bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wounds and mental health care: system thinking
Authors: Samuriwo Ray , Hannigan Ben 
Published: September 2019

PurposeThis paper considers how the quality of wound care delivered to people experiencing mental ill health can be improved at the system level in line with the global focus on improving population health. The purpose of this paper is to identify how the quality of wound care delivered to mental health care service users can be improved at a population level through system thinking informed by boundary theory.Design/methodology/approachThis paper is a critical analysis of practice underpinned by systems thinking and boundary theory.FindingsTissue viability care and mental health care have different professional cultures and identities that are manifest in the way that they are organised and deliver care. If improvements in wound care-related outcomes at a population level are to be achieved, then it is important that the wound care needs of people experiencing mental ill health are addressed. Systems thinking and boundary theory provide a useful conceptual framework for informing quality improvement for people experiencing mental ill health at a population level. Integrated care plans are a useful mechanism for delivering comprehensive care that brings about wound healing and recovery from mental ill health.Social implicationsIntegrated wound and mental health care plans transcend the professional boundaries that exist between tissue viability and mental health care services. Improvements in the quality and safety of care delivered to people with wounds who also utilise mental health services can be achieved through the use of integrated care plans. Health care policy and organisation need to meet the wound-related needs of people using mental health services.Originality/valueThere has been a focus on improving many aspects of wound care in line with the global focus on grand convergence in population health, but there has been very little emphasis on improving the wound-related outcomes of people that use mental health services. Systems thinking and boundary theory provide a useful framework for understanding how wound care for people experiencing mental ill health can be improved at a population level. Integrated care plans are a useful way of ensuring that safe high-quality wound care is consistently delivered to people experiencing mental ill health.
Technological evolution and tourist decision-making: a perspective article
Authors: Stylos Nikolaos 
Published: September 2019

Purpose
This paper aims to demonstrate the importance of technological advancements in shaping tourist decision-making. It reviews relevant theories and underlines the need for new theoretical frameworks that would illustrate the role of cognitive technologies, i.e. artificial intelligence (AI) applications, in tourist decision-making.

Design/methodology/approach
A critical analysis and synthesis of interdisciplinary literature was undertaken, aiming to discuss the theoretical frameworks and approaches used and to offer a future perspective based on major technological advances.

Findings
The technological advancements play a structural role in tourist decision-making processes, with digital technologies and cyber-physical systems becoming extensions of a tourist’s self.

Research limitations/implications
The study offers the basis for a new theoretical framework in the area of tourism decision-making, considering the future of cyber-physical-human systems.

Originality/value
This study exemplifies the main elements of tourism decision-making theory and describes the need for a paradigm shift, as new forms of AI will complement human intelligence.
Dose down‐titration of biological disease‐modifying antirheumatic drugs in daily clinical practice: Shared decision‐making and patient treatment preferences in Japanese patients with rheumatoid arthritis
Authors: Komiya Takaaki , Takase‐Minegishi Kaoru , Sakurai Natsuki , Nagai Hideto , Hamada Naoki , Soejima Yutaro , Sugiyama Yumiko , Tsuchida Naomi , Kunishita Yosuke , Kishimoto Daiga , Kobayashi Kouji , Kamiyama Reikou , Yoshimi Ryusuke , Kirino Yohei , Ohno Shigeru , Nakajima Hideaki 
Published: September 2019

AbstractAimTo determine characteristics of rheumatoid arthritis (RA) patients in Japan who received the same biological disease‐modifying antirheumatic drugs (bDMARDs) for at least 6 months and to identify factors associated with successful down‐titration of bDMARDs dependent on shared decision‐making.MethodsWe included consecutive RA patients who received the same bDMARD with low disease activity or remission for at least 6 months in our two university hospitals. Patients treated with the bDMARD standard dose were defined as SD, while those treated with bDMARD down‐titration were defined as DT. We retrospectively reviewed clinical charts and compared data between the two groups.ResultsOf 288 patients with RA, 204 (70.8%) and 84 (29.2%) continued standard dose treatment and underwent down‐titration treatment, respectively. Sixty‐six of 84 (78.6%) down‐titration‐treated patients continued to show low disease activity or remission, whereas 18 (21.4%) relapsed 18.9 ± 24.4 months after bDMARD down‐titration was started. Univariate predictor analysis showed that the probable factors of down‐titration were no history of bDMARD treatment (P = .001) and low initial Disease Activity Assessment of 28 joint score (P = .048). Other clinical characteristics had no significant relationship with successful down‐titration.ConclusionsThus, bDMARD‐naïve patients and those with low initial disease activity are more likely to agree to attempt down‐titration. However, the timing and method of down‐titration should be made in shared decision‐making between patients and rheumatologists.
Age attenuates the transcriptional changes that occur with sleep in the medial prefrontal cortex
Authors: Guo Xiaofeng , Keenan Brendan T. , Sarantopoulou Dimitra , Lim Diane C. , Lian Jie , Grant Gregory R. , Pack Allan I. 
Published: September 2019

AbstractSleep abnormalities are common with aging. Studies show that sleep plays important roles in brain functions, and loss of sleep is associated with increased risks for neurological diseases. Here, we used RNA sequencing to explore effects of age on transcriptome changes between sleep and sleep deprivation (SD) in medial prefrontal cortex and found that transcriptional changes with sleep are attenuated in old. In particular, old mice showed a 30% reduction in the number of genes significantly altered between sleep/wake and, in general, had smaller magnitudes of changes in differentially expressed genes compared to young mice. Gene ontology analysis revealed differential age effects on certain pathways. Compared to young mice, many of the wake‐active functions were similarly induced by SD in old mice, whereas many of the sleep‐active pathways were attenuated in old mice. We found similar magnitude of changes in synaptic homeostasis genes (Fos, Arc, and Bdnf) induced by SD, suggesting intact synaptic upscaling on the transcript level during extended wakefulness with aging. However, sleep‐activated processes, such as DNA repair, synaptogenesis, and axon guidance, were sensitive to the effect of aging. Old mice expressed elevated levels of immune response genes when compared to young mice, and enrichment analysis using cell‐type‐specific markers indicated upregulation of microglia and oligodendrocyte genes in old mice. Moreover, gene sets of the two cell types showed age‐specific sleep/wake regulation. Ultimately, this study enhances understanding of the transcriptional changes with sleep and aging, providing potential molecular targets for future studies of age‐related sleep abnormalities and neurological disorders.
Contrast sensitivity is associated with outer‐retina thickness in early‐stage diabetic retinopathy
Authors: McAnany J. Jason , Park Jason C. , Liu Karen , Liu Michelle , Chen Yi‐Fan , Chau Felix Y. , Lim Jennifer I. 
Published: September 2019

AbstractPurposeTo determine the relationship between contrast sensitivity (CS) and outer‐retina thickness (ORT) in diabetics who have minimal or no diabetic retinopathy (DR).MethodsTwenty non‐diabetic control subjects and 40 type‐2 diabetic subjects participated (20 had no clinically apparent DR [NDR] and 20 had mild non‐proliferative DR [NPDR]). No subject had a history of treatment for macular oedema. Letter CS, microperimetry (MP) sensitivity and visual acuity (VA) were measured. Letter CS and MP measurements were performed over the central 6° of the visual field. Spectral domain optical coherence tomography (SD‐OCT) images were obtained at corresponding locations, outer‐retina thickness was quantified, and structure–function relationships were evaluated.ResultsAnalysis of variance indicated significant letter CS differences among the groups (p < 0.001). Letter CS was reduced significantly for the mild NPDR group (p < 0.001; 33% reduction), but not the NDR group (p = 0.08). There were no significant differences in MP sensitivity or ORT among the groups (both p > 0.10). Nevertheless, Hoeffding's D tests indicated significant associations between ORT and letter CS (p < 0.001) and between ORT and MP sensitivity for the mild NPDR group (p = 0.01). VA was not significantly associated with ORT for either diabetic group (both p > 0.49).ConclusionsOuter‐retina thickness is associated with letter CS and MP sensitivity, but not VA, in mild NPDR. This finding highlights the usefulness of simple letter CS measures and suggests neural dysfunction can occur in the absence of marked structural abnormalities in early‐stage DR.
CO‐OP OPEN MEMBERSHIP: ECONOMIC AND FINANCIAL EFFECTS
Authors: CABALEIRO‐CASAL María José , IGLESIAS‐MALVIDO Carlos , MARTÍNEZ‐FONTAÍÑA Rocío 
Published: September 2019

ABSTRACTThis paper aims to analyze the objectives pursued by cooperatives upon opening doors to new members and how this affects business activity and financial indicators. Surprisingly, the results show that accepting new partners makes no positive impact on the return on assets, but it does make a variable impact on financial indicators according to the type of cooperative. Distinguishing between agricultural and worker co‐ops, we conduct a cross‐sectional study of a sample of Galician cooperatives to find whether they apply this principle the same way regardless of membership size. Our results corroborate that cooperatives apply the principle differently. This not only allows us to extract other relevant information from accounting for cooperatives, but it also permits other agents like financial entities to obtain indicators that reflect the true company image more adequately.
Rapid Lump Examination (RLE) – a bedside 3‐dimensional microscopy of tumor specimens
Authors: Peters Nina , Schubert Melanie , Bauer Juergen , Ghoreschi Franziska C. , Moehrle Matthias 
Published: September 2019

SummaryBackgroundDue to rising skin cancer incidence rates there is an urgent need for a quick, reliable and cost‐effective therapy. Previous studies showed that fresh tumor tissue and margins could be directly examined microscopically with high sensitivity and specificity.ObjectiveComparing the accuracy of rapid lump examination (RLE) for the detection of basal cell carcinoma (BCC) during micrographic surgery with formalin‐fixed paraffin‐embedded hematoxylin and eosin (HE)‐stained sections.Methods and Materials382 specimens of 118 excised samples with suspected BCC were examined with RLE and compared with formalin‐fixed paraffin‐embedded HE‐stained sections. For RLE, following a standardized 60 sec staining protocol, the fresh tissue samples were observed directly with a stereomicroscope.ResultsFor BCC, RLE had a high but insufficient diagnostic accuracy compared to the gold standard of formalin‐fixed paraffin‐embedded HE‐stained sections. The sensitivity was 76 % (95 % CI = [66.18 %; 84.5 %]) and specificity was 91 % (95 % CI = [86.73 %; 93.75 %]).ConclusionsRLE is a fast and simple technique for microscopically controlled surgery (MCS) of basal cell carcinomas that requires training. The experience of the examiner has a major influence on the results. RLE has great potential to speed up the workflow in Mohs surgery but should be improved in the future.
Validity and reliability of a self‐assessment scale for Dental and Oral Health student's perception of transferable skills in Australia
Authors: Sun Jing , Adegbosin Adeyinka Emmanuel , Reher Vanessa , Rehbein Gail , Evans Jane 
Published: September 2019

AbstractBackgroundThe Australian Dental Council's (ADC) competency framework requires graduating dental practitioners to be competent in a number of transferable skills, which includes: being scientifically versed, technically skilled and capable of safe independent work and teamwork, whilst adhering to high ethical standards (Australian Dental Council. Professional Competencies of the Newly Qualified Dentist. Melbourne, Australia: ADC; 2016). Part of the role of dental educators is to ensure graduating students acquire requisite transferable skills, in line with regulatory requirements (Chuenjitwongsa et al. Eur J Dent Educ. 2018;22:1). In order to achieve this, it is imperative to assess students' own understanding or perception of transferable skill requirement upon graduation. The objective of this study was to develop a valid and reliable scale for this assessment.MethodA cohort of students drawn across three different dental programmes: undergraduate dentistry (years 1‐3); post‐graduate dentistry (years 4‐5); and Bachelor of Dental Technology/Prosthesis, participated in this study. A self‐assessment questionnaire containing relevant open‐ and closed‐ended questions was administered. The questionnaire assessed students' perception of transferable skills for their future career and attitude towards learning and developing transferable skills.ResultIn total, we successfully assessed 388 of the 391 students sampled (99.2% response rate), their mean age was 24.3 years (SD ± 5.7), and 53.3% were females, whilst 46.7% were males. Overall, exploratory factor analysis (EFA) extracted five factors for students' perception of current skill level, and four factors for future skill requirements. The factor structures were confirmed using confirmatory factor analysis (CFA), and the structure had a good model fit and high levels of reliability, with respect to individual dimension and content validity.ConclusionsThe structure derived from the transferable skill survey administered to a cohort of dental students suggests that the transferable skill survey can be utilised as a valid and reliable screening tool to test students' perception of transferable skill requirements.
Voriconazole enhances UV‐induced DNA damage by inhibiting catalase and promoting oxidative stress
Authors: Lee Vivian , Gober Michael D. , Bashir Hasan , O'Day Conor , Blair Ian A. , Mesaros Clementina , Weng Liwei , Huang Andrew , Chen Aaron , Tang Rachel , Anagnos Vince , Li JiLon , Roling Sophie , Sagaityte Emilija , Wang Andrew , Lin Chenyan , Yeh Christopher , Atillasoy Cem , Marshall Christine , Dentchev Tzvete , Ridky Todd , Seykora John T. 
Published: September 2019

AbstractCutaneous squamous cell carcinoma (cSCC) is the second most common form of skin cancer and is associated with cumulative UV exposure. Studies have shown that prolonged voriconazole use promotes cSCC formation; however, the biological mechanisms responsible for the increased incidence remain unclear. Here, we show that voriconazole directly increases oxidative stress in human keratinocytes and promotes UV‐induced DNA damage as determined by comet assay, 8‐oxoguanine immunofluorescence and mass spectrometry. Voriconazole treatment of human keratinocytes potentiates UV‐induced apoptosis and activation of the p38 MAP kinase and 53BP1 UV stress response pathways. The p38 MAP kinase activation promoted by voriconazole exposure can be mitigated by pretreating keratinocytes with N‐acetylcysteine. Voriconazole increases oxidative stress in keratinocytes by directly inhibiting catalase leading to lower intracellular NADPH levels and the triazole moieties in voriconazole are critical for inhibiting catalase. Furthermore, voriconazole is shown to promote UV‐induced dysplasia in an in vivo model. Together, these data demonstrate that voriconazole potentiates oxidative stress in UV‐irradiated keratinocytes through catalase inhibition. Use of antioxidants may mitigate the pro‐oncogenic effects of voriconazole.
Biogeographic variation in temperature sensitivity of decomposition in forest soils
Authors: Li Jinquan , Nie Ming , Pendall Elise , Reich Peter B. , Pei Junmin , Noh Nam Jin , Zhu Ting , Li Bo , Fang Changming 
Published: September 2019

AbstractDetermining soil carbon (C) responses to rising temperature is critical for projections of the feedbacks between terrestrial ecosystems, C cycle, and climate change. However, the direction and magnitude of this feedback remain highly uncertain due largely to our limited understanding of the spatial heterogeneity of soil C decomposition and its temperature sensitivity. Here we quantified C decomposition and its response to temperature change with an incubation study of soils from 203 sites across tropical to boreal forests in China spanning a wide range of latitudes (18°16′ to 51°37′N) and longitudes (81°01′ to 129°28′E). Mean annual temperature (MAT) and mean annual precipitation primarily explained the biogeographic variation in the decomposition rate and temperature sensitivity of soils: soil C decomposition rate decreased from warm and wet forests to cold and dry forests, while Q10‐MAT (standardized to the MAT of each site) values displayed the opposite pattern. In contrast, biological factors (i.e. plant productivity and soil bacterial diversity) and soil factors (e.g. clay, pH, and C availability of microbial biomass C and dissolved organic C) played relatively small roles in the biogeographic patterns. Moreover, no significant relationship was found between Q10‐MAT and soil C quality, challenging the current C quality–temperature hypothesis. Using a single, fixed Q10‐MAT value (the mean across all forests), as is usually done in model predictions, would bias the estimated soil CO2 emissions at a temperature increase of 3.0°C. This would lead to overestimation of emissions in warm biomes, underestimation in cold biomes, and likely significant overestimation of overall C release from soil to the atmosphere. Our results highlight that climate‐related biogeographic variation in soil C responses to temperature needs to be included in next‐generation C cycle models to improve predictions of C‐climate feedbacks.
Bariatric surgery for Prader‐Willi syndrome was ineffective in producing sustainable weight loss: Long term results for up to 10 years
Authors: Liu Shirley Yuk‐Wah , Wong Simon Kin‐Hung , Lam Candice Chuen‐Hing , Ng Enders Kwok‐Wai 
Published: September 2019

SummaryBackgroundObesity control in Prader‐Willi syndrome (PWS) is notoriously difficult. The role of bariatric surgery in PWS remains controversial as long‐term data are lacking.ObjectivesTo evaluate the 10‐year outcomes of bariatric surgery in PWS.MethodsThis was a prospective observational study on PWS patients who received bariatric surgery and multidisciplinary follow‐up programmes for obesity control. Outcomes on weight reduction and comorbidity resolution were evaluated.ResultsBetween 2008 and 2013, five PWS patients (two males, mean age 19.2 ± 3.0 years) with body mass index of 47.3 ± 6.9 kg m−2 received sleeve gastrectomy (n = 2), one anastomosis gastric bypass (n = 2), and Roux‐en‐Y gastric bypass (n = 1) after failing all non‐operative weight loss programmes. The median follow‐up was 8.4 ± 2.2 years. The best mean percentage of total weight loss (%TWL) was achieved at 2 years (24.7%). %TWL dropped to 23.3% at 3 years, 11.9% at 5 years, 4.1% at 8 years, and 0% at 10 years. Each patient had at least three comorbidities preoperatively, but none of them had resolution of any one of the comorbidities at the last follow‐up.ConclusionsBariatric surgery could not produce sustainable long‐term weight loss or comorbidity resolution in PWS. This study suggests that bariatric surgery cannot be recommended to PWS patients as a standard treatment.
When mother knows best: A population genetic model of transgenerational versus intragenerational plasticity
Authors: Dury Guillaume J. , Wade Michael J. 
Published: September 2019

AbstractMany organisms exhibit phenotypic plasticity; producing alternate phenotypes depending on the environment. Individuals can be plastic (intragenerational or direct plasticity), wherein individuals of the same genotype produce different phenotypes in response to the environments they experience. Alternatively, an individual's phenotype may be under the control of its parents, usually the mother (transgenerational or indirect plasticity), so that mother's genotype determines the phenotype produced by a given genotype of her offspring. Under what conditions does plasticity evolve to have intragenerational as opposed to transgenerational genetic control? To explore this question, we present a population genetic model for the evolution of transgenerational and intragenerational plasticity. We hypothesize that the capacity for plasticity incurs a fitness cost, which is borne either by the individual developing the plastic phenotype or by its mother. We also hypothesize that individuals are imperfect predictors of future environments and their capacity for plasticity can lead them occasionally to make a low‐fitness phenotype for a particular environment. When the cost, benefit and error parameters are equal, we show that there is no evolutionary advantage to intragenerational over transgenerational plasticity, although the rate of evolution of transgenerational plasticity is half the rate for intragenerational plasticity, as predicted by theory on indirect genetic effects. We find that transgenerational plasticity evolves when mothers are better predictors of future environments than offspring or when the fitness cost of the capacity for plasticity is more readily borne by a mother than by her developing offspring. We discuss different natural systems with either direct intragenerational plasticity or indirect transgenerational plasticity and find a pattern qualitatively in accord with the predictions of our model.