Growing up in a western country: how applicable is the theory of second individuation to second generation Chinese youths? Implications for psychotherapeutic practice

The objective of this dissertation is to explore the applicability of the theory of “second individuation” (SI) to the second generation minority Chinese during the life cycle phase of adolescence (MCY) and the implication for psychotherapeutic practice. Using a modified systematic literature review methodology, several major findings emerged. The primary finding is that the SI theory has many socially constructed concepts that describe the development of a person living in an individualistically orientated environment. For instance, the development of “a self” which is based on separation and differentiation from others, with the development of autonomy and independence as a central developmental goal, is an individualistic ideal. However, these concepts do not describe the developmental goals of people who are immersed in the traditional Chinese culture. Exposed to both “East” and “West” values, the self development of the MCY is both individualistically and collectively orientated, rendering some aspects of MCY's developmental goals incompatible with the goals depicted in the SI theory. These incompatible aspects include retaining and valuing interdependence as well as togetherness and loyalty with their parents and family. Further, not predicted by the SI theory, external factors such as parental beliefs and acculturation levels, the social economic status of the family and society’s reception of minority youth, were found to strongly govern how the MCY negotiate their self and identity development. This dissertation demonstrates that the SI theory has its limitations when it is applied to the MCY population. Psychotherapists who entertain the idea of using the theory of SI as part of their therapeutic formulation and goal setting with their MCY clients will need to make adjustments to the theory to cater to the MCY’s collective ideals. The dissertation highlights that the therapeutic process with MCYs will need to incorporate the developmental goals of both worldviews in order to honour the needs of the family and the youth. A culturally competent therapist needs to have a sound understanding of the contractual interpersonal relationships and interactions within the Chinese population, display sensitivity to the culturally determined emotional expressions and forms of emotional management within the Chinese society, demonstrate the ability to understand both cultural worldviews, and be able to hold the tension of both. There is a need for psychotherapists to be aware of the cultural biases inherent in practice and develop the culturally competent skills needed to provide appropriate services to the MCY population

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Growing up in a western country: how applicable is the theory of second individuation to second generation Chinese youths? Implications for psychotherapeutic practice

The objective of this dissertation is to explore the applicability of the theory of “second individuation” (SI) to the second generation minority Chinese during the life cycle phase of adolescence (MCY) and the implication for psychotherapeutic practice. Using a modified systematic literature review methodology, several major findings emerged. The primary finding is that the SI theory has many socially constructed concepts that describe the development of a person living in an individualistically orientated environment. For instance, the development of “a self” which is based on separation and differentiation from others, with the development of autonomy and independence as a central developmental goal, is an individualistic ideal. However, these concepts do not describe the developmental goals of people who are immersed in the traditional Chinese culture. Exposed to both “East” and “West” values, the self development of the MCY is both individualistically and collectively orientated, rendering some aspects of MCY's developmental goals incompatible with the goals depicted in the SI theory. These incompatible aspects include retaining and valuing interdependence as well as togetherness and loyalty with their parents and family. Further, not predicted by the SI theory, external factors such as parental beliefs and acculturation levels, the social economic status of the family and society’s reception of minority youth, were found to strongly govern how the MCY negotiate their self and identity development. This dissertation demonstrates that the SI theory has its limitations when it is applied to the MCY population. Psychotherapists who entertain the idea of using the theory of SI as part of their therapeutic formulation and goal setting with their MCY clients will need to make adjustments to the theory to cater to the MCY’s collective ideals. The dissertation highlights that the therapeutic process with MCYs will need to incorporate the developmental goals of both worldviews in order to honour the needs of the family and the youth. A culturally competent therapist needs to have a sound understanding of the contractual interpersonal relationships and interactions within the Chinese population, display sensitivity to the culturally determined emotional expressions and forms of emotional management within the Chinese society, demonstrate the ability to understand both cultural worldviews, and be able to hold the tension of both. There is a need for psychotherapists to be aware of the cultural biases inherent in practice and develop the culturally competent skills needed to provide appropriate services to the MCY population

Granulin-epithelin precursor is an oncofetal protein defining hepatic cancer stem cells.

BACKGROUND AND AIMS: Increasing evidence has suggested that hepatocellular carcinoma (HCC) might originate from a distinct subpopulation called cancer stem cells (CSCs), which are responsible for the limited efficacy of conventional therapies. We have previously demonstrated that granulin-epithelin precursor (GEP), a pluripotent growth factor, is upregulated in HCC but not in the adjacent non-tumor, and that GEP is a potential therapeutic target for HCC. Here, we characterized its expression pattern and stem cell properties in fetal and cancerous livers. METHODS: Protein expression of GEP in fetal and adult livers was examined in human and mouse models by immunohistochemical staining and flow cytometry. Liver cancer cell lines, isolated based on their GEP and/or ATP-dependent binding cassette (ABC) drug transporter ABCB5 expression, were evaluated for hepatic CSC properties in terms of colony formation, chemoresistance and tumorigenicity. RESULTS: We demonstrated that GEP was a hepatic oncofetal protein that expressed in the fetal livers, but not in the normal adult livers. Importantly, GEP+ fetal liver cells co-expressed the embryonic stem (ES) cell-related signaling molecules including β-catenin, Oct4, Nanog, Sox2 and DLK1, and also hepatic CSC-markers CD133, EpCAM and ABCB5. Phenotypic characterization in HCC clinical specimens and cell lines revealed that GEP+ cancer cells co-expressed these stem cell markers similarly as the GEP+ fetal liver cells. Furthermore, GEP was shown to regulate the expression of ES cell-related signaling molecules β-catenin, Oct4, Nanog, and Sox2. Isolated GEP(high) cancer cells showed enhanced colony formation ability and chemoresistance when compared with the GEP(low) counterparts. Co-expression of GEP and ABCB5 better defined the CSC populations with enhanced tumorigenic ability in immunocompromised mice. CONCLUSIONS: Our findings demonstrate that GEP is a hepatic oncofetal protein regulating ES cell-related signaling molecules. Co-expression of GEP and ABCB5 further enriches a subpopulation with enhanced CSC properties. The current data provide new insight into the therapeutic strategy

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical science. © The Author(s) 2019. Published by Oxford University Press

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field