bluuebunny/crossref_metadata_2025_split huggingface dataset:
Codependency and Prefrontal Cortex Functioning: Preliminary Examination of Substance Use Disorder Impacted Family Members
Authors: Zielinski Mazie , Bradshaw Spencer , Mullet Natira , Hawkins Lindsey , Shumway Sterling , Story Chavez Megan 
Published: May 2019

Background and ObjectivesSubstance use disorders (SUDs) have negative impacts on an entire family system and each family member may be at risk to develop a “codependency” on their SUD loved‐one. Research has demonstrated that SUDs in the family environment associate with altered brain functioning of family members; however, research has not examined specific associations between codependency and brain functioning.MethodsPrefrontal cortex (PFC) activation of family members (n = 38) was assessed using functional near‐infrared spectroscopy as they viewed images of a SUD loved‐one (experimental group; n = 26) or of a “target family member” (control group; n = 12). Correlations between PFC activation and codependency were examined.ResultsA significant negative association was found between codependency and left dorsomedial PFC activation in response to images of a loved‐one with a SUD. This association was significantly larger than that found in the control group in response to a target family member, and that found in response to other affective images.Discussion and ConclusionsThe left dorsomedial PFC is associated with executive functioning during responses to emotional and social situations. Findings may suggest that family members experiencing codependency may be limited in effectively responding to their SUD loved‐one, and highlight the importance of systemic treatment and family member recovery.Scientific SignificanceCodependency is often discussed as a learned condition and research has only recently examined brain processes of family members with a loved‐one with a SUD. This research is the first to demonstrate an association between codependency and PFC functioning. (Am J Addict 2019;28:367–375)
Stress, burnout, depression and work satisfaction among UK anaesthetic trainees; a quantitative analysis of the Satisfaction and Wellbeing in Anaesthetic Training study
Authors: Looseley A. , Wainwright E. , Cook T.M. , Bell V. , Hoskins S. , O'Connor M. , Taylor G. , Mouton R. ,   the SWeAT Study investigator group
Published: May 2019

SummaryThere is growing evidence that anaesthetic trainees experience, and may be particularly susceptible to, high levels of work stress, burnout and depression. This is concern for the safety and wellbeing of these doctors and for the patients they treat. To date, there has been no in‐depth evaluation of these issues among UK anaesthetic trainees to examine which groups may be most affected, and to identify the professional and personal factors with which they are associated. We conducted an anonymous electronic survey to determine the prevalence of perceived stress, risk of burnout/depression and work satisfaction among anaesthetic trainees within South‐West England and Wales, and explored in detail the influence of key baseline characteristics, lifestyle and anaesthetic training variables. We identified a denominator of 619 eligible participants and received 397 responses, a response rate of 64%. We observed a high prevalence of perceived stress; 37% (95%CI 32–42%), burnout risk 25% (21–29%) and depression risk 18% (15–23%), and found that these issues frequently co‐exist. Having no children, > 3 days sickness absence in the previous year, ≤ 1 h.week−1 of exercise and > 7.5 h.week−1 of additional non‐clinical work were independant predictors of negative psychological outcomes. Although female respondents reported higher stress, burnout risk was more likely in male respondents. This information could help in the identification of at‐risk groups as well as informing ways to support these groups and to influence resource and intervention design. Targeted interventions, such as modification of exercise behaviour and methods of reducing stressors relating to non‐clinical workloads, warrant further research.
Stress, burnout, depression and work satisfaction among UK anaesthetic trainees: a qualitative analysis of in‐depth participant interviews in the Satisfaction and Wellbeing in Anaesthetic Training study
Authors: Wainwright E. , Looseley A. , Mouton R. , O'Connor M. , Taylor G. , Cook T. M. ,   the SWeAT study investigator group
Published: May 2019

SummaryAnaesthetists experience unique stressors, and recent evidence suggests a high prevalence of stress and burnout in trainee anaesthetists. There has been no in‐depth qualitative analysis to explore this further. We conducted semi‐structured interviews to explore contributory and potentially protective factors in the development of perceived stress, burnout, depression and low work satisfaction. We sampled purposively among participants in the Satisfaction and Wellbeing in Anaesthetic Training study, reaching data saturation at 12 interviews. Thematic analysis identified three overarching themes: factors enabling work satisfaction; stressors of being an anaesthetic trainee; and suggestions for improving working conditions. Factors enabling work satisfaction were patient contact; the privilege of enabling good patient outcomes; and strong support at home and work. Stressors were demanding non‐clinical work‐loads; exhaustion from multiple commitments; a ‘love/hate’ relationship, as trainees value clinical work but find the training burden immense; feeling ‘on edge’, even unsafe at work; and the changing way society sees doctors. Nearly all trainees discussed feeling some levels of burnout (which were high and distressing for some) and also high levels of perceived stress. However, trainees also experienced distinct elements of work satisfaction and support. Suggested recommendations for improvement included: allowing contracted hours for non‐clinical work; individuals taking responsibility for self‐care in and out of work; cultural acceptance that doctors can struggle; and embedding wellbeing support more deeply in organisations and the specialty. Our study provides a foundation for further work to inform organisational and cultural changes, to help translate anaesthetic trainees’ passion for their work into a manageable and satisfactory career.
Essential thrombocythaemia treated with recombinant interferon: ‘real world' United Kingdom referral centre experience
Authors: Desterro Joana , McLornan Donal P. , Curto Garcia Natalia , O'Sullivan Jennifer , Alimam Samah , Keohane Clodagh , Woodley Claire , Francis Yvonne , Kordasti Shahram , Radia Deepti H. , Harrison Claire N. 
Published: May 2019

SummaryStandard first‐line therapy choice for essential thrombocythaemia (ET) requiring cytoreduction, supported by randomized trials, is low‐dose aspirin with hydroxycarbamide, but the role of recombinant interferon‐alfa (IFNα)‐2a/2b and pegylated (PEG)‐IFN‐α‐2a/2b is increasingly highlighted. Longer‐term outcome data, however, remains somewhat scarce, particularly in the ‘real world'. We hereby report on a large, well‐annotated cohort of ET patients from a single referral centre undergoing therapy with either IFNα or (PEG)‐IFN‐α‐2a/2b and demonstrate high rates of complete haematological responses, good tolerability and safety, low rates of thromboembolic events in compliant patients and confirm feasibility of long‐term therapy in a significant proportion of patients.
Mitigating placental injuries through up-regulating DAF in experimental APS mice: new mechanism of progesterone
Authors: Zhang Y , Jin S 
Published: May 2019

SummaryAnti-phospholipid syndrome (APS) is characterized by recurrent pathological pregnancy, arterial or venous thrombosis in the presence of anti-phospholipid antibody (aPL). Complement activation is recognized as an intermediate link leading to placental thrombosis and placental inflammation in APS model mice. Decay accelerating factor (DAF, CD55), MAC-inhibitory protein (MAC-IP, CD59) and membrane co-factor protein (MCP, CD46) are important complement inhibitory proteins (CIPs) highly expressed in normal placenta to curb excessive complement activation and its mediated injuries. Anti-β2 glycoprotein I (anti-β2GPI) antibody is an important aPL. We found that placental DAF and CD46 decreased in β2GPI passively immunized APS model mice, accompanied by C3 deposition, neutrophil infiltration and increased proinflammatory cytokine levels detected in its placenta. Progesterone supplement can up-regulate DAF but not CD46 expression, curb C3 activation and decrease proinflammatory cytokines levels to reduce fetal loss frequency. Progesterone receptor antagonist (mifepristone) or knock-down DAF with specific siRNA, above the protective effects of progesterone, were significantly weakened. Another sex hormone, oestrogen, has no significant effect on placental DAF and C3 contents and fetal loss frequency in the APS mice model. This may be an important mechanism by which progesterone induces maternal–fetal immune tolerance. At the same time, it may provide evidence for the use of progesterone in APS abortion patients.
Hinted Star Coordinates for Mixed Data
Authors: Matute J. , Linsen L. 
Published: May 2019

AbstractMixed data sets containing numerical and categorical attributes are nowadays ubiquitous. Converting them to one attribute type may lead to a loss of information. We present an approach for handling numerical and categorical attributes in a holistic view. For data sets with many attributes, dimensionality reduction (DR) methods can help to generate visual representations involving all attributes. While automatic DR for mixed data sets is possible using weighted combinations, the impact of each attribute on the resulting projection is difficult to measure. Interactive support allows the user to understand the impact of data dimensions in the formation of patterns. Star Coordinates is a well‐known interactive linear DR technique for multi‐dimensional numerical data sets. We propose to extend Star Coordinates and its initial configuration schemes to mixed data sets. In conjunction with analysing numerical attributes, our extension allows for exploring the impact of categorical dimensions and individual categories on the structure of the entire data set. The main challenge when interacting with Star Coordinates is typically to find a good configuration of the attribute axes. We propose a guided mixed data analysis based on maximizing projection quality measures by the use of recommended transformations, named hints, in order to find a proper configuration of the attribute axes.
The effect of excessive fat tissue on the measure of bone mineral density by dual X‐ray absorptiometry: the impact of substantial weight loss following sleeve gastrectomy
Authors: Maïmoun Laurent , Mariano‐Goulart Denis , Jaussent Audrey , Lefebvre Patrick , Picot Marie‐Christine , Mahadea Krishna , Boudousq Vincent , Fouillade Clémence , Nocca David , Ben Bouallègue Fayçal 
Published: May 2019

SummaryPurposeDual‐energy X‐ray absorptiometry (DXA) is used in clinical routine to determine areal bone mineral density (aBMD). However, it is not clear whether excessive fat mass or substantial weight loss modify the aBMD measurements. The aim of this study was to evaluate the effect of soft tissue composition on aBMD measured by DXA using a clinical model (i.e. sleeve gastrectomy: SG) that induces substantial body weight loss.MethodsAreal bone mineral density and body composition (fat mass: FM and lean tissue mass: LTM) were determined by DXA in 41 obese patients (33 women, 80.5%) just before SG and 1 month later.ResultsOne month after SG, mean weight loss was −9.8 ± 2.6 kg, with a significant decrease in LTM and FM (kg) ranging from −7.3% to −9.5%. The relative variation in aBMD was increased at the lumbar spine (2.45 ± 3.44%) and decreased at the hip (−1.47 ± 2.28%), whereas no variation was observed for the whole body and radius. The variation in aBMD at the lumbar spine was inversely correlated with variations in weight, whole‐body FM and trunk FM, but not LTM.ConclusionThis study shows evidence of a potential effect of body composition, particularly FM, on aBMD. However, given the modest change in aBMD, which was close to the precision error of aBMD measurements, it appears that significant weight loss does not have a clinically significant impact on the evaluation of aBMD using DXA.
Transcriptomics in tissue glucocorticoid sensitivity
Authors: Nicolaides Nicolas C. , Polyzos Alexandros , Koniari Eleni , Lamprokostopoulou Agaristi , Papageorgiou Ifigeneia , Golfinopoulou Eleni , Papathanasiou Chrysanthi , Sertedaki Amalia , Thanos Dimitris , Chrousos George P. , Charmandari Evangelia 
Published: May 2019

AbstractBackgroundSynthetic glucocorticoids are widely used in the treatment of several inflammatory, autoimmune and lymphoproliferative disorders. However, considerable variation in response to therapeutic doses of glucocorticoids has been documented among individuals. The aim of our study was to identify novel glucocorticoid sensitivity‐determining genes using genome‐wide expression profiling in healthy subjects.MethodsOne hundred one healthy subjects [mean age ± standard error of the mean (SEM); 26.52 ± 0.50 years] were given 0.25 mg dexamethasone at midnight, and serum cortisol concentrations were determined at 08:00 hours the following morning. Subjects were stratified into the 10% most glucocorticoid‐sensitive and 10% most glucocorticoid‐resistant according to the serum cortisol concentrations. Genomic DNA, RNA and plasma samples were obtained in the 22 subjects one month later.ResultsTranscriptomic analysis showed variability between glucocorticoid‐resistant and glucocorticoid‐sensitive subjects. One hundred thirty‐three genes were upregulated and 49 downregulated in the glucocorticoid‐resistant compared to the glucocorticoid‐sensitive group. Further analysis revealed differences between 3 glucocorticoid‐resistant and 3 glucocorticoid‐sensitive subjects. The majority of the 1058 upregulated genes and 1139 downregulated genes were found to participate in telomere maintenance, systemic lupus erythematosus and Alzheimer's disease. Interestingly, Synuclein A, a key molecule in Parkinson's disease, was upregulated in the subgroup of glucocorticoid‐sensitive subjects.ConclusionsWe have identified differences in tissue sensitivity to glucocorticoids among healthy subjects at the transcriptomic level. These differences are associated with differential expression of genes related to autoimmune and neurological disorders.
Myelination key factor krox‐20 is downregulated in Schwann cells and murine sciatic nerves infected by Mycobacterium leprae
Authors: Casalenovo Mariane Bertolucci , Rosa Patrícia Sammarco , de Faria Bertoluci Daniele Ferreira , Barbosa Adriana Sierra Assencio Almeida , Nascimento Dejair Caitano do , de Souza Vânia Nieto Brito , Nogueira Maria Renata Sales 
Published: May 2019

SummarySchwann cells (SCs) critically maintain the plasticity of the peripheral nervous system. Peripheral nerve injuries and infections stimulate SCs in order to retrieve homeostasis in neural tissues. Previous studies indicate that Mycobacterium leprae (ML) regulates the expression of key factors related to SC identity, suggesting that alterations in cell phenotype may be involved in the pathogenesis of neural damage in leprosy. To better understand whether ML restricts the plasticity of peripheral nerves, the present study sought to determine the expression of Krox‐20, Sox‐10, c‐Jun and p75NTR in SC culture and mice sciatic nerves, both infected by ML Thai‐53 strain. Primary SC cultures were stimulated with two different multiplicities of infection (MOI 100:1; MOI 50:1) and assessed after 7 and 14 days. Sciatic nerves of nude mice (NU‐Foxn1nu) infected with ML were evaluated after 6 and 9 months. In vitro results demonstrate downregulation of Krox‐20 and Sox‐10 along with the increase in p75NTR‐immunolabelled cells. Concurrently, sciatic nerves of infected mice showed a significant decrease in Krox‐20 and increase in p75NTR. Our results corroborate previous findings on the interference of ML in the expression of factors involved in cell maturation, favouring the maintenance of a non‐myelinating phenotype in SCs, with possible implications for the repair of adult peripheral nerves.
Effectiveness of using eye mask and earplugs on sleep length and quality among intensive care patients: A quasi‐experimental study
Authors: Bani Younis Mohammad K. , Hayajneh Ferial A. , Alduraidi Hamza 
Published: May 2019

AbstractAimThis study aims to assess the effect of using a combination of eye mask and earplugs on the perceived quality of sleep among patients admitted to intensive care units.DesignControl group, pretest and posttest, quasi‐experimental design was used.MethodsData were collected from 103 intensive care patients in two governmental hospitals in Jordan. The participants were assigned either an experimental or a control group. The experimental group participants received routine care in the first night and used the eye mask and earplug during their sleep in the second night. Control group participants, on the other hand, received routine care only in both nights. The number of hours slept was reported by nurses, and the perceived quality of sleep was self‐reported by participants using the Richards‐Campbell Sleep Scale.ResultsExperimental group participants slept more hours and reported significantly better perceived quality of sleep after the use of eye mask and earplugs, as compared both with themselves in the first night and with control group participants.ConclusionCombining eye masks and earplugs is effective in prolonging the sleep of intensive care patients and improving its quality.
The effect of a transtheoretical model–based motivational interview on self‐efficacy, metabolic control, and health behaviour in adults with type 2 diabetes mellitus: A randomized controlled trial
Authors: Selçuk‐Tosun Alime , Zincir Handan 
Published: May 2019

AbstractAimThis study aimed to determine the effect of a transtheoretical model–based motivational interview method on self‐efficacy, metabolic control, and health behaviour in adults with type 2 diabetes mellitus.MethodsA randomized controlled study design was used. The study was conducted with 50 individuals with type 2 diabetes mellitus, divided into an intervention group and a control group. The researcher held motivational interviews with the patients in the intervention group. Both groups were observed at the beginning of the study and 6 months after the baseline interview. The study data were collected between January 8 and November 18, 2014.ResultsComparing the intervention and the control groups, the differences in the level of self‐efficacy and participants' metabolic values were significant (P < .05). The number of participants in the action stage of the intervention group for nutrition, exercise, and medication use significantly increased compared with the control group (P < .05).ConclusionThe transtheoretical model–based motivational interview method increased the self‐efficacy level of participants with type 2 diabetes mellitus, which helped them improve their metabolic control and health behaviour stages over this 6‐month period.
Continuous glucose monitoring in adults with type 1 diabetes: A balance between benefits and barriers: A critical incident study
Authors: Sørgård Beate , Iversen Marjolein M. , Mårtensson Jan 
Published: May 2019

AbstractAims and objectivesTo describe positively and negatively perceived situations experienced by adults with type 1 diabetes using continuous glucose monitoring and the actions they take to deal with these situations.BackgroundReal‐time continuous glucose monitoring has been shown to improve glycaemic control and reduce hypoglycaemia. Although many patients with type 1 diabetes report great benefits when using continuous glucose monitoring, a substantial number discontinue using the device. Little is known about the different situations and experiences with the daily use of continuous glucose monitoring that contribute to such differences.DesignA descriptive design based on the critical incident technique was used. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ) (see File S1).MethodsIndividual interviews were conducted with a purposive sample of 23 adults with type 1 diabetes, including current and former users of continuous glucose monitoring from four different outpatient clinics.ResultsThe participants described that they felt that the use of continuous glucose monitoring was a balance between benefits and barriers, and how, through their actions, they tried to adapt their use of continuous glucose monitoring to fit their lifestyles. Various life events affected and altered the balance between benefits and barriers and thus affected their use of continuous glucose monitoring.ConclusionsContinuous glucose monitoring is perceived as an effective and important tool in the self‐management of diabetes type 1. It enables a better everyday life and increased satisfaction with treatment. At the same time, the use of continuous glucose monitoring can be both demanding and challenging.Relevance to clinical practiceUnderstanding the complex interplay between perceived benefits, treatment burden and adherence to continuous glucose monitoring use is important for nurses engaged in diabetes care. Education and support regarding the use of continuous glucose monitoring must be based on the understanding and perspectives of the patient to alleviate stress and barriers and enhance self‐efficacy. As the use of continuous glucose monitoring can change over time, this must be a continuous process beyond initial training.
The Fabrication of an Acrylic Repositioning Stent for Use During Intensity Modulated Radiation Therapy: A Feasibility Study
Authors: Lee Vincent Sung Kin , Nguyen Caroline Tram , Wu Jonn 
Published: May 2019

AbstractPurposeRadiotherapy is one of the main treatment modalities for head and neck cancers. To minimize damage to normal tissues during radiotherapy, various methods of stabilization have been used, including thermoplastic facemasks and repositioning stents. The goal is to assess the effect of using a customized oral repositioning stent on patient positioning during the course of radiotherapy.Materials and MethodsTen consecutive patients scheduled to undergo intensity modulated radiation therapy (IMRT) for cancers of the maxillary sinus, nasal cavity, or oral cavity were recruited to participate in the study (ST group). These patients were matched to 2 retrospective cohorts, one using the original repositioning stent design (OB group), and the other with no stabilization stent (NB group). Hard baseplate wax was used to create a customized wax pattern of the proposed acrylic stent chairside, and processed in heat‐cured clear hard acrylic. Relative stability of the daily patient setup was assessed by comparing measurements from surrogate bony landmarks to radiation isocentres obtained from the initial reconstructed planning computed tomograph (CT) to each daily KeV image.ResultsThere was no stent fracture or distortion throughout treatments, and no patients’ treatments were required to be aborted, delayed, or replanned. Mean 3D deviations for the ST, OB, and NB groups were 0.29 ± 0.10 cm, 0.32 ± 0.14 cm, and 0.31 ± 0.13 cm, respectively. The ANOVA test revealed no significant difference in triangulated variations between the treatment groups (F = 0.18, p = 0.84). Patient stability data demonstrated mean vertical, longitudinal, and lateral variations that did not appear different when compared to 2 retrospective cohorts. Although the deviations were not statistically significant between matched cohorts, the added durability of the stent and comfort for patients, without affecting IMRT timeline, are considered clinically significant.ConclusionBy using a customized repositioning stent, it is possible to maintain patient stability comparable to prior protocols and within the range of clinical guidelines, while providing superior comfort and ease of insertion to the patients.