bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility and acceptability of adherence support for direct acting antiviral therapy for hepatitis C in a low‐threshold primary health‐care opioid agonist treatment program
Authors: Chronister Karen J. , Lothian Rebecca , Gilliver Rosie , Kearley John , Read Phillip
Published: February 2019

Introduction and Aims

To maximise the benefits of direct acting antivirals in Australia, innovative options for marginalised populations to receive daily or weekly medication may be beneficial. This study evaluated the feasibility and acceptability of direct acting antivirals provision by leveraging an opioid agonist treatment program to support adherence regardless of opioid agonist treatment enrolment.

Design and Methods

Feasibility was evaluated by monitoring selection of dosing options by clients initiating direct acting antivirals during the first 6 months. Client acceptability was assessed using a cross‐sectional survey after 6 months. Pre‐ and post‐implementation surveys of attitudes and concerns regarding the program were compared to evaluate staff acceptability.

Results

Among 79 clients commencing direct acting antivirals, 30 (38%) chose adherence support. Among these, 12 (40%) were not simultaneously enrolled in opioid agonist treatment. Clients were satisfied with service provision and access despite introducing daily dosing. All highly marginalised clients receiving direct acting antivirals with adherence support found this helpful. Staff concerns identified prior to the program proved unfounded.

Discussion and Conclusions

This study demonstrates providing adherence support for direct acting antivirals regardless of client participation in opioid agonist treatment is both feasible and acceptable with minimal impact on service provision. Availability of direct acting antivirals in opioid agonist treatment or primary health‐care settings expands the pool of people who may receive effective treatment for hepatitis C virus and reduces treatment barriers.
S2k Guidelines for Cutaneous Basal Cell Carcinoma – Part 2: Treatment, Prevention and Follow‐up
Authors: Lang Berenice M. , Balermpas Panagiotis , Bauer Andrea , Blum Andreas , Brölsch G. Felix , Dirschka Thomas , Follmann Markus , Frank Jorge , Frerich Bernhard , Fritz Klaus , Hauschild Axel , Heindl Ludwig M. , Howaldt Hans‐Peter , Ihrler Stephan , Kakkassery Vinodh , Klumpp Bernhard , Krause‐Bergmann Albrecht , Löser Christoph , Meissner Markus , Sachse Michael M. , Schlaak Max , Schön Michael P. , Tischendorf Lutz , Tronnier Michael , Vordermark Dirk , Welzel Julia , Weichenthal Michael , Wiegand Susanne , Kaufmann Roland , Grabbe Stephan
Published: February 2019

Basal cell carcinoma (BCC) is the most common malignant tumor among fair‐skinned individuals, and its incidence had been steadily rising in the past decades. In order to maintain the highest quality of patient care possible, the German S2k guidelines were updated following a systematic literature search and with the participation of all professional societies and associations involved in the management of the disease. Part 2 addresses issues such as proper risk stratification, the various therapeutic approaches, and prevention as well as follow‐up of patients with basal cell carcinoma.
Hautentzündungen mit Arthritis, Synovitis und Enthesitis. Teil 2: Rheumatoide Arthritis, reaktive Arthritis, Morbus Reiter, Lyme‐Borreliose, Dermatomyositis und Lupus erythematodes
Authors: Schempp Christoph M. , Schauer Franziska , Huhn Christian K. , Venhoff Nils , Finzel Stephanie
Published: February 2019

Die Syndrome mit gleichzeitiger Entzündung von Haut und Gelenken stellen oft eine Herausforderung für Dermatologen und Rheumatologen dar. Im vorausgehenden ersten Teil dieser Übersicht wurden die Psoriasisarthritis und die autoinflammatorischen Erkrankungen SAPHO‐Syndrom, Morbus Still und Morbus Behçet behandelt. Hier folgen rheumatoide Arthritis, reaktive Arthritis, Morbus Reiter und Lyme‐Borreliose. Anschließend werden die Dermatomyositis und der Lupus erythematodes besprochen, häufige autoimmunologische Krankheiten, bei denen neben Haut oft auch die Gelenke betroffen sind. Jedes Krankheitsbild wird hinsichtlich Epidemiologie, Pathogenese, Klinik, Diagnostik und Therapie abgehandelt.
A neurodevelopmental approach to myotonic dystrophy type 1
Authors: Angeard Nathalie
Published: February 2019

This commentary is on the original article by Lindeblad et al. on pages 1214‐1220 of this issue.
A bio‐psycho‐social view of cerebral palsy: friendships reduce mental health disorders
Authors: Paulus Frank W
Published: February 2019

This commentary is on the original article by Whitney et al. on pages 937–942 of this issue.
Diabetes distress in young adults with early‐onset Type 1 diabetes and its prospective relationship with HbA1cand health status
Authors: Stahl‐Pehe A. , Glaubitz L. , Bächle C. , Lange K. , Castillo K. , Tönnies T. , Yossa R. , Holl R. W. , Rosenbauer J.
Published: February 2019

Aim

This study aimed to determine cross‐sectional relationships between diabetes distress and health‐related variables, and prospective associations between diabetes distress and future glycaemic control (HbA1c) and health status among young adults with early‐onset Type 1 diabetes.

Methods

Data were collected from a nationwide cohort study of adults whose Type 1 diabetes onset occurred from 0 to 4 years of age during 1993–2002. Questionnaire surveys were conducted in 2012–2013 and 2015–2016 (N = 584). Diabetes distress was assessed via the Problem Areas in Diabetes (PAID) scale (0–100 points), depressive symptoms via the Patient Health Questionnaire‐9 (PHQ‐9) and health status via the 12‐Item Short Form Health Survey (SF‐12) questionnaire. Multivariable linear regression analyses were applied to cross‐sectional and longitudinal data.

Results

In the cross‐sectional analyses, higherPAIDscale total scores (representing higher distress levels) were observed in women than in men and in participants with more severe depressive symptoms.PAIDscores were lower in individuals with better physical and mental health. A 1 mmol/mol increase in HbA1cwas associated with a 0.28‐point increase [95% confidence interval (95%CI) 0.20, 0.36] in diabetes distress. In longitudinal analyses adjusting for age, sex, socio‐economic index and HbA1cat baseline, a 10‐point higherPAIDscore at baseline was associated with a 1.82 mmol/mol higher HbA1clevel (95%CI0.43, 3.20) and a 2.48‐point lowerSF‐12 mental health score (95%CI−3.55, −1.42) three years later.

Conclusions

The cross‐sectional and longitudinal analyses results suggest that diabetes distress impairs health‐related outcomes in young adults with early‐onset diabetes.
Body weight and eGFR during dulaglutide treatment in type 2 diabetes and moderate‐to‐severe chronic kidney disease (AWARD‐7)
Authors: Tuttle Katherine R. , Lakshmanan Mark C. , Rayner Brian , Zimmermann Alan G. , Woodward Brad , Botros Fady T.
Published: February 2019

In patients with type 2 dibetes and moderate‐to‐severe chronic kidney disease, dulaglutide treatment led to body weight (BW) loss and lesser eGFR decline compared to insulin glargine. As BW may affect muscle mass, creatinine‐based eGFR can be altered independently of kidney function. Cystatin C‐based eGFR is not affected by muscle mass. The objective of this post‐hoc analysis was to determine whether the lesser eGFR decline with dulaglutide was related to BW loss. Baseline characteristics were similar between treatments ([mean ± SD] age, 64.6 ± 8.6 years; women, 48%; BW, 89.1 ± 17.7 kg; eGFR [CKD‐EPI‐cystatin C] 38 ± 14 mL/min/1.73m2). BW decreased with dulaglutide 1.5 and 0.75 mg and increased with insulin glargine ([LSM change (SE)], −2.66 [0.47] kg and −1.71 [0.45] vs 1.57 [0.43] kg; P < 0.001). Changes in eGFR were not significant with dulaglutide 1.5 and 0.75 mg, but eGFR significantly decreased with insulin glargine (eGFR‐CKD‐EPI‐cystatin C [LSM change (95%CI)], −0.7 [−2.5, 1.0] and −0.7 [−2.4, 1.1] vs −3.3 [−5.1, −1.6] mL/min/1.73 m2; P ≤ 0.037 vs glargine). Changes in BW did not correlate with changes in eGFR‐CKD‐EPI‐cystatin C (r = −0.041; n = 471; P = 0.379) or eGFR‐CKD‐EPI‐creatinine (r = −0.074; n = 473; P = 0.106). In conclusion, the lesser decline in eGFR observed with dulaglutide was not influenced by BW loss.
Pharmaco‐electroencephalographic responses in the rat differ between active and inactive locomotor states
Authors: Hansen Ingeborg H. , Agerskov Claus , Arvastson Lars , Bastlund Jesper F. , Sørensen Helge B. D. , Herrik Kjartan F.
Published: February 2019

Quantitative electroencephalography from freely moving rats is commonly used as a translational tool for predicting drug‐effects in humans. We hypothesized that drug‐effects may be expressed differently depending on whether the rat is in active locomotion or sitting still during recording sessions, and proposed automatic state‐detection as a viable tool for estimating drug‐effects free of hypo‐/hyperlocomotion‐induced effects. We aimed at developing a fully automatic and validated method for detecting two behavioural states: active and inactive, in one‐second intervals and to use the method for evaluating ketamine, DOI, d‐cycloserine, d‐amphetamine, and diazepam effects specifically within each state. The developed state‐detector attained high precision with more than 90% of the detected time correctly classified, and multiple differences between the two detected states were discovered. Ketamine‐induced delta activity was found specifically related to locomotion. Ketamine and DOI suppressed theta and beta oscillations exclusively during inactivity. Characteristic gamma and high‐frequency oscillations (HFO) enhancements of the NMDAR and 5HT2A modulators, speculated associated with locomotion, were profound and often largest during the inactive state. State‐specific analyses, theoretically eliminating biases from altered occurrence of locomotion, revealed only few effects of d‐amphetamine and diazepam. Overall, drug‐effects were most abundant in the inactive state. In conclusion, this new validated and automatic locomotion state‐detection method enables fast and reliable state‐specific analysis facilitating discovery of state‐dependent drug‐effects and control for altered occurrence of locomotion. This may ultimately lead to better cross‐species translation of electrophysiological effects of pharmacological modulations.
Effect of oxidative stress in rostral ventrolateral medulla on sympathetic hyperactivity after traumatic brain injury
Authors: Chen Jigang , Chen Wen , Han Kaiwei , Qi Enbo , Chen Rongbin , Yu Minkun , Hou Lijun , Lv Liquan
Published: February 2019

Sympathetic hyperactivity occurs in a subgroup of patients after traumatic brain injury (TBI). The rostral ventrolateral medulla (RVLM) is a key region for the activity of sympathetic nervous system. Oxidative stress in the RVLM is proved to be responsible for the increased level of sympathetic activity in animal models of hypertension and heart failure. In this study, we investigated whether oxidative stress in the RVLM contributed to the development of sympathetic hyperactivity after TBI in rats. Model of diffuse axonal injury was induced using Sprague‐Dawley rats, and level of mean arterial pressure (MAP) and plasma Norepinephrine (NE) was measured to evaluate the sympathetic activity. For the assessment of oxidative stress, expression of reactive oxygen species (ROS), malondialdehyde (MDA), and superoxide dismutase (SOD) in the RVLM was determined. Microinjection of Tempol into the RVLM was performed to determine the effect of oxidative stress on sympathetic hyperactivity. According to the results, TBI led to elevated MAP and plasma NE in rats. It also induced a significantly increased level of ROS, MDA production and decreased level of SOD in the RVLM. The sympathetic activity, ROS, and MDA in the RVLM decreased significantly after microinjection of Tempol. Therefore, the present results suggested that oxidative stress in the RVLM was involved in the development of sympathetic hyperactivity following TBI.
Writing recounts of habitual events: Investigating a genre‐based approach
Authors: Abdel‐Malek Myriam
Published: February 2019

This multiple case study investigated the application of the genre‐based approach (GBA) in a second‐semester university‐level Arabic class. This article depicts the linguistic features that make possible the recounting of habitual events (recount) in Arabic and outlines how during the GBA, both (1) the notion of purpose for writing and (2) the connection between that purpose and the necessary language features helped students produce culturally informed recounts. An analysis of the writing of three students, representing three different performance levels, before and after having received instruction in genre‐based writing, revealed differences in the linguistic resources that students employed to convey meaning. Implications for foreign language genre pedagogy are discussed.
Activity‐regulated cytoskeleton‐associated protein (Arc/Arg3.1) regulates anxiety‐ and novelty‐related behaviors
Authors: Penrod Rachel D. , Kumar Jaswinder , Smith Laura N. , McCalley Daniel , Nentwig Todd B. , Hughes Brandon W. , Barry Gabriella M. , Glover Kelsey , Taniguchi Makoto , Cowan Christopher W.
Published: February 2019

The activity‐regulated cytoskeleton‐associated protein (Arc, also known as Arg3.1) regulates glutamatergic synapse plasticity and has been linked to neuropsychiatric illness; however, its role in behaviors associated with mood and anxiety disorders remains unclear. We find that stress upregulates Arc expression in the adult mouse nucleus accumbens (NAc)—a brain region implicated in mood and anxiety behaviors. Global Arc knockout mice have altered AMPAR‐subunit surface levels in the adult NAc, and the Arc‐deficient mice show reductions in anxiety‐like behavior, deficits in social novelty preference, and antidepressive‐like behavior. Viral‐mediated expression of Arc in the adult NAc of male, global Arc KO mice restores normal levels of anxiety‐like behavior in the elevated plus maze (EPM). Consistent with this finding, viral‐mediated reduction of Arc in the adult NAc reduces anxiety‐like behavior in male, but not female, mice in the EPM. NAc‐specific reduction of Arc also produced significant deficits in both object and social novelty preference tasks. Together our findings indicate that Arc is essential for regulating normal mood‐ and anxiety‐related behaviors and novelty discrimination, and that Arc's function within the adult NAc contributes to these behavioral effects.
Emergency surgery and American Society of Anesthesiologists physical status score are the most influential risk factors of death in nonagenarian surgical patients
Authors: Fariña‐Castro Roberto , Roque‐Castellano Cristina , Artiles‐Armas Manuel , Marchena‐Gómez Joaquín
Published: February 2019

Aim

The number of nonagenarians undergoing surgery has increased considerably in recent decades as a result of population aging. Greater knowledge of the most influential factors affecting perioperative morbidity and mortality would improve the quality of care and provision of health resources for these patients. The objective of the present study was to analyze the perioperative mortality, and its most determinant factors, among nonagenarian patients who underwent a surgical procedure in the Department of General and Digestive Surgery.

Methods

A retrospective descriptive study was carried out in a cohort of 159 consecutive non‐selected surgical nonagenarian patients. Clinical data, type of operation, perioperative hemodynamic instability, the need for blood transfusion and medical/surgical complications were evaluated as predictor variables. The outcome variable was operative mortality.

Results

The mean age was 91.8 years (SD ± 2.0); there were 60 men (37.7%) and 99 (62.3%) women. Perioperative mortality was 28.93% (46 patients). The variables age (P = 0.025), American Society of Anesthesiologists physical status score (P < 0.001), neoplastic pathology (P = 0.025), intestinal surgery (P = 0.001), emergent surgery (P ≤ 0.001), perioperative blood transfusion (P = 0.003), postoperative medical complications (P < 0.001) and surgical complications (P = 0.022) showed a statistically significant correlation with mortality. American Society of Anesthesiologists physical status score (P = 0.007), emergent surgery (P < 0.032) and perioperative blood transfusion (P = 0.047) were identified as independent predictors of mortality.

Conclusions

Surgery should not be denied to nonagenarian patients based only on their age. Emergency surgery and American Society of Anesthesiologists physical status classification are the most significant factors when deciding whether to intervene. Geriatr Gerontol Int 2019; 19: 293–298.
Spironolactone‐induced XPB degradation depends on CDK7 kinase and SCFFBXL18 E3 ligase
Authors: Ueda Masanobu , Matsuura Kenkyo , Kawai Hidehiko , Wakasugi Mitsuo , Matsunaga Tsukasa
Published: February 2019

The multisubunit complex transcription factor IIH (TFIIH) has dual functions in transcriptional initiation and nucleotide excision repair (NER). TFIIH is comprised of two subcomplexes, the core subcomplex (seven subunits) including XPB and XPD helicases and the cyclin‐dependent kinase (CDK)‐activating kinase (CAK) subcomplex (three subunits) containing CDK7 kinase. Recently, it has been reported that spironolactone, an anti‐aldosterone drug, inhibits cellular NER by inducing proteasomal degradation of XPB and potentiates the cytotoxicity of platinum‐based drugs in cancer cells, suggesting possible drug repositioning. In this study, we have tried to uncover the mechanism underlying the chemical‐induced XPB destabilization. Based on siRNA library screening and subsequent analyses, we identified SCFFBXL18 E3 ligase consisting of Skp1, Cul1, F‐box protein FBXL18 and Rbx1 responsible for spironolactone‐induced XPB polyubiquitination and degradation. In addition, we showed that CDK7 kinase activity is required for this process. Finally, we found that the Ser90 residue of XPB is essential for the chemical‐induced destabilization. These results led us to propose a model that spironolactone may trigger the phosphorylation of XPB at Ser90 by CDK7, which promotes the recognition and polyubiquitination of XPB by SCFFBXL18 for proteasomal degradation.
Aiming for the optimal bicarbonate prescription for maintenance hemodialysis therapy in end‐stage renal disease
Authors: Bozikas Andreas , Kiriakoutzik Iliana , Petrou Ioannis , Touroutzis Theodoros , Kitoukidi Eleni , Pisanidou Pinelopi , Vakiani Styliani , Georgilas Nikolaos , Martika Antigoni , Pangidis Panagiotis , Spaia Sofia
Published: February 2019

Introduction: Acidemia and alkalemia, as a result of gradual depletion of the body's buffers followed by rapid repletion during hemodialysis (HD), are linked to adverse consequences. We examined the acid‐base status with dialysis bath of higher bicarbonate (HC03−) concentration or standard HC03− bath plus oral HC03− supplementation.

Methods: A total of 60 stable HD patients (pts) were evaluated according to their pre‐dialysis acid‐base status both before the first and the second session of the week dialyzed against standard base dialysate of 35 mmol/L. Those who presented predialysis HC03− <22 mmol/L (25 pts) were assigned to dialysis against bath of increased HC03− levels (37 mmol/L) for 2 weeks (period A) and subsequently to dialysis with the standard dialysate bath plus daily oral sodium bicarbonate at a dose of 5 g/day for 2 weeks (period B). Pre and post‐dialysis acid‐base status at each study period and relevant laboratory tests were recorded.

Findings: Pre‐dialysis acid‐base values were similar between the first and the second dialysis session. Twenty‐five points had pre‐dialysis pH <7.35, while 42 (the younger ones) presented pre‐dialysis HC03− <22 mmol/L. After dialysis session 18 pts had pH >7.45. Comparing the two study periods, interdialytic weight was similar, pre‐dialysis HC03− levels were improved with oral bicarbonate, while post‐dialysis HC03− were higher during period A. Three pts could not tolerate the symptoms of alkalemia during period A.

Discussion: The impact of conventional HC03− concentrations of 35 mmol/L results in a considerable degree of pre‐dialysis acidemia. Increasing the HC03− in bath results in more prominent post‐dialysis alkalemia, however, it is not sufficient to maintain acid‐base status during the interdialytic period. Oral bicarbonate supplement at a dose of 5 g/day (divided in three daily doses) results in a more balanced acid‐base status, avoiding post‐dialysis alkalemia.
Patient stakeholder engagement in research: A narrative review to describe foundational principles and best practice activities
Authors: Harrison James D. , Auerbach Andrew D. , Anderson Wendy , Fagan Maureen , Carnie Martha , Hanson Catherine , Banta Jim , Symczak Gina , Robinson Edmondo , Schnipper Jeffrey , Wong Celene , Weiss Rachel
Published: February 2019

Background

Health research is evolving to include patient stakeholders (patients, families and caregivers) as active members of research teams. Frameworks describing the conceptual foundations underlying this engagement and strategies detailing best practice activities to facilitate engagement have been published to guide these efforts.

Objective

The aims of this narrative review are to identify, quantify and summarize (a) the conceptual foundational principles of patient stakeholder engagement in research and (b) best practice activities to support these efforts.

Search Strategy, Inclusion Criteria, Data Extraction and Synthesis

We accessed a publicly available repository of systematically identified literature related to patient engagement in research. Two reviewers independently screened articles to identify relevant articles and abstracted data.

Main Results

We identified 990 potentially relevant articles of which 935 (94.4%) were excluded and 55 (5.6%) relevant. The most commonly reported foundational principles were “respect” (n = 25, 45%) and “equitable power between all team members” (n = 21, 38%). Creating “trust between patient stakeholders and researchers” was described in 17 (31%) articles. Twenty‐seven (49%) articles emphasized the importance of providing training and education for both patient stakeholder and researchers. Providing financial compensation for patient stakeholders’ time and expertise was noted in 19 (35%) articles. Twenty articles (36%) emphasized regular, bidirectional dialogue between patient partners and researchers as important for successful engagement.

Discussion and Conclusions

Engaging patient stakeholders in research as partners presents an opportunity to design, implement and disseminate patient‐centred research. This review creates an overarching foundational framework for authentic and sustainable partnerships between patient stakeholders and researchers.
Exploring views of pharmacists on antibacterial prescribing: a Maltese perspective
Authors: Attard Pizzuto Maresca , Camilleri Liberato , Azzopardi Lilian M , Serracino-Inglott Anthony
Published: February 2019

Objectives

To investigate the perception of Maltese pharmacists to prescribe a selected number of antibiotics.

Methods

A self-administered questionnaire entitled ‘Antibiotic Prescribing by Pharmacists’ was developed to study pharmacist perception to prescribing a selected number of antibacterial agents. The questionnaire was validated by a two-round Delphi technique and disseminated to all practising pharmacists (N = 930) during a 3-month period.

Key findings

Two hundred and nine pharmacists answered the questionnaire. The majority of pharmacists (77%) were in agreement with pharmacists prescribing a selected number of antibacterials. Reasons given are that pharmacist prescribing would increase recognition of the participation of pharmacists within patient care and as members of the healthcare team. Protocol-based prescribing was the preferred model for prescribing by 60% of pharmacists. Half of the respondents (50%) feel competent to prescribe, 34% have no opinion and 16% do not feel competent at all. Co-amoxiclav for an uncomplicated upper respiratory tract infection was the antibacterial that most pharmacists (51%) feel confident prescribing. When pharmacists were asked whether they feel comfortable prescribing other medications rather than antibacterials, 93% answered positively, with 83% feeling mostly comfortable prescribing lactulose solution.

Conclusion

Pharmacists in Malta are in agreement with prescribing selected antibiotics for minor ailments. A collaborative approach between medical practitioners and pharmacists should be evaluated as a possible national structure towards achieving better antibiotic prescribing whilst giving patient access to the use of antibacterials as necessary.
Constipation‐induced pressor effects as triggers for cardiovascular events
Authors: Ishiyama Yusuke , Hoshide Satoshi , Mizuno Hiroyuki , Kario Kazuomi
Published: February 2019

Constipation is associated with cardiovascular events. Changes to the intestinal microbiota by constipation can induce atherosclerosis, blood pressure rise, and cardiovascular events. Constipation increases with age and often coexists with cardiovascular risk factors. In addition, strain at stool causes blood pressure rise, which can trigger cardiovascular events such as congestive heart failure, arrhythmia, acute coronary disease, and aortic dissection. However, because cardiovascular medical research often focuses on more dramatic interventions, the risk from constipation can be overlooked. Physicians caring for patients with cardiovascular disease should acknowledge constipation and straining with it as important cardiovascular risk, and prematurely intervene to prevent it. The authors review and discuss the relationship between constipation and cardiovascular disease.
PECAM‐1 modulates liver damage induced by synergistic effects of TNF‐α and irradiation
Authors: Malik Gesa , Wilting Jörg , Hess Clemens Friedrich , Ramadori Giuliano , Malik Ihtzaz Ahmed
Published: February 2019

The mechanisms of radiation‐induced liver damage are poorly understood. We investigated if tumour necrosis factor (TNF)‐α acts synergistically with irradiation, and how its activity is influenced by platelet endothelial cell adhesion molecule‐1 (PECAM‐1). We studied murine models of selective single‐dose (25 Gy) liver irradiation with and without TNF‐α application (2 μg/mouse; i.p.). In serum of wild‐type (wt)‐mice, irradiation induced a mild increase in hepatic damage marker aspartate aminotransferase (AST) in comparison to sham‐irradiated controls. AST levels further increased in mice treated with both irradiation and TNF‐α. Accordingly, elevated numbers of leucocytes and increased expression of the macrophage marker CD68 were observed in the liver of these mice. In parallel to hepatic damage, a consecutive decrease in expression of hepatic PECAM‐1 was found in mice that received radiation or TNF‐α treatment alone. The combination of radiation and TNF‐α induced an additional significant decline of PECAM‐1. Furthermore, increased expression of hepatic lipocalin‐2 (LCN‐2), a hepatoprotective protein, was detected at mRNA and protein levels after irradiation or TNF‐α treatment alone and the combination of both. Signal transducer and activator of transcription‐3 (STAT‐3) seems to be involved in the signalling cascade. To study the involvement of PECAM‐1 in hepatic damage more deeply, the liver of both wt‐ and PECAM‐1‐knock‐out‐mice were selectively irradiated (25 Gy). Thereby, ko‐mice showed higher liver damage as revealed by elevated AST levels, but also increased hepatoprotective LCN‐2 expression. Our studies show that TNF‐α has a pivotal role in radiation‐induced hepatic damage. It acts in concert with irradiation and its activity is modulated by PECAM‐1, which mediates pro‐ and anti‐inflammatory signalling.
Longitudinal assessment of exercise capacity and quality of life outcome measures in cystic fibrosis: A year‐long prospective pilot study
Authors: Bhatia Rajeev , Kaye Melissa , Roberti‐Miller Adria
Published: February 2019

Background

Multiple outcomes measures including exercise capacity and quality of life are necessary to get complete and accurate picture of cystic fibrosis (CF) progression. In this pilot study, we investigated these measures in CF longitudinally for a year to determine (a) minimal clinically important difference (MCID) for 6‐minute walk distance (6MWD) and CF Health‐Related Quality of Life Questionnaire (CFQ‐R) domains and (b) how 6MWD, CFQ‐R, and spirometry change during times of exacerbation and baseline health and their relationship among each other.

Methods

Subjects with moderate and severe CF (baseline FEV1 less than 70% predicted) at Akron Children's Hospital CF centre were followed for a full year longitudinally. All three tests (6MWT, CFQ‐R, and spirometry) were done during each outpatient visit and weekly during inpatient admission. MCID was estimated for these parameters using distribution‐based methods. Finally, data were examined visually using longitudinal graphs for each subject.

Results

Twelve CF subjects (eight [67%] males and age range 13‐46 years) were followed for a full year resulting in at least four encounters per subject. 6MWD (m) and CFQ‐R respiratory had an MCID of 33 m and 7.3, respectively. MCIDs for FEV1 (percentage predicted) and CFQ‐R physical were 7.1 and 11.4, respectively. The longitudinal evaluation of multiple outcome measures during periods of disease exacerbation and baseline health showed that these parameters did not appear to change in accordance with each other.

Conclusion

In this pilot study, MCIDs for 6MWD and CFQ‐R domains were calculated for the first time to facilitate their use as additional outcome measures in CF. The disparity among multiple outcome measures highlights that these measures together may provide a more complete picture in CF than any single measure alone.
Vessel Wall MRI Added to MR Angiography in the Evaluation of Suspected Vasculopathies
Authors: Song Jae W. , Obusez Emmanuel C. , Raymond Scott B. , Rafla Samuel D. , Schaefer Pamela W. , Romero Javier M.
Published: February 2019

BACKGROUND AND PURPOSE

We hypothesized that vessel wall MR imaging (VWI) with 3D‐time‐of‐flight magnetic resonance imaging (3D‐TOF‐MRA) together increases the ability to detect abnormal intracranial vessel segments compared to 3D‐TOF‐MRA alone.

METHODS

Ninety‐three consecutive subjects with a clinical history of suspected vasculopathy imaged with both VWI and 3D‐TOF‐MRAs were retrospectively reviewed. The 3D‐TOF‐MRAs were reviewed by two independent neuroradiologists classifying arterial segments as normal or abnormal based on caliber changes. Following a 2‐week wash‐out period, the 3D‐TOF‐MRAs with VWI together were re‐evaluated for caliber changes and/or vessel wall enhancement. A third neuroradiologist served as consensus. Significance was assessed by McNemar's test.

RESULTS

Forty‐two subjects with VWI and 3D‐TOF‐MRAs met the inclusion criteria. By 3D‐TOF‐MRA alone, 12.3% (95% confidence interval [CI], 10.7‐15.1) of the arterial segments were identified as abnormal compared to 20.8% (95% CI, 18.2‐23.4) by VWI and 3D‐TOF‐MRA together (P < .0001).

CONCLUSIONS

3D‐TOF‐MRA and VWI together identifies a higher number of abnormal vessel segments than 3D‐TOF‐MRA alone and may provide a more accurate assessment of disease burden.
Ability to control directional lip‐closing force during voluntary lip pursing in healthy young adults
Authors: Miyamoto Takeshi , Yamada Kazuhiro , Hijiya Keiko , Kageyama Toru , Kato Takafumi , Sugo Hideaki , Shimono Ryosuke , Masuda Yuji
Published: February 2019

Background

It is considered important to evaluate the ability to control lip‐closing force (LCF).

Objective

This study aimed to investigate the ability to control directional LCF.

Methods

The experimental system included an apparatus developed to measure LCF during lip pursing in eight directions (upper, lower, right, left and the four directions in between) and a display showing the exerted LCF and a target value in each direction in real time. Twenty subjects (10 men and 10 women) were instructed to maintain the LCF at a specific target value using visual feedback. Based on our preliminary experiments, the target value was set as 50% of the maximum LCF, and the range was set at the target value ±8%. The accuracy rate was defined as the ratio of the matched time, in which the subject was able to keep the LCF in the target range, to the total 3 seconds.

Results

The accuracy rate of men was higher than in women in the lower, lower left and lower right directions. The accuracy rate of the directional LCF differed significantly depending on the direction. In assessing the accuracy rate for each directional LCF, the rates of upper and lower directional LCF were significantly higher than those of oblique directional LCF. No significant relationship was observed between the accuracy rate and the maximum LCF except for one direction in men subjects.

Conclusions

Our findings suggest that the ability to control directional LCF is affected by sex and the force direction.
The Invisible Hand is an Ideology: Toward a Social Psychology of Neoliberalism
Authors: Bettache Karim , Chiu Chi‐Yue
Published: February 2019

On the one hand, neoliberalism, originally an economic theory, has evolved into a sociopolitical ideology and extended its hegemonic influence to all areas of life, including the production of psychological knowledge in academia and the practice of psychology in various domains. On the other hand, neoliberalism has been criticized as the root of all problems in contemporary societies. Widespread discontent with neoliberalism is seen as the catalyst for the rising popularity of populism, the election of Donald Trump in the United States, and the Brexit referendum. The discontent with neoliberalism has also inspired imaginations of what a postneoliberal society may be like, as evidenced by the rise of neosocialists such as Alexandria Ocasio‐Cortez in the United States or Jeremy Corbyn in the United Kingdom. In this issue, we have gathered multidisciplinary insights to answer questions that would constitute a preliminary agenda of a social psychology of neoliberalism. These questions include: how neoliberalism can be studied social psychologically? What are the neoliberalist constraints on knowledge creation and social practices? How can social psychology shed light on the psychological responses to the hegemonic impact of neoliberalism and contribute to the imagination of a postneoliberal world? In short, is social psychology of neoliberalism a feasible and useful intellectual project for producing actionable social knowledge?
Growth performance, biochemical, cytological and molecular aspects of rabbits exposed to lead toxicity
Authors: Taha Heba S. A. , Abdelnour Sameh A. , Alagawany Mahmoud
Published: February 2019

Heavy metals have enormous variety of deleterious effects on many organs in the body. This study demonstrated the toxic influences of lead on the growth, biochemical, cellular and molecular aspects of developing rabbits. Seventy‐five rabbits (New Zealand NZW) were divided into five equal groups as follows; control (C) and four treatment groups (T1‐4) orally administered lead acetate solution as follow T1: 20, T2: 30, T3: 50 and T4: 70 mg/kg body weight. Lead resulted in a significant decrease in live body weight, daily body weight gain and feed intake in T3 and T4 compared to those in other groups. Blood haematology measurements such as red blood cells, haematocrit (HCT), mean corpuscular volume, platelet, white blood cells and lymphocytes were significantly influenced by the high level of lead. Oral administration of lead significantly reduced total proteins in the serum. It was observed that the high lead level led to significantly (p < 0.05) increased levels of aspartate aminotransferase, alanine aminotransferase enzymes, urea and creatinine. Four random amplified polymorphic DNA primers polymorphism were detected among the treatment groups. Total number of induced bands (loss or appearance) compared with control group were 4, 10, 10 and 14 bands using primers P1, P2, P3 and P4 respectively. Number of micronuclei showed a dose–response increase and the difference was highly significant especially between control compared with T3 and T4 groups. From our results, we can conclude that exposure of rabbits to lead acetate resulted in negative effects on the growth performance and altered the haematological and biochemical parameters, in addition to its adverse impact on cytological and molecular characterization of animals.
Heteroskedasticity‐Robust Unit Root Testing for Trending Panels
Authors: Herwartz Helmut , Maxand Simone , Walle Yabibal M.
Published: February 2019

Time‐varying volatility and linear trends are common features of several macroeconomic time series. Recent articles have proposed panel unit root tests (PURTs) that are pivotal in the presence of volatility shifts, excluding linear trends, however. This article proposes a new PURT that works well for data that is both heteroskedastic and trending. Under the null hypothesis, the test statistic has a limiting Gaussian distribution. We derive the local asymptotic power to underpin the consistency of the test statistic. Simulation results reveal that the test performs well in small samples. As an empirical illustration, we examine the stationarity of energy use per capita in OECD economies. While the series are in general difference stationary, they could also be considered as trend stationary for specific time spans.
Accuracy of self‐monitoring: does experience, ability or case difficulty matter?
Authors: Hautz Wolf E , Schubert Sebastian , Schauber Stefan K , Kunina‐Habenicht Olga , Hautz Stefanie C , Kämmer Juliane E , Eva Kevin W
Published: February 2019

Context

The ability to self‐monitor one's performance in clinical settings is a critical determinant of safe and effective practice. Various studies have shown this form of self‐regulation to be more trustworthy than aggregate judgements (i.e. self‐assessments) of one's capacity in a given domain. However, little is known regarding what cues inform learners’ self‐monitoring, which limits an informed exploration of interventions that might facilitate improvements in self‐monitoring capacity. The purpose of this study is to understand the influence of characteristics of the individual (e.g. ability) and characteristics of the problem (e.g. case difficulty) on the accuracy of self‐monitoring by medical students.

Methods

In a cross‐sectional study, 283 medical students from 5 years of study completed a computer‐based clinical reasoning exercise. Confidence ratings were collected after completing each of six cases and the accuracy of self‐monitoring was considered to be a function of confidence when the eventual answer was correct relative to when the eventual answer was incorrect. The magnitude of that difference was then explored as a function of year of seniority, gender, case difficulty and overall aptitude.

Results

Students demonstrated accurate self‐monitoring by virtue of giving higher confidence ratings (57.3%) and taking a shorter time to work through cases (25.6 seconds) when their answers were correct relative to when they were wrong (41.8% and 52.0 seconds, respectively; p< 0.001 and d > 0.5 in both instances). Self‐monitoring indices were related to student seniority and case difficulty, but not to overall ability or student gender.

Conclusions

This study suggests that the accuracy of self‐monitoring is context specific, being heavily influenced by the struggles students experience with a particular case rather than reflecting a generic ability to know when one is right or wrong. That said, the apparent capacity to self‐monitor increases developmentally because increasing experience provides a greater likelihood of success with presented problems.
Transformative learning as pedagogy for the health professions: a scoping review
Authors: Van Schalkwyk Susan C , Hafler Janet , Brewer Timothy F , Maley Moira A , Margolis Carmi , McNamee Lakshini , Meyer Ilse , Peluso Michael J , Schmutz Ana MS , Spak Judy M , Davies David ,   the Bellagio Global Health Education Initiative
Published: February 2019

Context

Transformative learning (TL) has been described as learning that challenges established perspectives, leading to new ways of being in the world. As a learning theory it has resonated with educators globally, including those in the health professions. Described as a complex metatheory, TL has evolved over time, eliciting divergent interpretations of the construct. This scoping review provides a comprehensive synthesis of how TL is currently represented in the health professions education literature, including how it influences curricular activities, to inform its future application in the field.

Methods

Arksey and O'Malley's six‐step framework was adopted to review the period from 2006 to May 2018. A total of 10 bibliographic databases were searched, generating 1532 potential studies. After several rounds of review, first of abstracts and then of full texts, 99 studies were mapped by two independent reviewers onto the internally developed data extraction sheet. Descriptive information about included studies was aggregated. Discursive data were subjected to content analysis.

Results

A mix of conceptual and empirical research papers, which used a range of qualitative methodologies, were included. Studies from the USA, the UK and Australia were most prevalent. Insights relating to how opportunities for TL were created, how it manifests and influences behaviour, as well as how it is experienced, demonstrated much congruency. Conceptions of TL were seen to be clustered around the work of key theorists.

Conclusions

The training of health professionals often takes place in unfamiliar settings where students are encouraged to be active participants in providing care. This increases the opportunity for exposure to learning experiences that are potentially transformative, allowing for a pedagogy of uncertainty that acknowledges the complexity of the world we live in and questions what we believe we know about it. TL provides educators in the health professions with a theoretical lens through which they can view such student learning.
Theory to Practice: Reflections on a Consulting Life
Authors: Druckman Daniel
Published: February 2019

In this essay, I recount my career experiences as a research consultant in Washington DC. These experiences, over the course of 23 years, provide examples of how theory and research can be used to guide practice. The account is chronological, beginning with my first consulting assignment in 1975, where I worked with a US delegation on resolving a negotiation impasse, to the 1990s where I directed study groups on a variety of human performance and international conflict resolution topics. These projects consisted both of applications of research‐based knowledge and the generation of research ideas for new projects. By immersing myself in both theory and practice, I could transform basic research into applied insights and induce research ideas from practice. This was the kind of career that Jeff Rubin aspired to having. The IACM Rubin award recognizes the way that his aspiration was fulfilled by one of his colleagues.
The Double Helix of Theory and Practice: Celebrating Stephen J. Goldberg as a Scholar, Practitioner, and Mentor
Authors: Olekalns Mara , Shestowsky Donna , Skratek Sylvia P. , De Pauw Ann‐Sophie
Published: February 2019

In this tribute to the 2014 recipient of the International Association for Conflict Management's Rubin Theory‐to‐Practice Award recipient, we celebrate the multifaceted contributions of Stephen J. Goldberg. The contributors highlight the role that he has played as a mentor inspiring young scholars, as a champion for grievance mediation, a designer of dispute resolution systems including the enduring power–rights–interests framework, and as a scholar. The article closes with reflections from Steve Goldberg about the intertwined nature of theory and practice, the ongoing cycle in which each informs the other and in which each makes the other stronger.
Non‐trophic plant–animal interactions mediate positive density dependence among conspecific saplings
Authors: Żywiec Magdalena , Fedriani José M. , Kurek Przemysław , Holeksa Jan
Published: February 2019

Trophic plant–animal interactions (e.g. browsing by ungulates, insect attack) are an important and well‐studied source of mortality in many tree populations. Non‐trophic tree–animal interactions (e.g. deer antler rubbing) also frequently lead to tree death, and thus have significant effects on forest ecosystem functioning, but they are much less well studied than trophic interactions are. As deer populations have increased in recent decades in the Northern Hemisphere, their impact on tree populations via browsing and antler rubbing will increase. The aim of the study was to illustrate the potential ability of non‐trophic plant–animal interactions to regulate the dynamics of a natural forest. Specifically, we wanted to determine whether and how density and distance‐dependent processes affect sapling mortality caused by an antler rubbing by red deer Cervus elaphus. We used a spatially explicit approach to examine density and distance‐dependent mortality effects in almost two thousand Picea abies saplings over 20 years, based on a fully mapped permanent 14.4 ha plot in a natural subalpine old‐growth spruce forest. Antler rubbing by deer was the main identified cause of sapling mortality, and it showed a strong spatial pattern: positive density dependence of survival among spruce saplings. Deer selectively killed spruce saplings that were isolated from conspecifics. In consequence, non‐trophic plant–deer interactions were a major driver of the spatial pattern of P. abies sapling survival. The other mortality causes (e.g. breaking, overturning) did not show density‐dependent patterns or their effects were much weaker. In the medium and long term, the density‐dependent pattern of sapling mortality due to antler rubbing can alter the tree stand structure. Our results highlight the ecological relevance of non‐trophic plant–animal interactions for forest ecosystem functioning.