bluuebunny/crossref_metadata_2025 huggingface dataset:
Praktische Relevanz neuer Studiendaten
Authors: Schikora Stephanie
Published: June 2018

Der Mensch im Mittelpunkt: praktische Relevanz neuer Studiendaten für individualisierte Therapiestrategien – dies war Anfang Mai einer der Themenschwerpunkte der 53. Jahrestagung der Deutschen Diabetes Gesellschaft in Berlin, denn nicht jede Therapie ist für jeden Patienten geeignet. Stets gilt es, die neuen wissenschaftlichen Ergebnisse schnell in die Versorgung von Menschen mit Diabetes mellitus einfließen zu lassen, damit möglichst viele Patienten die für sie optimale Behandlung erhalten. Luft für Verbesserungen scheint es beispielsweise bei Menschen mit einem Typ-2-Diabetes und kardiovaskulären Vorerkrankungen zu geben oder auch bei hochbetagten Menschen mit Diabetes.
Follow-Up of the Novel Free Margin Running Suture Technique for Mitral Valve Repair
Authors: Agnino Alfonso , Lanzone Alberto Maria , Albertini Andrea , Anselmi Amedeo
Published: June 2018

The free margin running suture (FMRS) is a novel technique for nonresection correction of degenerative mitral regurgitation. It was employed in 37 minimally invasive mitral repair cases. We performed a retrospective collection of in-hospital data and a clinical/echocardiographic follow-up. All patients were discharged with none or mild mitral regurgitation, except one who had mild-to-moderate (2+) regurgitation. At follow-up (average: 2.1 years), all patients were alive; there were no instances of recurrent regurgitation, one case of 2+ regurgitation, and no valve-related complications. Average mitral valve area, mean gradient, and coaptation length were 2.9 cm2 ±0.1, 3.5 mm Hg ±0.9, and 1.1 cm ±0.2.
Methods to Obtain Percutaneous Access to Difficult-to-Reach Masses and Collections in the Abdomen and Pelvis
Authors: Low Jason , Huang Steven
Published: June 2018

Image-guided biopsy and drainage of collections in the abdomen and pelvis are frequently performed in interventional radiology practices. Many options are available to facilitate access to masses and collections in challenging locations. This review focuses on the technique and efficacy associated with the various options available, including out-of-plane access, patient positioning, needle techniques (i.e., blunt and curved needle tip), adjunctive use of electromagnetic tracking devices, organ displacement, and transorgan access.
Ernährung bei chronischen Nierenerkrankungen: wann, was, wie
Authors: Bischoff Stephan , Basrai Maryam
Published: June 2018

Chronic kidney disease is associated with metabolic disorders. The nutrient requirement varies considerably and often it is not covered. This is why many patients experience severe deficiencies („kidney disease wasting“), which limits their quality of life and prognosis. On the other hand sodium, potassium and phosphate must be limited. Nutritional therapy is a relevant part of the therapy.
In situ measurements of the spectral reflectance of metallic mirrors at the H
α line in a low density Ar–H plasma
Authors: Dickheuer Sven , Marchuk Oleksandr , Brandt Christian , Pospieszczyk Albrecht , Goriaev Andrei , Ialovega Mykola , Göths Beatrix , Krasikov Yuri , Krimmer Andreas , Mertens Philippe , Kreter Arkadi
Published: June 2018

The efficient and reliable control and monitoring of the quality of the optical properties of mirrors is an open problem in laboratory plasmas. Until now, the measurement of the reflectance of the first mirrors was based on the methods that require additional light calibration sources. We propose a new technique based on the ratio of the red- and blue-shifted emission signals of the reflected hydrogen atoms which enables the in situ measurement of the spectral reflectance of metallic mirrors in low-density Ar–H or Ar–D plasmas. The spectral reflectance coefficients were measured for C, Al, Ag, Fe, Pd, Ti, Sn, Rh, Mo, and W mirrors installed in the linear magnetized plasma device PSI-2 operating in the pressure range of 0.01-0.1 Pa. The results are obtained for the Hα line using the emission of fast atoms induced by excitation of H atoms through Ar at a plasma-solid interface by applying a negative potential U = −80, …, −220 V to the mirror. The agreement between the measured and theoretical data of reflectance is found to be within 10% for the investigated materials (except for C). The spectra also allow us to efficiently determine the material of the mirror.
A topological wave transistor protected by the Euler characteristic
Authors: Sklan Sophia R. , Li Baowen
Published: June 2018

Although topological materials have recently seen tremendous development, their applications have remained elusive. Simultaneously, there exists considerable interest in pushing the limits of topological materials, including the exploration of new forms of topological protection and the establishment of topologically protected order in non-electronic systems. Here, we develop some novel forms of topological order (i.e., topological charges), primarily the Euler characteristic as well as manifold class. We further demonstrate that these topological orders can protect bulk current transmission, even when the topologically trivial phase possesses an arbitrarily large band gap. Such a transition between topologically trivial, periodic dispersion and topologically non-trivial, aperiodic dispersion can be obtained by spatio-temporal modulation, such as the anomalous Doppler shift of waves in a gapped periodic medium. Since a wave's momentum can induce an anomalous Doppler shift, we thus establish that such a transition can be used to construct a truly rigorous transistor (i.e., with switching and gain) for bosonic waves (light, sound, etc.) and that such a transistor should be experimentally realizable. Our work suggests that additional topological charges may become relevant in moving beyond topological electronics.
Vibration-induced structures in scanning tunneling microscope light emission spectra of Ni(110)-(2 × 1) O
Authors: Uehara Yoicihi , Inaoka Takeshi , Nishio Takayuki , Katano Satoshi
Published: June 2018

We obtained scanning tunneling microscopy (STM) light emission spectra of a Ni(110)-(2 × 1) O surface. A mosaic of nanoscale bright and dark domains was observed in the STM image. When the tip was fixed over the dark domain, stepwise structures were observed at 100 and 150 meV below the quantum cutoff in the STM light emission spectra. These energies were consistent with the reported vibrational energies of oxygen atoms adsorbed on the Ni(110)-(2 × 1) O surface, and indicated the expected isotope shifts between 16 O and 18O. Therefore, these stepwise structures are induced by the vibrations of adsorbed oxygen atoms. The 100-meV mode corresponded to the vibration polarized parallel to the surface. A theory describing the coupling between the STM light emission and vibration polarized parallel to the surface is proposed. We conclude that the oxygen atoms cover the dark domain and bare Ni atoms correspond to the bright domain. When the exposure level of oxygen was approximately 1/10 of that for Ni(110)-(2 × 1) O, bright-imaged nanostructures were observed in the terrace where bare Ni atoms are exposed. The step structure caused by the vibrations of adsorbed oxygen was observed in the STM light emission spectra of the bright-imaged nanostructures, showing that these structures are covered by oxygen atoms. In other words, the isolated nanostructures covered by oxygen atoms are imaged not as dark, but as bright, unlike in the case of Ni(110)-(2 × 1) O observed by STM.
Electric polarization is described in 2-D manganese-based organic-inorganic hybrids
Authors: De Jarnette Drew
Published: June 2018

Out-of-plane polarization in a layered, manganese organic-inorganic hybrid explains an underlying mechanism that can induce ferroelectricity and enable their use in new application areas.
Neural nets enhance the accessibility of metagratings
Authors: Agner Mary Alexandra
Published: June 2018

A novel use of neural nets assists in the development of a mathematical relationship between the structural and diffraction properties of metagratings.
Trimming and production losses associated with bacterial arthritis in lambs presented to an abattoir in southern Australia
Authors: Lloyd Joan , Schröder Johann , Rutley David
Published: June 2018

Bacterial arthritis in sheep is a painful and debilitating condition that is widespread across all sheep-raising regions and climatic zones of Australia. At slaughter, bacterial arthritis in sheep causes economic losses through the condemnation of all or parts of the carcass, as specified in the Australian Standard for the Hygienic Production and Transportation of Meat and Meat Products for Human Consumption. In this study, we investigated the economic cost of arthritis in lambs presenting to an abattoir in southern Australia using a combination of the prevalence of arthritis detected during meat inspection, condemnation rates, trim weight and carcass weight, and fat measurements. Data were collected on 354 lines of lambs representing 63287 carcasses. One hundred and sixty nine consignments, or approximately one-half of the consignments, had at least one carcass with arthritis/polyarthritis detected by meat inspection personnel. Four hundred and twenty-two, or 0.7%, of the carcasses had arthritis/polyarthritis in at least one joint. When arthritis was present, on average 2.0% of the line was affected. Three carcasses with arthritis were condemned and the remainder trimmed, with an average trim weight of 0.7 kg. In addition, arthritis reduced the growth of lambs by 1.2 kg hot standard carcass weight, approximately 2.7 kg liveweight (assuming 45% dressing percentage) and reduced fat cover by 1.8 mm.
Auxin methylation is required for differential growth in
Arabidopsis
Authors: Abbas Mohamad , Hernández-García Jorge , Pollmann Stephan , Samodelov Sophia L. , Kolb Martina , Friml Jiří , Hammes Ulrich Z. , Zurbriggen Matias D. , Blázquez Miguel A. , Alabadí David
Published: June 2018

Asymmetric auxin distribution is instrumental for the differential growth that causes organ bending on tropic stimuli and curvatures during plant development. Local differences in auxin concentrations are achieved mainly by polarized cellular distribution of PIN auxin transporters, but whether other mechanisms involving auxin homeostasis are also relevant for the formation of auxin gradients is not clear. Here we show that auxin methylation is required for asymmetric auxin distribution across the hypocotyl, particularly during its response to gravity. We found that loss-of-function mutants in
Arabidopsis IAA CARBOXYL METHYLTRANSFERASE1
(
IAMT1
) prematurely unfold the apical hook, and that their hypocotyls are impaired in gravitropic reorientation. This defect is linked to an auxin-dependent increase in
PIN
gene expression, leading to an increased polar auxin transport and lack of asymmetric distribution of PIN3 in the
iamt1
mutant. Gravitropic reorientation in the
iamt1
mutant could be restored with either endodermis-specific expression of
IAMT1
or partial inhibition of polar auxin transport, which also results in normal
PIN
gene expression levels. We propose that IAA methylation is necessary in gravity-sensing cells to restrict polar auxin transport within the range of auxin levels that allow for differential responses.
A Research on Multi-objective Generation Optimization Scheduling of the TGC Reservoirs Considering Ecological and Shipping Benefits
Authors: Hu Xiangyang , Wang Xuemin , Chen Fang , Yu Shan
Published: June 2018

Due to the increasing energy demand and the lack of comprehensive utilization of water resources, this paper has established a generation-shipping-ecological optimization (GSEO) model to Balance the benefits between shipping, power generation and ecology. then, the Three Gorges Cascade (TGC) is taken as the research object, and the efficiency evaluation methods of shipping and ecological benefits are proposed. Finally, the actual inflows of the abundant, average and dry years are studied as the samples to solve the GSEO model. The simulation results indicate that the model and the benefit evaluation methods proposed in this paper are feasible and effective.
Survey-Defined and Interview-Elicited Challenges That Faced Ethiopian Government Hospital Laboratories as They Applied ISO 15189 Accreditation Standards in Resource-Constrained Settings in 2017
Authors: Girma Mekonnen , Desale Adinew , Hassen Fatuma , Sisay Abay , Tsegaye Aster
Published: June 2018

Objectives

The World Health Organization African Regional Office recommends ISO 15189 standards to improve performance quality in sub-Saharan African laboratories. We specify challenges Ethiopian laboratorians encountered applying ISO 15189 standards.

Methods

From a structured survey at 12 Ethiopian government hospitals, 175 laboratory staff replied; all were aware of the ISO standards and 138 had been involved in the ISO 15189 inspection process. In addition, 11 laboratory heads, 10 quality officers, and three medical directors were interviewed in depth.

Results

Half or more respondents identified six challenges obstructing accreditation to a “large” or “very large” degree: (1) low management support, (2) inadequate training, (3) insufficient infrastructure, (4) excessive documentation, (5) little mentorship, and (6) increased accreditation-related workload. Interviewees added (7) poor equipment, (8) unavailable/poor-quality reagents, and (9) high staff turnover.

Conclusions

The survey and interviews specified nine major challenges for Ethiopian government hospital laboratories that seriously obstruct meeting ISO 15189 demands.
Functions of short lifetime biological structures at large: the case of intrinsically disordered proteins
Authors: Uversky Vladimir N
Published: June 2018

Although for more than a century a protein function was intimately associated with the presence of unique structure in a protein molecule, recent years witnessed a skyrocket rise of the appreciation of protein intrinsic disorder concept that emphasizes the importance of the biologically active proteins without ordered structures. In different proteins, the depth and breadth of disorder penetrance are different, generating an amusing spatiotemporal heterogeneity of intrinsically disordered proteins (IDPs) and intrinsically disordered protein region regions (IDPRs), which are typically described as highly dynamic ensembles of rapidly interconverting conformations (or a multitude of short lifetime structures). IDPs/IDPRs constitute a substantial part of protein kingdom and have unique functions complementary to functional repertoires of ordered proteins. They are recognized as interaction specialists and global controllers that play crucial roles in regulation of functions of their binding partners and in controlling large biological networks. IDPs/IDPRs are characterized by immense binding promiscuity and are able to use a broad spectrum of binding modes, often resulting in the formation of short lifetime complexes. In their turn, functions of IDPs and IDPRs are controlled by various means, such as numerous posttranslational modifications and alternative splicing. Some of the functions of IDPs/IDPRs are briefly considered in this review to shed some light on the biological roles of short-lived structures at large.
An efficient multi-locus mixed model framework for the detection of small and linked QTLs in F2
Authors: Wen Yang-Jun , Zhang Ya-Wen , Zhang Jin , Feng Jian-Ying , Dunwell Jim M , Zhang Yuan-Ming
Published: June 2018

In the genetic system that regulates complex traits, metabolites, gene expression levels, RNA editing levels and DNA methylation, a series of small and linked genes exist. To date, however, little is known about how to design an efficient framework for the detection of these kinds of genes. In this article, we propose a genome-wide composite interval mapping (GCIM) in F2. First, controlling polygenic background via selecting markers in the genome scanning of linkage analysis was replaced by estimating polygenic variance in a genome-wide association study. This can control large, middle and minor polygenic backgrounds in genome scanning. Then, additive and dominant effects for each putative quantitative trait locus (QTL) were separately scanned so that a negative logarithm P-value curve against genome position could be separately obtained for each kind of effect. In each curve, all the peaks were identified as potential QTLs. Thus, almost all the small-effect and linked QTLs are included in a multi-locus model. Finally, adaptive least absolute shrinkage and selection operator (adaptive lasso) was used to estimate all the effects in the multi-locus model, and all the nonzero effects were further identified by likelihood ratio test for true QTL identification. This method was used to reanalyze four rice traits. Among 25 known genes detected in this study, 16 small-effect genes were identified only by GCIM. To further demonstrate GCIM, a series of Monte Carlo simulation experiments was performed. As a result, GCIM is demonstrated to be more powerful than the widely used methods for the detection of closely linked and small-effect QTLs.
Modelling signalling networks from perturbation data
Authors: Dorel Mathurin , Klinger Bertram , Gross Torsten , Sieber Anja , Prahallad Anirudh , Bosdriesz Evert , Wessels Lodewyk F A , Blüthgen Nils
Published: June 2018

Motivation

Intracellular signalling is realized by complex signalling networks, which are almost impossible to understand without network models, especially if feedbacks are involved. Modular Response Analysis (MRA) is a convenient modelling method to study signalling networks in various contexts.

Results

We developed the software package STASNet (STeady-STate Analysis of Signalling Networks) that provides an augmented and extended version of MRA suited to model signalling networks from incomplete perturbation schemes and multi-perturbation data. Using data from the Dialogue on Reverse Engineering Assessment and Methods challenge, we show that predictions from STASNet models are among the top-performing methods. We applied the method to study the effect of SHP2, a protein that has been implicated in resistance to targeted therapy in colon cancer, using a novel dataset from the colon cancer cell line Widr and a SHP2-depleted derivative. We find that SHP2 is required for mitogen-activated protein kinase signalling, whereas AKT signalling only partially depends on SHP2.

Availability and implementation

An R-package is available at https://github.com/molsysbio/STASNet.

Supplementary information

Supplementary data are available at Bioinformatics online.
MolArt: a molecular structure annotation and visualization tool
Authors: Hoksza David , Gawron Piotr , Ostaszewski Marek , Schneider Reinhard
Published: June 2018

MolArt fills the gap between sequence and structure visualization by providing a light-weight, interactive environment enabling exploration of sequence annotations in the context of available experimental or predicted protein structures. Provided a UniProt ID, MolArt downloads and displays sequence annotations, sequence-structure mapping and relevant structures. The sequence and structure views are interlinked, enabling sequence annotations being color overlaid over the mapped structures, thus providing an enhanced understanding and interpretation of the available molecular data.

Availability and implementation

MolArt is released under the Apache 2 license and is available at https://github.com/davidhoksza/MolArt. The project web page https://davidhoksza.github.io/MolArt/ features examples and applications of the tool.
Cortical Neuron Migration and Dendrite Morphology are Regulated by Carboxypeptidase E
Authors: Liang Chen , Carrel Damien , Omelchenko Anton , Kim Hyuck , Patel Aashini , Fanget Isabelle , Firestein Bonnie L
Published: June 2018

Higher brain function relies on proper development of the cerebral cortex, including correct positioning of neurons and dendrite morphology. Disruptions in these processes may result in various neurocognitive disorders. Mutations in the CPE gene, which encodes carboxypeptidase E (CPE), have been linked to depression and intellectual disability. However, it remains unclear whether CPE is involved in early brain development and in turn contributes to the pathophysiology of neurocognitive disorders. Here, we investigate the effects of CPE knockdown on early brain development and explore the functional significance of the interaction between CPE and its binding partner p150Glued. We demonstrate that CPE is required for cortical neuron migration and dendrite arborization. Furthermore, we show that expression of CPE-C10 redistributes p150Glued from the centrosome and that disruption of CPE interaction with p150Glued leads to abnormal neuronal migration and dendrite morphology, suggesting that a complex between CPE and p150Glued is necessary for proper neurodevelopment.
Simultaneous Determination of Quercitrin, Afzelin, Amentoflavone, Hinokiflavone in Rat Plasma by UFLC–MS-MS and Its Application to the Pharmacokinetics of Platycladus orientalis Leaves Extract
Authors: Shan Chen-xiao , Guo Shu-chen , Yu Sheng , Shan Ming-qiu , Li Sam Fong Yau , Chai Chuan , Cui Xiao-bing , Zhang Li , Ding An-wei , Wu Qi-nan
Published: June 2018

Leaves of Platycladus orientalis have been used as blood cooling and homeostatic therapy for thousands of years in traditional Chinese medicine. Emerging evidences of modern pharmacology have proved flavonoids as the key elements responsible for the efficacies. However, there has been no report on pharmacokinetic study of the flavonoids from Platycladus orientalis leaves extract. In this study, a sensitive and rapid ultra-flow liquid chromatography-tandem mass spectrometry method was established and validated for the simultaneous determination of amentoflavone, afzelin, hinokiflavone and quercitrin in rat plasma. The four flavonoids and luteolin (internal standard, IS) were recovered from rat plasma by methanol–ethyl acetate (v:v, 50:50). Chromatographic separation was performed on a C18 column with gradient elution. Our results showed that the recoveries from spiked control samples were more than 85% for all analytes and IS. The relative standard deviations of intra-day and inter-day precision were within 15% while the REs ranged from −6.6% to 8.0%. The validated method in this study was successfully applied to pharmacokinetic study in healthy rats after oral administration of P. orientalis leaves extract.
SecA inhibitors as potential antimicrobial agents: differential actions on SecA-only and SecA-SecYEG protein-conducting channels
Authors: Jin Jinshan , Hsieh Ying-Hsin , Chaudhary Arpana S , Cui Jianmei , Houghton John E , Sui Sen-fang , Wang Binghe , Tai Phang C
Published: June 2018

Sec-dependent protein translocation is an essential process in bacteria. SecA is a key component of the translocation machinery and has multiple domains that interact with various ligands. SecA acts as an ATPase motor to drive the precursor protein/peptide through the SecYEG protein translocation channels. As SecA is unique to bacteria and there is no mammalian counterpart, it is an ideal target for the development of new antimicrobials. Several reviews detail the assays for ATPase and protein translocation, as well as the search for SecA inhibitors. Recent studies have shown that, in addition to the SecA-SecYEG translocation channels, there are SecA-only channels in the lipid bilayers, which function independently from the SecYEG machinery. This mini-review focuses on recent advances on the newly developed SecA inhibitors that allow the evaluation of their potential as antimicrobial agents, as well as a fundamental understanding of mechanisms of SecA function(s). These SecA inhibitors abrogate the effects of efflux pumps in both Gram-positive and Gram-negative bacteria. We also discuss recent findings that SecA binds to ribosomes and nascent peptides, which suggest other roles of SecA. A model for the multiple roles of SecA is presented.
Online peer support groups for family caregivers: are they reaching the caregivers with the greatest needs?
Authors: Friedman Esther M , Trail Thomas E , Vaughan Christine Anne , Tanielian Terri
Published: June 2018

Background

Online peer support groups are an increasingly common venue for caregivers supporting disabled family members to exchange informational, emotional, and instrumental support. We know very little, however, about who uses these groups and whether they are reaching those with the greatest needs.

Objective

To examine whether caregiving factors (ie, caregiving demands and strain, competing demands, access to support and services, and other caregiving characteristics) are related to online community support use and intensity of use.

Method

This study used data from a new survey of family caregivers who provide care to disabled military veterans. We used logistic regression models to examine the likelihood of online community support group usage and intensity of use as a function of a variety of caregiving factors.

Results

Those with greater caregiving demands were more likely to use online peer support. Specifically, helping the care recipient with more activities was associated with a statistically significantly greater likelihood of visiting an online community support group. Caring for a veteran with a neurological or psychological condition, which, in prior work, suggests more complex care needs, was also positively and significantly related to visiting an online community support group. Hours of care and several other caregiving factors were related to intensity of use.

Conclusions

We show that family caregivers with the most caregiving demands are most engaged with online support communities. This suggests that online communities could be used to support the most vulnerable family caregivers. The implications of this work for online support systems are discussed.
Reasoning and Deducing
Authors: Valaris Markos
Published: June 2018

What exactly is reasoning? While debate on this question is ongoing, most philosophers seem to agree on at least the following: reasoning is a mental process operating on contents, which consists in adopting or revising some of your attitudes in light of others. In this paper, I argue that this characterisation is mistaken: there is no single mental phenomenon that satisfies both of these conditions. Instead, I characterise two distinct mental phenomena, which I call ‘deducing’, on the one hand, and ‘reasoning’ or ‘inference’ on the other, to play each of these roles. Recognising this division of labour is essential to developing a better understanding of our rational economy.
A coding and non-coding transcriptomic perspective on the genomics of human metabolic disease
Authors: Timmons James A , Atherton Philip J , Larsson Ola , Sood Sanjana , Blokhin Ilya O , Brogan Robert J , Volmar Claude-Henry , Josse Andrea R , Slentz Cris , Wahlestedt Claes , Phillips Stuart M , Phillips Bethan E , Gallagher Iain J , Kraus William E
Published: June 2018

Genome-wide association studies (GWAS), relying on hundreds of thousands of individuals, have revealed >200 genomic loci linked to metabolic disease (MD). Loss of insulin sensitivity (IS) is a key component of MD and we hypothesized that discovery of a robust IS transcriptome would help reveal the underlying genomic structure of MD. Using 1,012 human skeletal muscle samples, detailed physiology and a tissue-optimized approach for the quantification of coding (>18,000) and non-coding (>15,000) RNA (ncRNA), we identified 332 fasting IS-related genes (CORE-IS). Over 200 had a proven role in the biochemistry of insulin and/or metabolism or were located at GWAS MD loci. Over 50% of the CORE-IS genes responded to clinical treatment; 16 quantitatively tracking changes in IS across four independent studies (P = 0.0000053: negatively: AGL, G0S2, KPNA2, PGM2, RND3 and TSPAN9 and positively: ALDH6A1, DHTKD1, ECHDC3, MCCC1, OARD1, PCYT2, PRRX1, SGCG, SLC43A1 and SMIM8). A network of ncRNA positively related to IS and interacted with RNA coding for viral response proteins (P < 1 × 10−48), while reduced amino acid catabolic gene expression occurred without a change in expression of oxidative-phosphorylation genes. We illustrate that combining in-depth physiological phenotyping with robust RNA profiling methods, identifies molecular networks which are highly consistent with the genetics and biochemistry of human metabolic disease.
Measuring precarious employment in Europe 8 years into the global crisis
Authors: Matilla-Santander Nuria , Lidón-Moyano Cristina , González-Marrón Adrián , Bunch Kailey , Martín-Sánchez Juan Carlos , Martínez-Sánchez Jose M
Published: June 2018

Background

The objective of this study is to describe the prevalence of precarious employment in the European Union (EU) using a multidimensional approach, 8 years into the economic crisis (2014).

Methods

We use data from the Flash Eurobarometer 398 among salaried workers (n = 7702). We calculated the proportion and its 95% confidence intervals (CI 95%) for each of the precarious employment dimensions (not having the ability to exercise rights, vulnerability, disempowerment and temporariness), the prevalence of precarious employment (presenting at least one dimension) and the proportion of workers presenting one, two, three or four dimensions.

Results

Two out of three workers had a precarious employment. The prevalence of precariousness was higher in Eastern (72.64%; CI 95%: 61.78; 81.34) than in Nordic European countries (51.17%; CI 95%: 44.30; 58.00). The most prevalent dimension was not having the ability to exercise rights (42.39%).

Conclusions

Precarious employment is an important social determinant of health. Therefore, the EU policy-makers should take into consideration the new forms of employment and legislate accordingly.
Implementation of a unique hepatitis C care continuum model in Rwanda
Authors: Mathur Poonam , Comstock Emily , Makuza Jean Damascene , Emmanuel Benjamin , Sebeza Jackson , Kiromera Athanase , Wilson Eleanor , Kattakuzhy Sarah , Nelson Amy , Kottilil Shyamasundaran , Riedel David J
Published: June 2018

Background

There has been an evolution in the treatment of chronic hepatitis C (HCV) due to highly effective direct-acting antivirals, however, restriction of treatment to medical specialists hinders escalation of HCV treatment. This is particularly true in resource-limited settings (RLS), which disproportionately represent the burden of HCV worldwide. The ASCEND study in Washington, DC, demonstrated that complete task-shifting can safely and effectively overcome a low provider-to-patient ratio and expand HCV treatment. However, this model has not been applied internationally to RLS.

Method

The validated ASCEND model was translated to an international clinical program in Kigali, Rwanda, aimed at training general medicine providers on HCV management and obtaining HCV prevalence data.

Results

The didactic training program administered to 11 new HCV providers in Rwanda increased provider’s knowledge about HCV management. Through the training program, 26% of patients seen during the follow-up period were screened for HCV and a prevalence estimate of 2% was ascertained. Of these patients, 30% were co-infected with hepatitis B.

Conclusion

The ASCEND paradigm can be successfully implemented in RLS to escalate HCV care, in a self-sustaining fashion that educates more providers about HCV management, while increasing the public’s awareness of HCV and access to treatment.
Maternal Western diet during gestation and lactation modifies adult offspring's cognitive and hedonic brain processes, behavior, and metabolism in Yucatan minipigs
Authors: Gautier Yentl , Luneau Isabelle , Coquery Nicolas , Meurice Paul , Malbert Charles‐Henri , Guerin Sylvie , Kemp Bas , Bolhuis J. Elizabeth , Clouard Caroline , Le Huërou‐Luron Isabelle , Blat Sophie , Val‐Laillet David
Published: June 2018

This study explores the long‐term effects of exposure to a maternal Western diet (WD) vs. standard diet (SD) in the Yucatan minipig, on the adult progeny at lean status (n = 32), and then overweight status. We investigated eating behavior, cognitive abilities, brain basal glucose metabolism, dopamine transporter availability, microbiota activity, blood lipids, and glucose tolerance. Although both groups demonstrated similar cognitive abilities in a holeboard test, WD pigs expressed a higher stress level than did SD pigs (immobility, P < 0.05) and lower performance in an alley maze (P = 0.06). WD pigs demonstrated lower dopamine transporter binding potential in the hippocampus and parahippocampal cortex (P < 0.05 for both), as well as a trend in putamen (P=0.07), associated with lower basal brain activity in the prefrontal cortex and nucleus accumbens (P < 0.05) compared with lean SD pigs. Lean WD pigs demonstrated a lower glucose tolerance than did SD animals (higher glucose peak, P < 0.05) and a tendency to a higher incremental area under the curve of insulin from 0 to 30 minutes after intravenous glucose injection (P < 0.1). Both groups developed glucose intolerance with overweight, but WD animals were less impacted than SD animals. These results demonstrate that maternal diet shaped the offspring's brain functions and cognitive responses long term, even after being fed a balanced diet from weaning, but behavioral effects were only revealed in WD pigs under anxiogenic situation; however, WD animals seemed to cope better with the obesogenic diet from a metabolic standpoint.—Gautier, Y., Luneau, I., Coquery, N., Meurice, P., Malbert, C.‐H., Guerin, S., Kemp, B., Bolhuis, J. E., Clouard, C., Le Huerou‐Luron, I., Blat, S., Val‐Laillet, D. Maternal Western diet during gestation and lactation modifies adult offspring's cognitive and hedonic brain processes, behavior, and metabolism in Yucatan minipigs. FASEB J. 32, 6478–6494 (2018). www.fasebj.org
Management of adverse reactions to first-line tuberculosis antibiotics
Authors: Nagarajan Sowmya , Whitaker Paul
Published: June 2018

Purpose of review

Tuberculosis (TB) is the commonest infectious cause of death globally. Adverse reactions to first-line tuberculosis antibiotics are common and have a major impact on the outcomes of patients as second-line antibiotics are less effective and more toxic. The present review addresses the most recent literature regarding epidemiology, investigating reactions, and reintroducing treatment in patients who have had their treatment interrupted.

Recent findings

Studies have demonstrated that up to 60% of patients experience adverse reactions to TB treatment; around a third of these are idiosyncratic and may relate to immune sensitization. There is an increased risk in patients with HIV. For patients with severe cutaneous reactions patch testing has an important role; however, systemic reactions to patch testing are common in patients with HIV. In-vitro testing remains limited to specialist centers but studies have identified drug-specific lymphocyte responses in patients with cutaneous and liver reactions. Desensitization of patients with severe cutaneous reactions have been demonstrated to be possible, albeit at high risk.

Management of these patients remains suboptimal. Better identification of predisposing factors, such as HLA alleles, are needed to identify patients at risk. Improved in-vitro diagnostics will reduce the need to re-expose the patient to the drug and optimized desensitization regimens will improve patient safety when drugs have to be re-introduced.
Organizational Factors Contributing to Incivility at an Academic Medical Center and Systems-Based Solutions: A Qualitative Study
Authors: Pattani Reena , Ginsburg Shiphra , Mascarenhas Johnson Alekhya , Moore Julia E. , Jassemi Sabrina , Straus Sharon E.
Published: June 2018

Purpose

A rise in incivility has been documented in medicine, with implications for patient care, organizational effectiveness, and costs. This study explored organizational factors that may contribute to incivility at one academic medical center and potential systems-level solutions to combat it.

Method

The authors completed semistructured individual interviews with full-time faculty members of the Department of Medicine (DOM) at the University of Toronto Faculty of Medicine, Toronto, Ontario, Canada, with clinical appointments at six affiliated hospitals, between June and September 2016. They asked about participants’ experiences with incivility, potential contributing factors, and possible solutions. Two analysts independently coded a portion of the transcripts until a framework was developed with excellent agreement within the research team, as signified by the Kappa coefficient. A single coder completed analysis of the remaining transcripts.

Results

Forty-nine interviews with physicians from all university ranks and academic position descriptions were completed. All participants had collegial relationships with colleagues but had observed, heard of, or been personally affected by uncivil behavior. Incivility occurred furtively, face-to-face, or online. The participants identified several organizational factors that bred incivility including physician nonemployee status in hospitals, silos within the DOM, poor leadership, a culture of silence, and the existence of power cliques. They offered many systems-level solutions to combat incivility through prevention, improved reporting, and clearer consequences.

Conclusions

Existing strategies to combat incivility have focused on modifying individual behavior, but opportunities may exist to reduce incivility through a greater understanding of the role of health care organizations in shaping workplace culture.
How Theory Can Inform Our Understanding of Experiential Learning in Quality Improvement Education
Authors: Goldman Joanne , Kuper Ayelet , Wong Brian M.
Published: June 2018

It is widely accepted that quality improvement (QI) education should be experiential. Many training programs believe that making QI learning “hands-on” through project-based learning will translate into successful learning about QI. However, this pervasive and overly simplistic interpretation of experiential QI learning, and the general lack of empirical exploration of the factors that influence experiential learning processes, may limit the overall impact of project-based learning on educational outcomes.

In this Perspective, the authors explore the opportunities afforded by a theoretically informed approach, to deepen understanding of the diverse factors that affect experiential QI learning processes in the clinical learning environment. The authors introduce the theoretical underpinnings of experiential learning more generally, and then draw on their experiences and data, obtained in organizing and studying QI education activities, to illuminate how sociocultural theories such as Billett’s workplace learning theory, and sociomaterial perspectives such as actor–network theory, can provide valuable lenses for increasing our understanding of the varied individuals, objects, contexts, and their relationships that influence project-based experiential learning. The two theoretically informed approaches that the authors describe are amongst numerous others that can inform a QI education research agenda aimed at optimizing educational processes and outcomes. The authors conclude by highlighting how a theoretically informed QI education research agenda can advance the field of QI education; they then describe strategies for achieving this goal.
Interprofessional Care in Teaching Practices: Lessons From “Bright Spots”
Authors: Bodenheimer Thomas , Knox Margae , Syer Sara
Published: June 2018

In this issue, Brandt and colleagues and Uhlig and colleagues highlight barriers faced by health professional schools implementing interprofessional education and describe how clinical learning environments can overcome those obstacles. Primary care residency teaching clinics provide an excellent opportunity for interprofessional education and patient care, with teachers and learners from various professions caring for patients together. This Invited Commentary offers three interprofessional education strategies used by five “bright spot” family medicine teaching clinics: (1) separate clinics for patients with complex health care needs during which learners from various professions see patients together; (2) interprofessional interactions in day-to-day patient care; and (3) case conferences across professions to discuss patients. The vignettes presented here demonstrate how the concepts outlined by Brandt and colleagues and Uhlig and colleagues can be put into practice.
Weight Loss Maintenance and Cellular Aging in the Supporting Health Through Nutrition and Exercise Study
Authors: Mason Ashley E. , Hecht Frederick M. , Daubenmier Jennifer J. , Sbarra David A. , Lin Jue , Moran Patricia J. , Schleicher Samantha G. , Acree Michael , Prather Aric A. , Epel Elissa S.
Published: June 2018

Objective

The aim of the study was to determine, within a weight loss clinical trial for obesity, the impact of intervention arm, weight change, and weight loss maintenance on telomere length (TL).

Methods

Adults (N= 194) with a body mass index between 30 and 45 were randomized to a 5.5-month weight loss program with (n= 100) or without (n= 94) mindfulness training and identical diet-exercise guidelines. We assessed TL at baseline and 3-, 6-, and 12-month postbaseline in immune cell populations (primarily in peripheral blood mononuclear cells [PBMCs], but also in granulocytes and T and B lymphocytes). We defined weight loss maintenance as having lost at least 5% or 10% of body weight (tested in separate models) from preintervention to postintervention, and having maintained this loss at 12 months. We predicted that greater weight loss and weight loss maintenance would be associated with TL lengthening.

Results

Neither weight loss intervention significantly predicted TL change nor did amount of weight change, at any time point. Across all participants, weight loss maintenance of at least 10% was associated with longer PBMC TL (b= 239.08, 95% CI = 0.92 to 477.25,p= .049), CD8+ TL (b= 417.26, 95% CI = 58.95 to 775.57,p= .023), and longer granulocyte TL (b= 191.56, 95% CI = −4.23 to 387.35,p= .055) at 12 months after accounting for baseline TL. Weight loss maintenance of 5% or more was associated with longer PBMC TL (b= 163.32, 95% CI = 4.00 to 320.62,p= .045) at 12 months after accounting for baseline TL. These tests should be interpreted in light of corrections for multiple tests.

Conclusions

Among individuals with obesity, losing and maintaining a weight loss of 10% or more may lead to TL lengthening, which may portend improved immune and metabolic function. TL lengthening in this study is of unknown duration beyond 12 months and requires further study.

Trial Registration: Clinicaltrials.gov identifier NCT00960414; Open Science Framework (OSF) preregistration: https://osf.io/t3r2g/.
Patient and Physician Experience with Interhospital Transfer: A Qualitative Study
Authors: Mueller Stephanie K. , Shannon Evan , Dalal Anuj , Schnipper Jeffrey L. , Dykes Patricia
Published: June 2018

Objectives

Although existing data suggest marked variability in interhospital transfer (IHT), little is known about specific factors that may impact the quality and safety of this care transition. We aimed to explore transferred patients’ and involved physicians’ experience with IHT to better understand the components of the transfer continuum and identify potential targets for improvement.

Methods

We performed a qualitative study using individual interviews of adult patients recently transferred to cardiology, general medicine, and oncology services at a tertiary care academic medical center, as well as their transferring physician, accepting attending physician, and accepting/admitting resident physician. We conducted a thematic analysis, using an inductive approach and an a priori framework from pre-established domains.

Results

Participants included 10 hospitalized adults (6 cardiology, 2 general medicine, and 2 oncology), 9 accepting attending physicians, 12 accepting and/or admitting resident physicians, and 5 transferring physicians (N = 36). Emergent themes demonstrated that participants held a shared understanding of the reason for transfer (most commonly access to more specialized care), and relayed a general dissatisfaction regarding the timing and lack of advanced notification of transfer. We also found distinct differences in IHT experience by stakeholder group: physician participants relayed discontent with intrahospital chains of communication and interhospital information exchange, and patient participants focused more readily on the physical aspects of IHT.

Conclusions

This study offers insight into IHT from the perspective of those most affected by this process, thereby identifying potential targets in addressing the quality and safety of this transition.
Contrast-enhanced Magnetic Resonance Imaging of Pelvic Bone Metastases at 3.0 T: Comparison Between 3-dimensional T1-weighted CAIPIRINHA-VIBE Sequence and 2-dimensional T1-weighted Turbo Spin-Echo Sequence
Authors: Yoon Min A , Hong Suk-Joo , Lee Kyu-Chong , Lee Chang Hee
Published: June 2018

Objective

This study aimed to compare 3-dimensional T1-weighted gradient-echo sequence (CAIPIRINHA–volumetric interpolated breath-hold examination [VIBE]) with 2-dimensional T1-weighted turbo spin-echo sequence for contrast-enhanced magnetic resonance imaging (MRI) of pelvic bone metastases at 3.0 T.

Methods

Thirty-one contrast-enhanced MRIs of pelvic bone metastases were included. Two contrast-enhanced sequences were evaluated for the following parameters: overall image quality, sharpness of pelvic bone, iliac vessel clarity, artifact severity, and conspicuity and edge sharpness of the smallest metastases. Quantitative analysis was performed by calculating signal-to-noise ratio and contrast-to-noise ratio of the smallest metastases. Significant differences between the 2 sequences were assessed.

Results

CAIPIRINHA-VIBE had higher scores for overall image quality, pelvic bone sharpness, iliac vessel clarity, and edge sharpness of the metastatic lesions, and had less artifacts (all P < 0.05). There was no significant difference in conspicuity, signal-to-noise ratio, or contrast-to-noise ratio of the smallest metastases (P > 0.05).

Conclusions

Our results suggest that CAIPIRINHA-VIBE may be superior to turbo spin-echo for contrast-enhanced MRI of pelvic bone metastases at 3.0 T.