Champions, converts, doubters, and defectors: the impact of shifting perceptions on momentum for change

Maintaining momentum is a key influence on the ultimate success of large-scale change. In this paper, we develop theory to explain how stable vs. shifting change-supportive perceptions over time differentially influence the perceived momentum associated with goal-directed change (i.e., change-based momentum). We use cross-level polynomial regression and data obtained early and one year later within an organization implementing a lean manufacturing transformation to model changes in individual perceptions. Results suggest that momentum perceptions are higher for “Champions” (stable and high perceptions over time) as compared to “Converts” (increasing perceptions over time), but momentum perceptions are lower for “Defectors” (decreasing perceptions over time) as compared to “Doubters” (stable and low perceptions over time). We find that even if participants converge upon change-supportive perceptions later in the change process, early divergent perceptions influence subsequent momentum for the change. These findings highlight the important role of temporal shifts in perceptions for organizational change processes

Mandatory Disclosure of Pharmaceutical Industry-Funded Events for Health Professionals

David Henry and colleagues examine compliance with new disclosure requirements of Medicines Australia, the pharmaceutical industry representative body, and argue that they fall short and instead more comprehensive reporting standards are needed

Abnormal metabolic network activity in REM sleep behavior disorder

OBJECTIVE: To determine whether the Parkinson disease-related covariance pattern (PDRP) expression is abnormally increased in idiopathic REM sleep behavior disorder (RBD) and whether increased baseline activity is associated with greater individual risk of subsequent phenoconversion. METHODS: For this cohort study, we recruited 2 groups of RBD and control subjects. Cohort 1 comprised 10 subjects with RBD (63.5 +/- 9.4 years old) and 10 healthy volunteers (62.7 +/- 8.6 years old) who underwent resting-state metabolic brain imaging with (18)F-fluorodeoxyglucose PET. Cohort 2 comprised 17 subjects with RBD (68.9 +/- 4.8 years old) and 17 healthy volunteers (66.6 +/- 6.0 years old) who underwent resting brain perfusion imaging with ethylcysteinate dimer SPECT. The latter group was followed clinically for 4.6 +/- 2.5 years by investigators blinded to the imaging results. PDRP expression was measured in both RBD groups and compared with corresponding control values. RESULTS: PDRP expression was elevated in both groups of subjects with RBD (cohort 1: p \u3c 0.04; cohort 2: p \u3c 0.005). Of the 17 subjects with long-term follow-up, 8 were diagnosed with Parkinson disease or dementia with Lewy bodies; the others did not phenoconvert. For individual subjects with RBD, final phenoconversion status was predicted using a logistical regression model based on PDRP expression and subject age at the time of imaging (r(2) = 0.64, p \u3c 0.0001). CONCLUSIONS: Latent network abnormalities in subjects with idiopathic RBD are associated with a greater likelihood of subsequent phenoconversion to a progressive neurodegenerative syndrome

Fragment properties of fragmenting heavy nuclei produced in central and semi-peripheral collisions

Fragment properties of hot fragmenting sources of similar sizes produced in central and semi-peripheral collisions are compared in the excitation energy range 5-10 AMeV. For semi-peripheral collisions a method for selecting compact quasi-projectiles sources in velocity space similar to those of fused systems (central collisions) is proposed. The two major results are related to collective energy. The weak radial collective energy observed for quasi-projectile sources is shown to originate from thermal pressure only. The larger fragment multiplicity observed for fused systems and their more symmetric fragmentation are related to the extra radial collective energy due to expansion following a compression phase during central collisions. A first attempt to locate where the different sources break in the phase diagram is proposed.Comment: 23 pages submitted to NP

Purinergic inhibition of Na+,K+,Cl− cotransport in C11-MDCK cells: Role of stress-activated protein kinases

Previously, we observed that sustained activation of P2Y1 leads to inhibition of Na+,K+,Cl− cotransport (NKCC) in C11 cells resembling intercalated cells from collecting ducts of the Madin-Darby canine kidney. This study examined the role of stress-activated protein kinases (SAPK) in NKCC inhibition triggered by purinergic receptors. Treatment of C11 cells with ATP led to sustained phosphorylation of SAPK such as JNK and p38. Activation of these kinases also occurred in anisomycin-treated cells. Surprisingly, we observed that compounds SP600125 and SB202190, known as potent inhibitors of JNK and p38 in cell-free systems, activated rather than inhibited phosphorylation of the kinases in C11 cells. Importantly, similarly to ATP, all the above-listed activators of JNK and p38 phosphorylation inhibited NKCC. Thus, our results suggest that activation of JNK and/or p38 contributes to NKCC suppression detected in intercalated-like cells from distal tubules after their exposure to P2Y1 agonists

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

BACKGROUND: Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. METHODS: A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. RESULTS: According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering telehealth within the broader organisation of health care services in remote and rural regions. CONCLUSION: This study identified core elements that should be considered when implementing telehealth applications with the purpose of supporting medical practice in rural and remote regions. Decision-makers need to be aware of the specific conditions that could influence telehealth integration into clinical practices and health care organisations. Thus, strategies addressing the identified conditions for telehealth success would facilitate the optimal implementation of this technology

Systematics of two-component superconductivity in YBa2Cu3O6.95YBa_{2}Cu_{3}O_{6.95} from microwave measurements of high quality single crystals

Systematic microwave surface impedance measurements of YBCO single crystals grown in $BaZrO_3$ crucibles reveal new properties that are not directly seen in similar measurements of other YBCO samples. Two key observations obtained from complex conductivity are: a new normal conductivity peak at around 80K and additional pairing below 65K. High pressure oxygenation of one of the crystals still yields the same results ruling out any effect of macroscopic segregation of O-deficient regions. A single complex order parameter cannot describe these data, and the results suggest at least two superconducting components. Comparisons with model calculations done for various decoupled two-component scenarios (i.e. s+d, d+d) are presented. Systematics of three single crystals show that the 80K quasiparticle peak is correlated with the normal state inelastic scattering rate. Close to Tc, the data follow a mean-field behavior. Overall, our results strongly suggest the presence of multiple pairing temperature and energy scales in $YBa_{2}Cu_{3}O_{6.95}$.Comment: 14 pages, 2-column, Revtex, 5 embedded postscript figures, uses graphicx. Postscript version also available at http://sagar.physics.neu.edu/preprints.htm

Assessing burned areas in wildfires and prescribed fires with spectral indices and SAR images in the Margalla Hills of Pakistan

The extent of wildfires cannot be easily mapped using field-based methods in areas with complex topography and in those areas, the use of remote sensing is an alternative. This study first obtained images from the Sentinel-2 satellites for the period 2015-2020 with the objective of applying multi-temporal spectral indices to assess areas burned in wildfires and prescribed fires in the Margalla Hills of Pakistan using Google Earth Engine (GEE). Using those images, the Normalized Difference Vegetation Index (NDVI) and the Normalized Burn Ratio (NBR), which are often used to assess the severity of fires, were calculated for wildfires and prescribed fires. For each satellite image scene, spectral indices values were extracted for the 5th, 20th, 40th, 60th, 80th and 95th percentiles of pixels of each burned area. Then, box plots representing the distribution of these values were plotted for each satellite image to identify whether the regeneration time subsequent to a fire, also known as the burn scar, and the severity of the fire differed between the autumn and summer wildfires, and with prescribed fires. A statistical test revealed no differences for the re-generation time amongst the three categories of fires, but that the severity of summer wildfires was significantly different from that of prescribed fire, and this, for both indices. Second, SAR images were obtained from the Sentinel-1 mission for the same period as that of the optical imagery. A visual interpretation of the 34 variables of SAR response revealed that the 95th percentile of the Normalized Signal Ratio (NSR p_95) is adequate to detect burned areas in the study area. Moreover, it was found that 95% of the plots analyzed by the 80th percentile NSR (NSR p_80) showed a good response to fires in comparison to the spectral indices

Vascular endothelial growth factor (VEGF) upregulates BCL-2 and inhibits apoptosis in human and murine mammary adenocarcinoma cells

Tumour progression is regulated by the balance of proliferation and apoptosis in the tumour cell population. To date, the role of vascular endothelial growth factor (VEGF) in tumour growth has been attributed to the induction of angiogenesis. VEGF has been shown to be a survival factor for endothelial cells, preventing apoptosis by inducing Bcl-2 expression. In both murine (4T1) and human (MDA-MB-231) metastatic mammary carcinoma cell lines, we found that VEGF upregulated Bcl-2 expression and anti-VEGF antibodies reduced Bcl-2 expression. These alterations in Bcl-2 expression were reflected by the levels of tumour cell apoptosis. VEGF resulted in reduced tumour cell apoptosis, whereas its inhibition with anti-VEGF neutralizing antibodies induced apoptosis directly in tumour cells. Therefore, in addition to its role in angiogenesis and vessel permeability, VEGF acts as a survival factor for tumour cells, inducing Bcl-2 expression and inhibiting tumour cell apoptosis. © 2001 Cancer Research Campaign http://www.bjcancer.co

Renin–angiotensin system gene polymorphisms among Saudi patients with coronary artery disease

BACKGROUND: Idiopathic REM sleep behavior disorder is a prodromal stage of Parkinson's disease and dementia with Lewy bodies. Hyposmia, reduced dopamine transporter binding, and expression of the brain metabolic PD-related pattern were each associated with increased risk of conversion to PD. The objective of this study was to study the relationship between the PD-related pattern, dopamine transporter binding, and olfaction in idiopathic REM sleep behavior disorder. METHODS: In this cross-sectional study, 21 idiopathic REM sleep behavior disorder subjects underwent (18) F-fluorodeoxyglucose PET, dopamine transporter imaging, and olfactory testing. For reference, we included (18) F-fluorodeoxyglucose PET data of 19 controls, 20 PD patients, and 22 patients with dementia with Lewy bodies. PD-related pattern expression z-scores were computed from all PET scans. RESULTS: PD-related pattern expression was higher in idiopathic REM sleep behavior disorder subjects compared with controls (P = 0.048), but lower compared with PD (P = 0.001) and dementia with Lewy bodies (P < 0.0001). PD-related pattern expression was higher in idiopathic REM sleep behavior disorder subjects with hyposmia and in subjects with an abnormal dopamine transporter scan (P < 0.05, uncorrected). CONCLUSION: PD-related pattern expression, dopamine transporter binding, and olfaction may provide complementary information for predicting phenoconversion. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society