count (P < .05). Our results support provision of NCM as a successful strategy to link persons co‐infected with HIV to HCV care, but interventions should persist beyond linkage to care. Capitalizing on social networks, treatment pathways for patients who drink alcohol, and integrated substance use services may help improve the HCV care continuum.
Increasing value in research: cost evaluations in health professions education
Authors: Schreurs Sanne , Cleutjens Kitty , oude Egbrink Mirjam G A
Published: November 2019

The authors use Foo et al.'s discussion of the value of economic evaluations to consider how such techniques might advance the practice of selection for medical school.
Effects of intestinal alkaline phosphatase on intestinal barrier function in a cecal ligation and puncture (CLP)‐induced mouse model for sepsis
Authors: Plaeke Philip , De Man Joris G. , Smet Annemieke , Malhotra‐Kumar Surbhi , Pintelon Isabel , Timmermans Jean‐Pierre , Nullens Sara , Jorens Philippe G. , Hubens Guy , De Winter Benedicte Y.
Published: November 2019

Background

Sepsis is a severe pathological condition associated with systemic inflammation, intestinal inflammation, and gastrointestinal barrier dysfunction. Intestinal alkaline phosphatase (IAP) has been demonstrated to detoxify lipopolysaccharide, an important mediator in the pathophysiology of sepsis. We investigated the effect of treatment with IAP on intestinal permeability, intestinal inflammation, and bacterial translocation.

Methods

OF‐1 mice were divided into 4 groups (n = 12/group), undergoing either a sham or cecal ligation and puncture (CLP) procedure to induce sepsis. Mice received IAP or a vehicle intraperitoneally 5 minutes prior to the onset of the CLP or sham procedure, which was repeated every 12 hours for two consecutive days. After two days, in vivo intestinal permeability, intestinal inflammation, and bacterial translocation were determined.

Key results

CLP‐induced sepsis resulted in significantly more weight loss, worse clinical disease scores, bacterial translocation, and elevated inflammatory cytokines. Intestinal permeability was increased up to 5‐fold (P < .001). IAP activity was significantly increased in septic animals. Treatment with IAP had no effect on clinical outcomes but reduced the increased permeability of the small intestine by 50% (P = .005). This reduction in permeability was accompanied by a modified gene expression of claudin‐1 (P = .025), claudin‐14 (P = .035), and interleukin 12 (P = .015). A discriminant analysis showed that treatment with IAP is linked to modified mRNA levels of several tight junction proteins and cytokines.

Conclusions and inferences

Treatment with IAP diminished CLP‐induced intestinal barrier disruption, associated with modified expression of several cytokines and claudins. Nevertheless, this effect did not translate into better clinical outcomes in our experimental setup.
Differential expression of microRNAs in colorectal cancer: Different patterns between isolated cancer gland and stromal cells
Authors: Sato Ayaka , Fujita Yasuko , Otsuka Koki , Sasaki Akira , Suzuki Hiromu , Matsumoto Takayuki , Sugai Tamotsu
Published: November 2019

Although microRNAs (miRNAs) play an important role in invasive tumor lesions, which involve cancer tissues mixed with stromal tissues, the differences in miRNA expression between cancer and stromal cells remain unclear. We selected 13 miRNAs and examined their differential expression patterns in cancer gland cells and surrounding stromal cells isolated from 24 colorectal cancer (CRC) specimens using a crypt isolation method. Although six miRNAs were upregulated in gland cells, only three were upregulated in the corresponding stromal cells, in the cancer compared with non‐cancer specimens. Next, we examined the differences in miRNA expression between isolated cancer gland and stromal cells. Five miRNAs showed statistical differences in their cancer‐related differential expression patterns between isolated cancer gland and stromal cells. We then compared these miRNA expression patterns in isolated cancer gland and stromal cells with those in fresh intact tumor tissues, consisting of cancer nests and stromal tissue, obtained from the 24 CRCs. The expression patterns of three miRNAs in the intact cancer tissue samples did not correspond with those in the isolated components. Identification of the expression patterns of miRNAs in both the cancer gland and stromal cell components of the tumor microenvironment greatly contributes to evaluating epigenetic regulation in CRC.
Managing Relief Inventories Responding to Natural Disasters: Gaps Between Practice and Literature
Authors: Ye Yusen , Jiao Wen , Yan Hong
Published: November 2019

In response to highly unpredictable sudden‐onset natural disasters, efficient and effective management of disaster relief inventory (DRI) is essential. This study proposes a simple framework based on three fundamental DRI‐related decision themes, which are (1) who respond to DRI calling, (2) where to locate DRI, and (3) how to control DRI, aiming at identifying the research gaps between the realities’ calling and the literature’s consideration with a focus on DRI management. We review relevant literature for each decision theme, summarize the insights provided by the literature, assess the practical needs and procedures and present our detailed perspectives on the research gaps in practice. The chief implication from our observations and arguments is that scaling up a DRI response for catastrophic disasters and events which prepares the whole community for worst‐case scenarios has been highlighted in academics and practice but lack operational research in the area of relevant decision‐making tactics. Existing research concerning the DRI management issues of various coordination forms of disaster responders, the location‐allocation decision‐making determinants with DRI prepositioning and the DRI control policy in the face of various disaster uncertainties is still far from being fully understood, appropriately characterized and profoundly discussed. We recommend the potential future research areas with the implications of this review in the last conclusion section, wishing to provide researchers a better understanding of the needs in the real‐world.
Sexual desire and emotional reactivity in chronically hospitalized Lebanese patients with schizophrenia
Authors: Kazour Francois , Obeid Sahar , Hallit Souheil
Published: November 2019

Purpose

To study the level of emotional reactivity of Lebanese patients with schizophrenia who have a high level of sexual desire.

Design/Methods

It is a cross‐sectional study, enrolling 30 men and 30 women, between April and June 2017. The sexual behavior questionnaire (SBQ) was used to explore the desire, sexual arousal, orgasm, ejaculation, pleasure, and satisfaction with sexuality.

Findings

A significantly higher mean emotional score, higher cognitive functioning score, higher motivation score, higher motor deficit score, higher sensory perception score, higher SBQ score, and higher emotional reactivity were found in patients who masturbate compared with those who did not.

Practice Implications

All these improvements in patients who masturbate might be associated with better social relations, which might improve patient integration in society.

Key points

Sustained sexual activity of patients with schizophrenia is associated with improved emotional and cognitive functioning.

The same applies to higher levels of motivation, motor skills, and sensoriality.

Sustained sexual activity of patients who have schizophrenia would indicate a better prognosis of schizophrenia.
Inoculation and habitat amelioration efforts in biological soil crust recovery vary by desert and soil texture
Authors: Faist Akasha M. , Antoninka Anita J. , Belnap Jayne , Bowker Matthew A. , Duniway Michael C. , Garcia‐Pichel Ferran , Nelson Corey , Reed Sasha C. , Giraldo‐Silva Ana , Velasco‐Ayuso Sergio , Barger Nichole N.
Published: November 2019

As dryland degradation continues, it is increasingly important to understand how to effectively restore biocrust communities. Potential techniques include the addition of biocrust inoculum to accelerate biocrust recovery. Enhanced erosion typical of degraded environments creates a challenge for these approaches, due to loss by wind or water and burial by saltating particles. To retain and protect added inoculum, the inclusion of habitat‐amelioration techniques can improve recovery rates. This study tested three different types of inoculum (field‐collected, greenhouse‐cultivated, and laboratory‐cultivated biocrust) coupled with two treatments to augment soil stability and ameliorate habitat limitations: soil surface polyacrylamide additions and installation of straw barriers. This was done across two deserts (Great Basin and Chihuahuan) and separated into generally coarse‐ or finer‐textured soils in each desert, with results monitored for 3 years (2015, 2016, 2017). While the inoculum type, coupled with habitat ameliorations, occasionally enhanced biocrust growth across years and treatments, in other cases, it made no difference compared to natural recovery rates. Rather, the desert location and soil texture groupings were the most prominent factors in determining recovery trajectories. Recovery proportions were similar in the finer‐textured sites in both the Great Basin and the Chihuahuan deserts, while the coarser‐textured site in the Great Basin did show some recovery over time and the Chihuahuan coarser‐textured site did not. This study demonstrates the importance of understanding site potential and identifying key limitations to biocrust recovery for successful restoration projects.
Challenges and strategies in communication with people with dementia and their informal caregivers in community pharmacies – a narrative approach
Authors: Heimerl Katharina , Pichler Barbara , Plunger Petra
Published: November 2019

Background

People with dementia and their informal caregivers get in touch with the healthcare system predominantly via contacts with primary care providers. Among these, community pharmacists have been denominated as the health professionals most accessible to the public. Communication with and counselling people with dementia and their informal caregivers present particular challenges to pharmacists.

Aim

This study aims to research the challenges faced and strategies used by community pharmacists who deal with people living with dementia and their informal caregivers.

Methods

Within the context of two workshops with 74 participants, 15 small groups were formed, each of which generated and discussed a small story. Fourteen of those narratives were reported, tape recorded and transcribed. In these 14 narratives, community pharmacists reflected on their experiences with people with dementia or their informal caregivers. The narratives were systematically analysed and interpreted.

Findings

Among the main challenges reported by the workshop participants are the difficulty of identifying a person with dementia; the question of what appropriate communication is; the only partially successful networking with doctors, nursing personnel and support institutions; unsuccessful counselling; and the tension between the economic situation and the care for people with dementia and their informal caregivers. In general, strategies for dealing with people with dementia are characterised by uncertainty whereas communication with informal caregivers is well rehearsed and effective.

Conclusions

Community pharmacies require possibilities to retreat for counselling as well as the possibility for pharmacists to take time for people with dementia and their informal caregivers in everyday pharmacy life. Reflective spaces for narrations about difficult situations provide relief for staff in community pharmacies.
The evolution of Zoraptera
Authors: Matsumura Yoko , Beutel Rolf G. , Rafael José A. , Yao Izumi , Câmara Josenir T. , Lima Sheila P. , Yoshizawa Kazunori
Published: November 2019

Zoraptera is one of the most enigmatic and least understood orders in insects. Based on a wide taxon sampling from all continents where the group is known, we applied a phylogenetic approach using multiple DNA sequences to elucidate species‐level relationships. The resulting phylogeny shows that Zoraptera is divided into three major clades, and that two comprise species distributed on different continents. The monophyly of these clades is at least partly supported by shared derived morphological features. The divergence age estimation and ancestral distribution area reconstruction suggest an ancient origin and early radiation initiated in the Permian. Plate tectonics theory suggests that the present distribution of Zoraptera was mainly established by vicariance, rather than dispersal. The three major clades probably originated on the Pangaea supercontinent, or alternatively on the linked Gondwana and Laurasia supercontinents. Their ancient origin explains previously found conspicuous interspecific variation of the genital apparatus, sperm structure and mating behaviour, in striking contrast to a highly conserved general body morphology. We compiled data of available reproductive features and reconstructed the character evolution. Our analyses revealed repeated acquisitions and/or losses of a hyperelongated intromittent organ, mating hooks and tergal protuberances.
Coaching to improve self‐directed learning
Authors: Wolff Margaret , Stojan Jennifer , Buckler Stacie , Cranford James , Whitman Laurie , Gruppen Larry , Santen Sally
Published: November 2019

Background

The continuously changing health care context necesitates that medical trainees develop self‐directed learning skills. This study examined the effect of coaching on the self‐directed learning process in pre‐clerkship medical students.

Methods

We conducted a longitudinal educational intervention using standardised patient assessments to determine the effect of self‐assessment, feedback, and coaching on the development and implementation of learning goals (LGs). Students were sorted into control and intervention groups. Following each assessment, students received feedback on performance and created LGs. Students in the intervention group worked with a faculty member coach on their LGs. Students in the control group developed their LGs without a coach. Prior to the final assessment, students reported whether they had implemented their LGs.

Results

Of 171 students enrolled, 167 completed all four assessments and were included. All 167 developed an LG after each assessment. Overall, 79.0% of students reported implementing an LG. Of students receiving coaching, 91.8% implemented an LG, whereas only 65.9% of students in the control group implemented an LG (odds ratio, OR 5.7; 95% confidence interval, CI 2.4–14.2). Students who received coaching were more likely to incorporate performance feedback into their LGs (90.2 versus 38.1%; p < 0.05).

Conclusions

For students, faculty member coaching facilitated better LG development and more frequent implementation compared with students who did not receive coaching.
Histologic margins and the residual tumour classification scheme: Is it time to use a validated scheme in human oncology to standardise margin assessment in veterinary oncology?
Authors: Liptak Julius M.
Published: November 2019

There is no consensus on the definition of a complete histologic excision in veterinary oncology; many definitions have been used in various studies, but these have been arbitrarily selected with no apparent justification. The residual tumour classification scheme, where a complete histologic excision is defined as a histologic tumour‐free margin >0 mm, has been used for >40 years in human oncology by all of the major clinical staging organizations and is considered highly prognostic for the vast majority of malignant tumours in people. Because of the widespread use of the residual tumour classification scheme both clinically and in research studies, this standardized approach permits better communication between clinicians, an evidence‐based decision‐making process for adjuvant treatment options following surgical resection, minimizes exposing patients to unnecessary adjuvant treatments and a better ability to compare local tumour control for specific tumours between different studies. The adoption of the residual tumour classification scheme in veterinary oncology would likely achieve similar outcomes and minimize the prevalent confusion within the veterinary community, amongst both general practitioners and specialists, regarding the definition of what constitutes a complete histologic excision.
Tumour‐infiltrating lymphocytes in canine melanocytic tumours: An investigation on the prognostic role of CD3+ and CD20+ lymphocytic populations
Authors: Porcellato Ilaria , Silvestri Serenella , Menchetti Laura , Recupero Francesca , Mechelli Luca , Sforna Monica , Iussich Selina , Bongiovanni Laura , Lepri Elvio , Brachelente Chiara
Published: November 2019

The study of the immune response in several types of tumours has been rapidly increasing in recent years with the dual aim of understanding the interactions between neoplastic and immune cells and their importance in cancer pathogenesis and progression, as well as identifying targets for cancer immunotherapy. Despite being considered one of the most immunogenic tumour types, melanoma can progress in the presence of abundant lymphocytic infiltration, therefore suggesting that the immune response is not able to efficiently control tumour growth. The purpose of this study was to investigate whether the density, distribution and grade of tumour‐infiltrating lymphocytes (TILs) in 97 canine melanocytic tumours is associated with histologic indicators of malignancy and can be considered a prognostic factor in the dog. As a further step in the characterization of the immune response in melanocytic tumours, an immunohistochemical investigation was performed to evaluate the two main populations of TILs, T‐lymphocytes (CD3+) and B‐lymphocytes (CD20+). The results of our study show that TILs are present in a large proportion of canine melanocytic tumours, especially in oral melanomas, and that the infiltrate is usually mild. The quantity of CD20+ TILs was significantly associated with some histologic prognostic factors, such as the mitotic count, the cellular pleomorphism and the percentage of pigmented cells. Remarkably, a high infiltration of CD20+ TILs was associated with tumour‐related death, presence of metastasis/recurrence, shorter overall and disease‐free survival, increased hazard of death and of developing recurrence/metastasis, hence representing a potential new negative prognostic factor in canine melanocytic tumours.
A survey of criteria used to evaluate applications for small animal surgery residency positions
Authors: Fleming Jeremy T. , Giuffrida Michelle A. , Culp William T. N. , Runge Jeffrey J.
Published: November 2019

Objective

To determine attributes of applicants to small animal surgery residency programs (SRP) that are considered important, favorable, or detrimental according to surgeons at SRP registered with the American College of Veterinary Surgeons (ACVS).

Study design

Online survey.

Sample population

Residency‐trained surgeons at ACVS‐registered SRP.

Methods

An online survey was advertised to eligible surgeons. Respondents anonymously provided information about their professional backgrounds and SRP interview practices and rated candidate attributes in terms of importance during application screening and favorable or detrimental effects during selection or ranking. Responses were compared by respondent practice setting and sex.

Results

Surveys were completed by 148 of 289 (51%) invited surgeons. Male and female surgeons were equally represented, and 61% worked in academia. Most respondents’ SRP offered in‐person interviews, typically to a select applicant group from whom residents were ultimately chosen. Letters of recommendation were the most influential factor in all phases of application review, particularly when respondents knew the writers. Other critical attributes were academic record, internship reputation, research activity, and indices of interpersonal skills. Nearly all respondents considered multiple prior unsuccessful applications detrimental. Academic respondents emphasized academic performance and academic internships; private practice respondents valued personal contact with applicants and surgical specialty internships. Responses did not differ by self‐identified gender.

Conclusion

Surgery residency program surgeons preferred first‐ or second‐time applicants with excellent academic credentials, specific internship and research experiences, and letters of support from trusted colleagues as well as strong interpersonal skills.

Clinical impact

Prospective residents can use this information to assess their candidacies, identify potential weaknesses, and prepare competitive applications.
Dynamic laryngeal collapse associated with poll flexion as a complication of laryngeal tie‐forward surgery in three harness racehorses
Authors: Vermedal Hanna , Strand Eric
Published: November 2019

Objective

To report dynamic laryngeal collapse (DLC) associated with poll flexion as a potential complication of the laryngeal tie‐forward procedure (LTFP) in harness racehorses.

Study design

Short case series.

Animals

Three harness racehorses.

Methods

Preoperative and postoperative medical records of all harness racehorses that underwent the LTFP were reviewed, as were high‐speed treadmill videoendoscopy recordings of 35 horses that returned for upper airway evaluation postoperatively.

Results

One standardbred and two Norwegian coldblooded trotters in which dorsal displacement of the soft palate had been initially diagnosed were found to have bilateral arytenoid cartilage and vocal fold collapse associated with poll flexion after the LTFP. These three horses were otherwise clinically normal when exercised in free head carriage.

Conclusion

Dynamic laryngeal collapse associated with poll flexion can occur as a complication after the LTFP in harness racehorses and should be considered as a differential in horses with persistence of airway problems after surgery.

Clinical significance

Postoperative DLC may be underdiagnosed in harness racehorses because this complication is obvious only when horses are driven with bit and reins during high speed treadmill or overground videoendoscopy.
Impact of Different Volume Sizes on Dynamic Stability of a Gas Turbine-Fuel Cell Hybrid System
Authors: Abrassi Alessio , Traverso Alberto , Tucker David , Liese Eric
Published: November 2019

A dynamic model is developed for a microgas turbine (MGT), characterized by an intrinsic free-spool configuration, coupled to large volumes. This is inspired by an experimental facility at the National Energy Technology Laboratory (NETL) called hybrid performance (Hyper), which emulates a hybrid MGT and Fuel Cell system. The experiment and model can simulate stable and unstable operating conditions. The model is used to investigate the effects of different volumes on surge events, and to test possible strategies to safely avoid or recover from unstable compressor working conditions. The modeling approach is started from the Greitzer lumped parameter approach, and it has been improved with integration of empirical methods and simulated components to better match the real Hyper plant layout and performance. Pressure, flowrate, and frequency plots are shown for the surge behavior comparing two different volume sizes, for cases where gas turbine shaft speed is uncontrolled (open loop) and controlled (closed-loop). The ability to recover from a surge event is also demonstrated.
Performance of r-Adaptation Using Truncation Error-Based Equidistribution
Authors: Jackson Charles W. , Roy Christopher J.
Published: November 2019

This paper investigates the computational cost of performing r-adaptation by equidistributing the truncation error. This adaptation approach is applied to several two-dimensional (2D) problems using the Euler and laminar Navier–Stokes equations. The costs of performing the adaptation are compared to uniform refinement, and it is shown that adaptation can be far cheaper than uniform refinement. This paper also presents a new method of refining the equidistributed meshes. This new approach allows the adaptation to be performed on much coarser meshes and provides a method of refining these coarse, adapted meshes to meet a discretization-error target for the problem. We show that this approach can be at least 16–24 times cheaper than uniform refinement for the problems investigated here. This approach also is at least ten times faster than performing r-adaptation on a fine enough mesh to obtain the target discretization-error level.
A Bayesian spherical harmonics source radiation model for sound field control
Authors: Caviedes-Nozal Diego , Heuchel Franz M. , Brunskog Jonas , Riis Nicolai A. B. , Fernandez-Grande Efren
Published: November 2019

In sound field reproduction and sound field control systems, the acoustic transfer functions between a set of sources and an extended reproduction area need to be accurately estimated in order to achieve good performance. This implies that large amounts of measurements should be performed if the area is large compared to the wavelengths of interest. In this paper, a method for reconstructing these transfer functions in highly damped conditions is proposed by using only a small number of measurements in the reproduction area. The source radiation is modeled with the spherical harmonics basis and its amplitude coefficients are fitted with Bayesian inference. This approach is validated in a sound field control experiment where a set of 12 control loudspeakers attenuate the sound pressure level generated by a set of six primary loudspeakers in a quiet zone while minimizing their radiation into a listening zone. The performance of the approach is studied by analyzing the sound field reconstruction and the sound field control performance. It is shown that it is possible to get—with few measurements and the source radiation model—results similar to those achieved using a dense grid of transfer function measurements.
Input impedance measurement of a narrow pipe with thermal gradient
Authors: Zaker Ashkan , Gibiat Vincent , Guilain Stephane
Published: November 2019

Input impedance measurement is commonly used in the design of internal combustion engines to improve their performance. The water-cooled charge-air cooler used in supercharged engines imposes a strong longitudinal thermal gradient on the air contained in its narrow channels. To isolate the resonances caused by the thermal gradient, the input impedance of a semi-infinite narrow pipe with multiple longitudinal temperature profiles is studied experimentally using the Two-Measurement Three-Calibration method. Three known non-resonant loads are used to calibrate the test bench. The importance of using a semi-infinite pipe as a calibration load in narrow pipes is further demonstrated. In the case of this paper, the acoustic propagation is highly influenced by the presence of microphones. The calibration process helps to take into account this influence. Measurements show that the presence of a non-uniform longitudinal temperature profile in the air inside a pipe modifies its input impedance.
Auditory enhancement under forward masking in normal-hearing and hearing-impaired listeners
Authors: Kreft Heather A. , Oxenham Andrew J.
Published: November 2019

A target within a spectrally notched masker can be enhanced by a preceding copy of the masker. Enhancement can also increase the effectiveness of the target as a forward masker. Enhancement has been reported in hearing-impaired listeners under simultaneous but not forward masking. However, previous studies of enhancement under forward masking did not fully assess the potential effect of differences in sensation level or spectral resolution between the normal-hearing and hearing-impaired listeners. This study measured enhancement via forward masking in hearing-impaired and age-matched normal-hearing listeners with different spectral notches in the masker, to account for potential differences in frequency selectivity, and with levels equated by adding a background masking noise to equate both sensation level and sound pressure level or by reducing the sound pressure level of the stimuli to equate sensation level. Hearing-impaired listeners showed no significant enhancement, regardless of spectral notch width. Normal-hearing listeners showed enhancement at high levels, but showed less enhancement when sensation levels were reduced to match those of the hearing-impaired group, either by reducing sound levels or by adding a masking noise. The results confirm a lack of forward-masked enhancement in hearing-impaired listeners but suggest this may be partly due to reduced sensation level.
Enteric-Coated Sodium Bicarbonate Attenuates Gastrointestinal Side-Effects
Authors: Hilton Nathan Philip , Leach Nicholas Keith , Craig Melissa May , Sparks S. Andy , McNaughton Lars Robert
Published: November 2019

Enteric-formulated capsules can mitigate gastrointestinal (GI) side effects following sodium bicarbonate (NaHCO3) ingestion; however, it remains unclear how encapsulation alters postingestion symptoms and acid–base balance. The current study aimed to identify the optimal ingestion form to mitigate GI distress following NaHCO3 ingestion. Trained males (n = 14) ingested 300 mg/kg body mass of NaHCO3 in gelatin (GEL), delayed-release (DEL), and enteric-coated (ENT) capsules or a placebo in a randomized cross-over design. Blood bicarbonate anion concentration, potential hydrogen, and GI symptoms were measured pre- and postingestion for 3 hr. Fewer GI symptoms were reported with ENT NaHCO3 than with GEL (p = .012), but not with DEL (p = .106) in the postingestion phase. Symptom severity decreased with DEL (4.6 ± 2.8 arbitrary units) compared with GEL (7.0 ± 2.6 arbitrary units; p = .001) and was lower with ENT (2.8 ± 1.9 arbitrary units) compared with both GEL (p < .0005) and DEL (p = .044) NaHCO3. Blood bicarbonate anion concentration increased in all NaHCO3 conditions compared with the placebo (p < .0005), although this was lower with ENT than with GEL (p = .001) and DEL (p < .0005) NaHCO3. Changes in blood potential hydrogen were reduced with ENT compared with GEL (p = .047) and DEL (p = .047) NaHCO3, with no other differences between the conditions. Ingestion of ENT NaHCO3 attenuates GI disturbances for up to 3 hr postingestion. Therefore, ENT ingestion forms may be favorable for those who report GI disturbances with NaHCO3 supplementation or for those who have previously been deterred from its use altogether.