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Translational science and implementation science are two disciplines that integrate scientific findings into practice within healthcare. One method to assess the integration of these fields is to review the academic crossover between the disciplines with respect to shared citations in the peer-reviewed literature.
Methods:
This paper used direct citation network analysis to identify potential conceptual gaps and connections between the literature in implementation science and translational science. Bibliographic references were downloaded from Web of Science to create directed citation network maps in VosViewer. Heat maps visualized the top cited literature in each field.
Results:
A literature search yielded 6,111 publications in translational science and 7,003 publications in implementation science. When all publications were combined in a directed citation network map, two separate groups of publications emerged, representing the two fields of implementation science and translational science. When the top 50 cited translational science publications were combined with implementation science publications, 14% had a 100%+ increase in citation links, 44% had a mean increase of 2.4%, and 42% shared no links. When the top 50 cited implementation science publications were combined with translational science publications, 2% had a 100%+ increase in citation links, 92% had a 3.3% mean increase, and 6% had no shared links.
Conclusions:
Results suggest moderate academic overlap in the way published authors cite each other between translational science and implementation science. We hope the implications of this paper may promote continued collaborations between these fields to disseminate lessons learned and bridge research into practice more efficiently.
Separation-related behaviours (SRBs) in dogs (Canis familiaris) often indicate poor welfare. Understanding SRB risk factors can aid prevention strategies. We investigated whether early-life experiences and dog-owner interactions affect SRB development. Using a longitudinal study, we conducted exploratory analyses of associations between potential risk factors and SRB occurrence in six month old puppies (n = 145). Dogs were less likely to develop SRBs if owners reported that, at ≤ 16 weeks old, puppies were restricted to crates/rooms overnight and had ≥ 9 h of sleep per night. Puppies with poor house-training at ≤ 16 weeks were more likely to show SRBs, as were those trained using dog treats or novel kibble versus other rewards. Puppies whose owners used more punishment/aversive techniques when responding to ‘bad’ behaviour had increased odds of SRBs at six months versus other puppies. Puppies whose owners reported ‘fussing’ over their dogs at six months in response to ‘bad’ behaviour upon their return, versus those whose owners responded in other ways, were six times more likely to display SRBs. Other factors, including dog breed, sex and source, showed no significant association with SRB occurrence. Thus, SRB development might be prevented by enabling sleep for ≥ 9 h in early life, providing enclosed space overnight, refraining from aversive training of puppies generally, and avoiding fussing over puppies in response to unwanted behaviour following separation. These recommendations derive from correlational longitudinal study results, so analysis of interventional data is required for confirmation regarding effective prevention strategies.
Giant coronary artery aneurysms and myocardial fibrosis after Kawasaki disease may lead to devastating cardiovascular outcomes. We characterised the vascular and myocardial outcomes in five selected Kawasaki disease patients with a history of giant coronary artery aneurysms that completely regressed.
Methods:
Five patients were selected who had giant coronary artery aneurysm in early childhood that regressed when studied 12–33 years after Kawasaki disease onset. Coronary arteries were imaged by coronary CT angiography, and coronary artery calcium volume scores were determined. We used endocardial strain measurements from CT imaging to assess myocardial regional wall function. Calprotectin and galectin-3 (gal-3) as biomarkers of inflammation and myocardial fibrosis were measured by enzyme-linked immunosorbent assay.
Results:
The five selected patients with regressed giant coronary artery aneurysms had calcium scores of zero, normal levels of calprotectin and gal-3, and normal appearance of the coronary arteries by coronary computed tomography angiography. CT strain demonstrated normal peak systolic and diastolic strain patterns in four of five patients. In one patient with a myocardial infarction at the time of Kawasaki disease diagnosis at the age of 10 months, CT strain showed altered global longitudinal strain, reduced segmental peak strain, and reduced diastolic relaxation patterns in multiple left ventricle segments.
Conclusions:
These patients illustrate that regression of giant aneurysms after Kawasaki disease is possible with no detectable calcium, normal biomarkers of inflammation and fibrosis, and normal myocardial function. Individuals with regressed giant coronary artery aneurysm still require longitudinal surveillance to assess the durability of this favourable outcome.
Prenatal diagnosis of bicuspid aortic valve is challenging. Bicuspid aortic valve is often associated with aortic dilation.
Methods:
Fetuses with postnatally confirmed bicuspid aortic valve were gestational age-matched with normal controls. Complex lesions were excluded. Aortic valve and arch measurements by two blinded investigators were compared.
Results:
We identified 27 cases and 27 controls. Estimated fetal weight percentile was lower in cases than controls. Seven cases had one or more significant lesions including perimembranous ventricular septal defects (n = 2), isolated annular hypoplasia (n = 2), and/or arch hypoplasia/coarctation (n = 4). Fetuses with bicuspid aortic valves had significantly smaller median z-scores of the aortic annulus (–1.60 versus –0.53, p < 0.001) and root (–1.10 versus –0.53, p = 0.040), and larger ratios of root to annulus (1.32 versus 1.21, p < 0.001), sinotubular junction to annulus (1.07 versus 0.99, p < 0.001), ascending aorta to annulus (1.29 versus 1.18, p < 0.001), and transverse aorta to annulus (1.04 versus 0.96, p = 0.023). Leaflets were “doming” in 11 cases (41%) and 0 controls (p = 0.010), “thickened” in 10 cases (37%) and 0 controls (p = 0.002). We noted similar findings in the subgroup without significant additional cardiac defects.
Conclusions:
The appearance of doming or thickened aortic valve leaflets on fetal echocardiogram is associated with bicuspid aortic valve. Compared to controls, fetuses with bicuspid aortic valve had smaller aortic annulus sizes (possibly related to smaller fetal size) without proportionally smaller aortic measurements, resulting in larger aortic dimension to annulus ratios. Despite inherent challenges of diagnosing bicuspid aortic valve prenatally, these findings may increase suspicion and prompt appropriate postnatal follow-up.
The ‘16Up’ study conducted at the QIMR Berghofer Medical Research Institute from January 2014 to December 2018 aimed to examine the physical and mental health of young Australian twins aged 16−18 years (N = 876; 371 twin pairs and 18 triplet sets). Measurements included online questionnaires covering physical and mental health as well as information and communication technology (ICT) use, actigraphy, sleep diaries and hair samples to determine cortisol concentrations. Study participants generally rated themselves as being in good physical (79%) and mental (73%) health and reported lower rates of psychological distress and exposure to alcohol, tobacco products or other substances than previously reported for this age group in the Australian population. Daily or near-daily online activity was almost universal among study participants, with no differences noted between males and females in terms of frequency or duration of internet access. Patterns of ICT use in this sample indicated that the respondents were more likely to use online information sources for researching physical health issues than for mental health or substance use issues, and that they generally reported partial levels of satisfaction with the mental health information they found online. This suggests that internet-based mental health resources can be readily accessed by adolescent Australians, and their computer literacy augurs well for future access to online health resources. In combination with other data collected as part of the ongoing Brisbane Longitudinal Twin Study, the 16Up project provides a valuable resource for the longitudinal investigation of genetic and environmental contributions to phenotypic variation in a variety of human traits.
Loneliness is related to mental and somatic health outcomes, including borderline personality disorder. Here, we analyze the sources of variation that are responsible for the relationship between borderline personality features (including four dimensions, affective instability, identity disturbance, negative relationships, self-harm and a total score) and loneliness. Using genetically informative data from two large nonclinical samples of adult twin pairs from Australia and the Netherlands (N = 11,329), we estimate the phenotypic, genetic and environmental correlations between self-reported borderline personality features and loneliness. Individual differences in borderline personality and loneliness were best explained by additive genetic factors with heritability estimates h2 = 41% for the borderline personality total score and h2 = 36% for loneliness, with the remaining variation explained by environmental influences that were not shared by twins from the same pair. Genetic and environmental factors influencing borderline personality (total score and four subscales separately) were also partial causes of loneliness. The correlation between loneliness and the borderline personality total score was rph = .51. The genetic correlation was estimated at rg = .64 and the environmental correlation at re = .40. Our study suggests common etiological factors in loneliness and borderline personality features.
The apolipoprotein E ε4 allele (APOE*ε4) is indicated as a risk for Alzheimer's disease and other age-related diseases. The risk attributable to APOE*ε4 for depression is less clear and may be because of confounding of the relationship between dementia and depression.
Aims
We examined the risk of APOE* ε4 for incident depression and depressive symptomology over a 12-year period across the adult lifespan.
Method
Participants were from the Personality and Total Health Through Life study, aged 20 to 24 (n = 1420), 40 to 44 (n = 1592) or 60–64 (n = 1768) at baseline, and interviewed every 4 years since 1999. Ethnicities other than White, those without genotyping and those with depression at baseline, or who reported strokes and scores on the Mini-Mental State Examination <27 at any observation, were excluded.
Results
Over the study period, there was no evidence that APOE*ε4+ was a risk factor for depression, including any depression (odds ratio (OR) = 0.94, 95% CI 0.77–1.16, P = 0.573), major depression (OR = 0.96, 95% CI 0.60–1.53, P = 0.860), minor depression (OR = 0.94, 95% CI 0.67–1.30, P = 0.695) or depressive symptomology (incidence rate ratio (IRR) = 1.02, 95% CI 0.97–1.08, P = 0.451). APOE*ε4 was unrelated to incident depression. Findings were consistent for all age cohorts.
Conclusions
Among cognitively intact Australian adults who were free of depression at baseline, there was little evidence that APOE*ε4+ carriers are at increased risk for depression over a 12-year period among those who are cognitively intact.
Behavioral and psychological symptoms of dementia (BPSD), constitute a major clinical component of Alzheimer’s disease (AD). There is a growing interest in BPSD as they are responsible for a large share of the suffering of patients and caregivers, and they strongly determine the patient’s lifestyle and management. Better detection and understanding of these symptoms is essential to provide appropriate management. This article is a consensus produced by the behavioral group of the European Alzheimer’s Disease Consortium (EADC). The aim of this article is to present clinical description and biological correlates of the major behavioral and psychological symptomatology in AD. BPSD is not a unitary concept. Instead, it should be divided into several symptoms or more likely: groups of symptoms, each possibly reflecting a different prevalence, course over time, biological correlate and psychosocial determinants. There is some clinical evidence for clusters within groups of BPSD. Biological studies indicate that patients with AD and BPSD are associated with variations in the pathological features (atrophy, brain perfusion/metabolism, histopathology) when compared to people with AD without BPSD. An individually tailored approach taking all these aspects into account is warranted as it may offer more, and better, pharmacological and non-pharmacological treatment opportunities.
The Single Ventricle Reconstruction Trial randomised neonates with hypoplastic left heart syndrome to a shunt strategy but otherwise retained standard of care. We aimed to describe centre-level practice variation at Fontan completion.
Methods:
Centre-level data are reported as median or median frequency across all centres and range of medians or frequencies across centres. Classification and regression tree analysis assessed the association of centre-level factors with length of stay and percentage of patients with prolonged pleural effusion (>7 days).
Results:
The median Fontan age (14 centres, 320 patients) was 3.1 years (range from 1.7 to 3.9), and the weight-for-age z-score was −0.56 (−1.35 + 0.44). Extra-cardiac Fontans were performed in 79% (4–100%) of patients at the 13 centres performing this procedure; lateral tunnels were performed in 32% (3–100%) at the 11 centres performing it. Deep hypothermic circulatory arrest (nine centres) ranged from 6 to 100%. Major complications occurred in 17% (7–33%). The length of stay was 9.5 days (9–12); 15% (6–33%) had prolonged pleural effusion. Centres with fewer patients (<6%) with prolonged pleural effusion and fewer (<41%) complications had a shorter length of stay (<10 days; sensitivity 1.0; specificity 0.71; area under the curve 0.96). Avoiding deep hypothermic circulatory arrest and higher weight-for-age z-score were associated with a lower percentage of patients with prolonged effusions (<9.5%; sensitivity 1.0; specificity = 0.86; area under the curve 0.98).
Conclusions:
Fontan perioperative practices varied widely among study centres. Strategies to decrease the duration of pleural effusion and minimise complications may decrease the length of stay. Further research regarding deep hypothermic circulatory arrest is needed to understand its association with prolonged pleural effusion.
This collection of essays pays tribute to Nancy Freeman Regalado, a ground-breaking scholar in the field of medieval French literature whose research has always pushed beyond disciplinary boundaries. The articles in the volume reflect the depth and diversity of her scholarship, as well as her collaborations with literary critics, philologists, historians, art historians, musicologists, and vocalists - in France, England, and the United States. Inspired by her most recent work, these twenty-four essays are tied together by a single question, rich in ramifications: how does performance shape our understanding of medieval and pre-modern literature and culture, whether the nature of that performance is visual, linguistic, theatrical, musical, religious, didactic, socio-political, or editorial? The studies presented here invite us to look afresh at the interrelationship of audience, author, text, and artifact, to imagine new ways of conceptualizing the creation, transmission, and reception of medieval literature, music, and art.
EGLAL DOSS-QUINBY is Professor of French at Smith College; ROBERTA L. KRUEGER is Professor of French at Hamilton College; E. JANE BURNS is Professor of Women's Studies and Adjunct Professor of Comparative Literature at the University of North Carolina, Chapel Hill.
Contributors: ANNE AZÉMA, RENATE BLUMENFELD-KOSINSKI, CYNTHIA J. BROWN, ELIZABETH A. R. BROWN, MATILDA TOMARYN BRUCKNER, E. JANE BURNS, ARDIS BUTTERFIELD, KIMBERLEE CAMPBELL, ROBERT L. A. CLARK, MARK CRUSE, KATHRYN A. DUYS, ELIZABETH EMERY, SYLVIA HUOT, MARILYN LAWRENCE, KATHLEEN A. LOYSEN, LAURIE POSTLEWATE, EDWARD H. ROESNER, SAMUEL N. ROSENBERG, LUCY FREEMAN SANDLER, PAMELA SHEINGORN, HELEN SOLTERER, JANE H. M. TAYLOR, EVELYN BIRGE VITZ, LORI J. WALTERS, AND MICHEL ZINK.
Chrétien de Troyes's twelfth-century romance Perceval ou le Conte du Graal stages a telling encounter between the naïve and bumbling Perceval and his newfound chivalric mentor, Gornemont de Gort, in which the mentor asks, “Et de vos armes, biax amis, / Me redites que savez faire?” (1391–2), [Tell me again, my friend, what can you do with your arms/armor?]. Perceval responds curiously:
Jes sai bien vestir et retraire, Si com li vallés m'en arma Qui devant moi en desarma Le chevalier qu'avoie mort. (1392–5)
[I can put them on and remove them, just like the squire who armed me after disarming the knight I had slain.]
Perceval's seemingly silly reply appears at first to miss the point of Gornemont's inquiry. Instead of attesting to his skills as a knight, the newly dubbed Perceval can speak only of his skill at dressing and undressing as a knight.
And yet, Perceval's remarks aptly convey the importance of material culture, especially clothing, in the creation of chivalric masculinity within the Arthurian world. As Laurie A. Finke and Martin B. Shichtman have shown in Cinematic Illuminations (in which they analyze both Chrétien's text and the film version of it, “Perceval Le Gallois,” directed by Eric Rohmer), knights in King Arthur's realm have to perform chivalry constantly in order to maintain it.
Background: Agitation is common in people with dementia, is distressing to patients and stressful to their carers. Drugs used to treat the condition have the potential to cause particularly severe side effects in older people with dementia and have been associated with an increased death rate. Alternatives to drug treatment for agitation should be sought. The study aimed to assess the effects of bright light therapy on agitation and sleep in people with dementia.
Methods: A single center randomized controlled trial of bright light therapy versus standard light was carried out. The study was completed prior to the mandatory registration of randomized controls on the clinical trials registry database and, owing to delays in writing up, retrospective registration was not completed.
Results: There was limited evidence of reduction in agitation in people on active treatment, sleep was improved and a suggestion of greater efficacy in the winter months.
Conclusions: Bright light therapy is a potential alternative to drug treatment in people with dementia who are agitated.
Genetic epidemiology explores the interrelationship of genetic and environmental risk factors in which genes are measured indirectly in ways that reflect aggregate effects "averaged" across the entire genome. This chapter describes the principles and methodology of psychiatric genetics using four-paradigm framework: basic genetic epidemiology, advanced genetic epidemiology, gene finding, and molecular genetics. Each of these paradigms has strengths and limitations, and they are in a process of dynamic interaction with each other. Genetic epidemiology has proved a reliable method to answer basic questions about the overall importance of genetic risk factors for psychiatric illness. The advanced genetic epidemiology paradigm has been used to study the relationships between neuroticism and depression. Molecular genetics is an entirely laboratory-based discipline applying a range of modern methods from genomics to neuroscience to try to identify and then trace pathophysiological pathways.
Kawasaki disease (KD), an acute vasculitis of infancy and early childhood, affords a unique opportunity to study acute endothelial cell (EC) damage in the setting of previously healthy arteries unaffected by underlying disease processes such as atherosclerosis, hypertension, or diabetes. KD is now the most common form of acquired heart disease in children in the United States and Japan (1,2). The vasculitis presents with clinical signs that include fever, rash, conjunctival injection, edema and erythema of the extremities, andmucosal erythema (3).Thevasculitis is self-limited, butwithout treatment, one in four children will develop coronary artery aneurysms occasionally accompanied by aneurysms of other mediumsized, muscular, extraparenchymal arteries (4). Echocardiography during the first 2 months after onset of fever is used to classify patients as having normal, dilated, or aneurismal coronary arteries. Long-term sequelae of the coronary artery aneurysms include ischemic heart disease and myocardial infarction. The acute inflammation can be abrogated in the majority of patients with a single dose (2 g/kg) of intravenous immunoglobulin (IVIG) and aspirin (80–100 mg/kg/day), which reduces the aneurysm rate to 3% to 5% (5).
The etiology of KD remains unknown, although an infectious cause is suspected based on seasonality and clustering of cases (2) and the similarity of clinical signs to other infectious diseases. In addition, the peak incidence in infants and children younger than 5 years, coupled with the rare occurrence of KD in adults and infants younger than 3 months of age, is consistent with infection with a widely disseminated agent that causes asymptomatic infection in most hosts and the acquisition of protective immunity and passage of transplacental antibodies.
