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As employees' international mobility has increased, implementing repatriation processes has become a significant human resource (HR) issue. Through an exploratory study using a semi-structured interview method, we examine repatriated employees' views about HR activities that facilitate and hinder the repatriation process in the emerging economy of India. Respondents described lack of formal repatriation assistance, no contact person in HR to help with repatriation, and lack of re-entry culture-related training as characteristic of the repatriation process. Managing employees' expectations, along with creating a more sensitive, structured, and strategic HR function, are recommended to improve the repatriation process. From a theoretical perspective, results point to the multi-dimensionality of the repatriation construct and provide evidence of the context-specificity of HR practices. © 2010 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Enterprise resource planning (ERP) systems are a strong fit with organizations dominated by routine, highly programmed technologies, and tightly regulated operations. However, while these settings are best suited for ERP implementation, they also have the greatest difficulty making use of the knowledge ERP systems generate because of their inherent rigidity, inertia, and resistance to change. This article examines how human resource management practices can help a firm overcome the problems and capitalize on the opportunities that ERP technology presents by facilitating an effective dual-core structure through an emphasis on knowledge management, human capital stewardship, and relationship building. © 2006 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

While it has long been recognized that the human resource function must take a more customer-oriented perspective on the design and delivery of HR programs, this view has focused primarily on internal customers. However, external customers can provide important input into HR activities (e.g., job analysis information), they can participate in HR activities (e.g., selection decisions), and the,, can use HR activities (e.g., receive training). By expanding customer orientation in the HR function to focus explicitly on external customers, a more direct relationship between human resource management and competitive organizational performance can be established. (c) 1999 John Wiley & Sons, Inc. [ABSTRACT FROM AUTHOR]

Sampled private practitioners from the Register of Clinical Social Workers, American Psychological and Psychiatric Associations were used to evaluate what percentage of these practitioners' caseloads are made up of clients who have been denied reimbursement by managed care organizations for ongoing therapy. The results indicate that 39% of the respondents' caseloads are of managed care insured clients, of whom nearly one-third have been denied reimbursement for ongoing therapy, and of whom 42% later reenter therapy with an acute exacerbation of symptoms. The results have potential ethical and legal complications for private practitioners treating clients insured by managed care organizations. [ABSTRACT FROM AUTHOR]

The authors used the rosters from the Register of Clinical Social Workers, the American Psychological and American Psychiatric Associations to contrast a random sample of 167 private practicing social workers, 158 psychologists and 187 psychiatrists from across the nation with respect to changes in these practitioners' financial well-being since joining managed care organization panels. Although no statistically significant differences were found between the three groups with respect to many indicators of financial well-being, each of the groups reported that their financial well-being had been adversely affected by managed care organization guidelines. Because the social workers in this study were found to spend a greater percentage of their time in private practice than psychologists and psychiatrists, managed care organizations' policies with respect to financial reimbursement are likely to impact them more adversely than professionals in other disciplines. Other changes in overhead costs, including office staffing, record keeping and malpractice insurance, as required by managed care organizations, were considered by many of the respondents to be among the most prominent issues affecting their financial well-being. [ABSTRACT FROM AUTHOR]

Disrupted blood flow in conditions such as peripheral artery disease and critical limb ischemia leads to variations in oxygen supply within skeletal muscle tissue, creating regions of poorly perfused, hypoxic skeletal muscle surrounded by regions of adequately perfused, normoxic muscle tissue. These oxygen gradients may have significant implications for muscle injury or disease, as mediated by the exchange of paracrine factors between differentially oxygenated tissue. However, creating and maintaining heterogeneous oxygen landscapes within a controlled experimental setup to ensure continuous paracrine signaling is a technological challenge. Here, we engineer oxygen-controlled microphysiological systems to investigate paracrine interactions between differentially oxygenated engineered muscle tissue. We fabricated microphysiological systems with dual oxygen landscapes that also had engineered control over paracrine interactions between hypoxic and normoxic skeletal muscle tissues, which were differentiated from C2C12 myoblasts cultured on micromolded gelatin hydrogels. The microphysiological systems interfaced with a new 3D-printed oxygen control well plate insert, which we designed to distribute flow to multiple microphysiological systems and minimize evaporation for longer timepoints. With our system, we demonstrated that amphiregulin, a myokine associated with skeletal muscle injury, exhibits unique upregulation in both gene expression and secretion after 24 hours due to paracrine interactions between hypoxic and normoxic skeletal muscle tissue. Our platform can be extended to investigate other impacts of paracrine interactions between hypoxic and normoxic skeletal muscle and can more broadly be used to elucidate many forms of oxygen-dependent crosstalk in other organ systems.

Myocardial infarctions locally deprive myocardium of oxygenated blood and cause immediate cardiac myocyte necrosis. Irreparable myocardium is then replaced with a scar through a dynamic repair process that is an interplay between hypoxic cells of the infarct zone and normoxic cells of adjacent healthy myocardium. In many cases, unresolved inflammation or fibrosis occurs for reasons that are incompletely understood, increasing the risk of heart failure. Crosstalk between hypoxic and normoxic cardiac cells is hypothesized to regulate mechanisms of repair after a myocardial infarction. To test this hypothesis, microfluidic devices are fabricated on 3D printed templates for co-culturing hypoxic and normoxic cardiac cells. This system demonstrates that hypoxia drives human cardiac fibroblasts toward glycolysis and a pro-fibrotic phenotype, similar to the anti-inflammatory phase of wound healing. Co-culture with normoxic fibroblasts uniquely upregulates pro-inflammatory signaling in hypoxic fibroblasts, including increased secretion of tumor necrosis factor alpha (TNF-α). In co-culture with hypoxic fibroblasts, normoxic human induced pluripotent stem cell (hiPSC)-derived cardiac myocytes also increase pro-inflammatory signaling, including upregulation of interleukin 6 (IL-6) family signaling pathway and increased expression of IL-6 receptor. Together, these data suggest that crosstalk between hypoxic fibroblasts and normoxic cardiac cells uniquely activates phenotypes that resemble the initial pro-inflammatory phase of post-infarct wound healing., (© 2024 Wiley‐VCH GmbH.)

Myocardial infarction (MI) causes hypoxic injury to downstream myocardial tissue, which initiates a wound healing response that replaces injured myocardial tissue with a scar. Wound healing is a complex process that consists of multiple phases, in which many different stimuli induce cardiac fibroblasts to differentiate into myofibroblasts and deposit new matrix. While this process is necessary to replace necrotic tissue, excessive and unresolved fibrosis is common post-MI and correlated with heart failure. Therefore, defining how cardiac fibroblast phenotypes are distinctly regulated by stimuli that are prevalent in the post-MI microenvironment, such as hypoxia and transforming growth factor-beta (TGF-β), is essential for understanding and ultimately mitigating pathological fibrosis. In this study, we acutely treated primary human adult cardiac fibroblasts with TGF-β1 or hypoxia and then characterized their phenotype through immunofluorescence, quantitative RT-PCR, and proteomic analysis. We found that fibroblasts responded to low oxygen with increased localization of hypoxia inducible factor 1 (HIF-1) to the nuclei after 4h, which was followed by increased gene expression of vascular endothelial growth factor A (VEGFA), a known target of HIF-1, by 24h. Both TGF-β1 and hypoxia inhibited proliferation after 24h. TGF-β1 treatment also upregulated various fibrotic pathways. In contrast, hypoxia caused a reduction in several protein synthesis pathways, including collagen biosynthesis. Collectively, these data suggest that TGF-β1, but not acute hypoxia, robustly induces the differentiation of human cardiac fibroblasts into myofibroblasts. Discerning the overlapping and distinctive outcomes of TGF-β1 and hypoxia treatment is important for elucidating their roles in fibrotic remodeling post-MI and provides insight into potential therapeutic targets.

Exposure of wildlife to anthropogenic noise is associated with disruptive effects. Research on this topic has focused on behavioural and physiological responses of animals to noise, with little work investigating links to cognitive function. Neurological processes that maintain cognitive performance can be impacted by stress and sleep disturbances. While sleep loss impairs cognitive performance in Australian magpies, it is unclear whether urban noise, which disrupts sleep, can impact cognition as well. To fill this gap, we explored how environmentally relevant urban noise affected the performance of wild-caught, city-living Australian magpies (Gymnorhina tibicen tyrannica) on a cognitive task battery including associative and reversal learning, inhibitory control, and spatial memory. Birds were housed and tested in a laboratory environment; sample sizes varied across tasks (n=7-9 birds). Tests were conducted over 4 weeks, during which all magpies were exposed to both an urban noise playback and a quiet control. Birds were presented with the entire test battery twice: following exposure to, and in the absence of, an anthropogenic noise playback; however, tests were always performed without noise (playback muted during testing). Magpies performed similarly in both treatments on all four tasks. We also found that prior experience with the associative learning task had a strong effect on performance, with birds performing better on their second round of trials. Like previous findings on Australian magpies tested on the same tasks in the wild under noisy conditions, we could not find any disruptive effects on cognitive performance in a controlled experimental laboratory setting., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2024. Published by The Company of Biologists Ltd.)

Introduction: Sleep plays a critical role in daily functioning and stroke recovery but receives little attention in stroke rehabilitation. Sleep disturbances are linked to affective and cognitive impairments, but temporal associations between sleep and affect and cognitive symptoms are less clear. Understanding these temporal associations may inform new directions in intervention and prevention to support continued stroke recovery., Objective: To examine the bidirectional temporal associations between sleep and affect and cognitive symptoms among community-dwelling stroke survivors., Design: A secondary analysis of a longitudinal observational study involving 7 days of ecological momentary assessment (EMA), during which participants completed eight EMA surveys and a sleep diary per day. Multilevel modeling was used to analyze data., Setting: Community., Participants: Community-dwelling stroke survivors (N = 40)., Interventions: Not applicable., Main Outcome Measures: EMA measures of depressed affect, cheerful affect, and cognitive symptoms. Sleep quality and duration as measured using a sleep diary., Results: Between-person sleep quality was negatively associated with next-day depressed affect (B = -.16; p = .028) and positively associated with next-day cheerful affect (B = .63; p < .001). Inversely, between-person depressed affect was negatively associated with next night sleep quality (B = -.77; p = .015), and vice versa for cheerful affect (between-person: B = .45; p < .001; within-person: B = .09; p = .008). Long sleep (>9 hours) was positively associated with next-day cognitive symptoms (B = .13; p = .002), whereas cognitive symptoms were associated with a higher odds of long sleep the following night (odds ratio [OR] = 0.25; p = .047)., Conclusions: This study identified the bidirectional associations of sleep with affect and cognitive symptoms in the context of the everyday life of stroke survivors. The findings suggest that interventions addressing sleep quality and duration may impact affect and cognitive symptoms, and vice versa., (© 2023 American Academy of Physical Medicine and Rehabilitation.)

Background and Objective: Palliative radiotherapy (RT) and systemic immuno- or targeted therapy both play significant roles in the treatment of advanced hepatocellular carcinoma (HCC). Concurrent application of these therapies is increasing, however, no guidelines exist regarding the combination of systemic therapy with RT. This narrative review summarises the existing literature reporting toxicity observed after concurrent treatment with RT and immuno- or targeted therapeutic agents commonly used in HCC., Methods: The PubMed database was searched for studies published between 2011 and 2023 reporting toxicity data on patients treated concurrently with RT and targeted agents used in HCC. Due to the paucity of relevant literature in HCC, the inclusion criteria were expanded to include non-HCC cohorts treated with targeted therapies commonly used in advanced HCC., Key Content and Findings: Sixty-seven articles were included in this review. Twenty-two articles reported combined RT with sorafenib, one with regorafenib, 22 with bevacizumab, three with lenvatinib and 19 with immune checkpoint inhibitors. Significant findings include a high rate severe hepatotoxicity with combination RT and sorafenib, ranging from 0-19% with liver stereotactic body radiotherapy (SBRT) and 3-18% with conventionally fractionated liver RT. Severe gastrointestinal (GI) toxicities including perforation and ulceration were seen with combination bevacizumab and RT, ranging from 0-27% in the acute setting and 0-23% in the late setting. The safety profile of combination immune checkpoint blockade agents and RT was similar to that seen in monotherapy., Conclusions: Existing data suggests that combination RT and targeted therapy given the risk of severe adverse events including hepatotoxicity and GI toxicity. There is an urgent need for future studies specifically examining the impact of combination therapy in HCC patients to guide clinical decision-making in the evolving landscape of immune- and targeted therapies.

Despite extensive research on avian vocal learning, we still lack a general understanding of how and when this ability evolved in birds. As the closest living relatives of the earliest Passeriformes, the New Zealand wrens (Acanthisitti) hold a key phylogenetic position for furthering our understanding of the evolution of vocal learning because they share a common ancestor with two vocal learners: oscines and parrots. However, the vocal learning abilities of New Zealand wrens remain unexplored. Here, we test for the presence of prerequisite behaviors for vocal learning in one of the two extant species of New Zealand wrens, the rifleman (Acanthisitta chloris). We detect the presence of unique individual vocal signatures and show how these signatures are shaped by social proximity, as demonstrated by group vocal signatures and strong acoustic similarities among distantly related individuals in close social proximity. Further, we reveal that rifleman calls share similar phenotypic variance ratios to those previously reported in the learned vocalizations of the zebra finch, Taeniopygia guttata. Together these findings provide strong evidence that riflemen vocally converge, and though the mechanism still remains to be determined, they may also suggest that this vocal convergence is the result of rudimentary vocal learning abilities., (© 2024. The Author(s).)

In pancreatic ductal adenocarcinoma (PDAC), no recurrent metastasis-specific mutation has been found, suggesting that epigenetic mechanisms, such as DNA methylation, are the major contributors of late-stage disease progression. Here, we performed the first whole-genome bisulfite sequencing (WGBS) on mouse and human PDAC organoid models to identify stage-specific and molecular subtype-specific DNA methylation signatures. With this approach, we identified thousands of differentially methylated regions (DMRs) that can distinguish between the stages and molecular subtypes of PDAC. Stage-specific DMRs are associated with genes related to nervous system development and cell-cell adhesions, and are enriched in promoters and bivalent enhancers. Subtype-specific DMRs showed hypermethylation of GATA6 foregut endoderm transcriptional networks in the squamous subtype and hypermethylation of EMT transcriptional networks in the progenitor subtype. These results indicate that aberrant DNA methylation contributes to both PDAC progression and subtype differentiation, resulting in significant and reoccurring DNA methylation patterns with diagnostic and prognostic potential., Competing Interests: The authors declare no competing interests., (© 2024 The Author(s).)

Background: Screening for risk behaviors is a routine and essential component of adolescent preventive health visits. Early identification of risks can inform targeted counseling and care. If stored in discrete fields in the electronic health record (EHR), adolescent screening data can also be used to understand risk behaviors across a clinic or health system or to support quality improvement projects., Objective: Goals of this pilot study were to adapt and implement an existing paper adolescent risk behavior screening tool for use as an electronic data capture tool (the eTeenQ), to evaluate acceptance of the eTeenQ, and to describe the prevalence of the selected risk behaviors reported through the eTeenQ., Methods: The multidisciplinary project team applied an iterative process to develop the 29-item eTeenQ. Two unique data entry forms were created with attention to (1) user interface and user experience, (2) the need to maintain patient privacy, and (3) the potential to transmit and store data for future use in clinical care and research. Three primary care clinics within a large health system piloted the eTeenQ from August 17, 2020, to August 27, 2021. During preventive health visits for adolescents aged 12 to 18 years, the eTeenQ was completed on tablets and responses were converted to a provider display for teens and providers to review together. Responses to the eTeenQ were stored in a REDCap (Research Electronic Data Capture; Vanderbilt University) database, and for patients who agreed, responses were transferred to an EHR flowsheet. Responses to selected eTeenQ questions are reported for those consenting to research. At the conclusion of the pilot, the study team conducted semistructured interviews with providers and staff regarding their experience using the eTeenQ., Results: Among 2816 adolescents with well visits, 2098 (74.5%) completed the eTeenQ. Of these, 1811 (86.3%) agreed to store responses in the EHR. Of 1632 adolescents (77.8% of those completing the eTeenQ) who consented for research and remained eligible, 1472 (90.2%) reported having an adult they can really talk to and 1510 (92.5%) reported feeling safe in their community, yet 401 (24.6%) reported someone they lived with had a gun and 172 (10.5%) reported having had a stressful or scary event that still bothered them. In addition, 157 (9.6%) adolescents reported they were or wondered if they were gay, lesbian, bisexual, pansexual, asexual, or other, and 43 (2.6%) reported they were or wondered if they were transgender or gender diverse. Of 11 staff and 7 providers completing interviews, all felt that the eTeenQ improved confidentiality and willingness among adolescents to answer sensitive questions. All 7 providers preferred the eTeenQ over the paper screening tool., Conclusions: Electronic capture of adolescent risk behaviors is feasible in a busy clinic setting and well accepted among staff and clinicians. Most adolescents agreed for their responses to risk behavior screening to be stored in the EHR., (© Shannon Neale, Ella Chrenka, Abhilash Muthineni, Rashmi Sharma, Mallory Layne Hall, Juliana Tillema, Elyse O Kharbanda. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org).)

The hypothesis that impoverished language experience affects complex sentence structure development around the end of early childhood was tested using a fully randomized, sentence-to-picture matching study in American Sign Language (ASL). The participants were ASL signers who had impoverished or typical access to language in early childhood. Deaf signers whose access to language was highly impoverished in early childhood (N = 11) primarily comprehended structures consisting of a single verb and argument (Subject or Object), agreeing verbs, and the spatial relation or path of semantic classifiers. They showed difficulty comprehending more complex sentence structures involving dual lexical arguments or multiple verbs. As predicted, participants with typical language access in early childhood, deaf native signers (N = 17) or hearing second-language learners (N = 10), comprehended the range of 12 ASL sentence structures, independent of the subjective iconicity or frequency of the stimulus lexical items, or length of ASL experience and performance on non-verbal cognitive tasks. The results show that language experience in early childhood is necessary for the development of complex syntax. RESEARCH HIGHLIGHTS: Previous research with deaf signers suggests an inflection point around the end of early childhood for sentence structure development. Deaf signers who experienced impoverished language until the age of 9 or older comprehend several basic sentence structures but few complex structures. Language experience in early childhood is necessary for the development of complex sentence structure., (© 2023 The Authors. Developmental Science published by John Wiley & Sons Ltd.)

After a myocardial infarction, the boundary between the injured, hypoxic tissue and the adjacent viable, normoxic tissue, known as the border zone, is characterized by an oxygen gradient. Yet, the impact of an oxygen gradient on cardiac tissue function is poorly understood, largely due to limitations of existing experimental models. Here, we engineered a microphysiological system to controllably expose engineered cardiac tissue to an oxygen gradient that mimics the border zone and measured the effects of the gradient on electromechanical function and the transcriptome. The gradient delayed calcium release, reuptake, and propagation; decreased diastolic and peak systolic stress; and increased expression of inflammatory cascades that are hallmarks of myocardial infarction. These changes were distinct from those observed in tissues exposed to uniform normoxia or hypoxia, demonstrating distinct regulation of cardiac tissue phenotypes by an oxygen gradient. Our border-zone-on-a-chip model advances functional and mechanistic insight into oxygen-dependent cardiac tissue pathophysiology.

Purpose: The purpose of this study was to describe the Language Access Profile Tool (LAPT) and its psychometric properties with the aim of evaluating its suitability as an alternative to the deaf or hard of hearing (DHH) Language Exposure Assessment Tool (D-LEAT) in clinical practice with DHH children age 12 years and younger., Method: We administered both the LAPT and D-LEAT to the caregivers of 105 DHH children 12 years old and younger from across the United States, 40% of whom were interviewed again after a delay of at least 1 month. Each interview resulted in a child-specific estimate of their cumulative experience with language input, expressed as a proportion divided across eight categories., Results: Participants in the sample reported experience with all eight input categories, but four categories were common and four were rare. Estimates for all input categories were consistent at both initial and follow-up interviews. Estimates for each input category were also strongly correlated with the corresponding estimates from the D-LEAT, although correlations for the rare categories should be interpreted cautiously., Conclusions: The LAPT demonstrates sufficient test-retest reliability and convergent validity to be a useful and more user-friendly alternative to the D-LEAT. We provide recommendations for how the LAPT and the D-LEAT can be best used in their current form., Supplemental Material: https://doi.org/10.23641/asha.20669001.

Climate warming is increasingly exposing wildlife to sublethal high temperatures, which may lead to chronic impacts and reduced fitness. Telomere length (TL) may link heat exposure to fitness, particularly at early-life stages, because developing organisms are especially vulnerable to adverse conditions, adversity can shorten telomeres, and TL predicts fitness. Here, we quantify how climatic and environmental conditions during early life are associated with TL in nestlings of wild purple-crowned fairy-wrens ( Malurus coronatus ), endangered songbirds of the monsoonal tropics. We found that higher average maximum air temperature (range 31 to 45 °C) during the nestling period was associated with shorter early-life TL. This effect was mitigated by water availability (i.e., during the wet season, with rainfall), but independent of other pertinent environmental conditions, implicating a direct effect of heat exposure. Models incorporating existing information that shorter early-life TL predicts shorter lifespan and reduced fitness showed that shorter TL under projected warming scenarios could lead to population decline across plausible future water availability scenarios. However, if TL is assumed to be an adaptive trait, population viability could be maintained through evolution. These results are concerning because the capacity to change breeding phenology to coincide with increased water availability appears limited, and the evolutionary potential of TL is unknown. Thus, sublethal climate warming effects early in life may have repercussions beyond individual fitness, extending to population persistence. Incorporating the delayed reproductive costs associated with sublethal heat exposure early in life is necessary for understanding future population dynamics with climate change.