bluuebunny/crossref_metadata_2025 huggingface dataset:
Untangling the influences of fire, habitat and introduced predators on the endangered heath mouse
Authors: Nalliah Rachel , Sitters Holly , Smith Amy , Di Stefano Julian
Published: August 2021

Globally, species extinctions are driven by multiple interacting factors including altered fire regimes and introduced predators. In flammable ecosystems, there is great potential to use fire for animal conservation, however most fire‐based conservation strategies do not explicitly consider interacting factors. In this study, we sought to understand the interrelationships between the endangered heath mouse Pseudomys shortridgei, fire, resource availability and the introduced fox Vulpes vulpes in southeast Australia. We predicted that heath‐mouse relative abundance would respond indirectly to post‐fire age class (recently burnt; 0–3 years since fire, early; 4–9 years, mid; 10–33 years and late; 34–79 years) via the mediating effects of resources (shrub cover and plant‐group diversity) and fox relative abundance. We used structural equation modelling to determine the strength of hypothesized pathways between variables, and mediation analysis to detect indirect effects. Both the cover of shrubs (0–50 cm from the ground) and fox relative abundance were associated with post‐fire age class. Shrub cover was highest 0–9 years after fire, while fox relative abundance was highest in recently burnt vegetation (0–3 years after fire). Heath mice were positively correlated with shrub cover and plant‐group diversity, and negatively correlated with fox relative abundance. We did not detect a direct relationship between heath mice and post‐fire age class, but they were indirectly associated with age class via its influence on both shrub cover and fox relative abundance. Our findings suggest that heath mice will benefit from a fire regime promoting dense shrub regeneration in combination with predator control. Understanding the indirect effects of fire on animals may help to identify complementary management practices that can be applied concurrently to benefit vulnerable species. Analytical and management frameworks that include multiple drivers of species abundance and explicitly recognize the indirect effects of fire regimes will assist animal conservation.
Faith leaders’ perceptions of needle exchange programs in the rural Illinois Delta Region: Religion as a social determinant of health
Authors: Grundy Stacy A. , Mozelewski Sasha R. , Adjei Boakye Eric , Lee Minjee , Levin Bruce L.
Published: August 2021

Background and Objectives

Despite increasing drug use in rural communities, potentially life‐saving harm reduction interventions, such as needle exchange programs (NEPs), remain underutilized. Religion is an integral component of the rural culture that has been shown to influence health, yet no studies to date have explored rural faith leaders’ perceptions of harm reduction strategies.

Methods

An online cross‐sectional survey was conducted among rural faith leaders (n = 133) in the rural Illinois Delta Region.

Results

While most of the respondents felt that drug abuse was an issue in their communities, support was mixed regarding whether they were in favor of NEPs with the majority of respondents having never heard of an NEP before this survey. While the majority believed that NEPs would help decrease bloodborne disease transmission, it was also perceived that NEPs would increase drug use. Significant differences in perceptions based on race, marital status, and political party also exist.

Conclusion and Scientific Significance

Congruent with previous harm reduction literature, many rural faith leaders have varied perceptions of NEPs. Rural faith leaders could benefit from education about NEPs, including the possible positive and negative impacts they can have on the community. Future studies should explore contextual differences among rural faith leaders. To date, no studies have examined faith‐based organizations’ perceptions of NEPs. The findings have the potential to increase the current body of knowledge and provide data to support recommendations for engaging faith‐based organizations in behavioral health service delivery.
Reproductive and pregnancy outcomes following embryo transfer in women with previous cesarean section: A systematic review and meta‐analysis
Authors: Riemma Gaetano , De Franciscis Pasquale , Torella Marco , Narciso Giuliana , La Verde Marco , Morlando Maddalena , Cobellis Luigi , Colacurci Nicola
Published: August 2021

Introduction

Cesarean section affects subsequent spontaneous pregnancies because of implantation issues. However, its impact on post‐embryo transfer pregnancies is still debated. This review aimed to evaluate the impact of a previous cesarean section on fertility and pregnancy outcomes of women undergoing fresh or frozen embryo transfer.

Material and methods

MEDLINE, Scopus, ClinicalTrials.gov, Scielo, EMBASE, Cochrane Library at the CENTRAL, and LILACS were searched from inception to February 2021. Studies were included if they evaluated reproductive or pregnancy outcomes after fresh or frozen embryo transfer in infertile women with a previous cesarean section relative to women with a previous vaginal delivery. Random‐effect meta‐analyses to calculate risk ratio (RR) or mean differences with 95% confidence intervals (CI) followed by subgroup analysis for fresh and frozen embryo transfer were performed. Risk of bias and quality assessment were conducted using Newcastle–Ottawa scale and GRADE criteria. The review was registered in the International Prospective Register of Systematic Reviews (CRD42021226297).

Results

Ten studies, with data provided for 13 696 participants, were eligible. For embryo transfers after cesarean section, compared with vaginal delivery, there was a significant reduction of the live birth rate (RR 0.88, 95% CI 0.79–0.99) and biochemical pregnancy rate (RR 0.89, 95% CI 0.82–0.96). No statistically significant differences were found for clinical pregnancy rate (RR 0.92, 95% CI 0.84–1.02), ectopic pregnancies (RR 1.00, 95% CI 0.68–1.46), pregnancy loss (RR 1.05, 95% CI 0.94–1.18), multiple pregnancies (RR 0.80, 95% CI 0.63–1.02), stillbirths (RR 0.86, 95% CI 0.27–2.69), birth defects (RR 1.71, 95% CI 0.49–5.96) or birthweight (mean difference 46.82, 95% CI −40.16 to 133.80). Subgroup analysis revealed an increased risk for preterm birth in post‐cesarean section fresh embryo transfer pregnancies (RR 1.59, 95% CI 1.16–2.19).

Conclusions

Low‐grade evidence shows that post‐embryo transfer pregnancies in infertile women who had a previous cesarean delivery result in reduced biochemical pregnancy and live birth rates relative to women with a previous vaginal delivery. An increased risk for preterm birth is notable in post‐fresh embryo transfer pregnancies.
Supporting doctors' well‐being and resilience during COVID‐19: A framework for rapid and rigorous intervention development
Authors: Gibson Smith Kathrine , Cunningham Kathryn B. , Cecil Joanne E. , Laidlaw Anita , Cairns Patrick , Scanlan Gillian M. , Tooman Tricia R. , Aitken Gill , Ferguson Julie , Gordon Lisi , Johnston Peter W. , Pope Lindsey , Wakeling Judy , Walker Kim A.
Published: August 2021

This paper aims to outline the development of a theoretically informed and evidence‐based intervention strategy to underpin interventions to support the well‐being of doctors during COVID‐19 and beyond; delineate new ways of working were employed to ensure a rapid and rigorous process of intervention development and present the resulting novel framework for intervention development. The research comprised four workstreams: literature review (WS1), qualitative study (WS2), intervention development and implementation (WS3) and evaluation (WS4). Due to time constraints, we employed a parallel design for WS1–3 with the findings of WS1–2 informing WS3 on a continual basis. WS3 was underpinned by the Behaviour Change Wheel. We recruited expert panels to assist with intervention development. We reflected on decisions taken to facilitate the rapid yet rigorous process of intervention development. The empirical output was a theoretically informed and evidence‐based intervention strategy to underpin interventions to support doctors' well‐being during COVID‐19 and beyond. The methodological output was a novel framework that facilitates rapid and rigorous development of interventions. The intervention strategy provides a foundation for development and evaluation of tailored interventions to support doctors' well‐being. The novel framework provides guidance for the development of interventions where the situation demands a rapid yet rigorous development process.
Where are the children? An autoethnography of deception in dementia in an acute hospital
Authors: Hodge Gary
Published: August 2021

An acute hospital environment is a confusing place for many patients requiring admission, especially when they are presenting as acutely unwell. This can be particularly difficult for people living with dementia. As cognition changes it is not uncommon for people living with dementia to have difficulties with their ability to orientate to time, place and person. These disorientating moments can lead to personal distress, and at times behavioural changes. As well as being distressing for the person living with dementia, it can also be emotionally and ethically challenging for acute hospital staff, including nurses. One area found to be particularly challenging is the concept of whether actively engaging with a person living with dementia's living truth is deceitful. This raises further questions of what forms of nurse responses to temporal disorientation might be constituted as lying, colluding, or alternatively validating. This article uses autoethnography as a research methodology with which to explore a mental health nurse's lived experience of the challenges of responding truthfully to disorientation and distress in an acute hospital. This article is not attempting to offer conclusive answers to these challenging ethical questions. It is instead re‐opening and re‐visiting the discourse of what is truth in dementia from a personal and professional nurse perspective through a lived narrative. The conclusion to the concept of truth in dementia is complex, nuanced and individualized. However, it is essential that a nurse's response to disorientation and distress is always person and living present focused, and not lie focused.
Genetic counseling and testing for hereditary hemorrhagic telangiectasia
Authors: Lam Shravika , Guthrie Kelsey S. , Latif Muhammad A. , Weiss Clifford R.
Published: August 2021

Genetic counseling is an important means of identifying a patient's genetic risk of hereditary hemorrhagic telangiectasia (HHT) and assisting patients in making informed decisions about their health. With an increase in understanding of the genetic mechanisms underlying HHT over the last decade, genetic counseling is increasingly being incorporated into the care of patients affected by HHT. In addition to refining the diagnosis of symptomatic patients, genetic testing can help to distinguish asymptomatic, at‐risk patients from those who are unaffected by HHT. The purpose of this review article is to summarize the current knowledge regarding the role of genetic counseling and genetic testing in identifying and managing HHT in at‐risk populations. This article also reviews the guidelines, outcomes, risks, and challenges of genetic counseling and testing for HHT in various patient populations, and provides an algorithm for the use of genetic counseling in symptomatic and asymptomatic patients.
Pharmacogenomic polygenic risk score for clopidogrel responsiveness among Caribbean Hispanics: A candidate gene approach
Authors: Duconge Jorge , Santiago Ednalise , Hernandez‐Suarez Dagmar F. , Moneró Mariangeli , López‐Reyes Andrés , Rosario Marines , Renta Jessicca Y. , González Pablo , Ileana Fernández‐Morales Laura , Antonio Vélez‐Figueroa Luis , Arce Orlando , Marín‐Maldonado Frances , Nuñez Héctor , Melin Kyle , Scott Stuart A. , Ruaño Gualberto
Published: August 2021

This multicenter clinical study was aimed at conducting a targeted pharmacogenomic association analysis of residual on‐clopidogrel platelet reactivity in 474 Caribbean Hispanic patients. Platelet reactivity was measured using the VerifyNow P2Y12 assay and clopidogrel resistance was defined as P2Y12 reaction units (PRUs) greater than or equal to 208. Genotyping was performed using the whole‐genome Infinium MEGA BeadChip array. An ancestry‐adjusted, weighted polygenic risk score (wPGxRS) was developed to account for the effect of multiple variants on PRU and compared between clopidogrel responders and nonresponders. The mean PRU across the study cohort was 173.8 ± 68.5 and 33.5% of patients were defined as clopidogrel resistant. Multivariate linear regression showed that 19% of PRU variability was attributed to nine independent predictors, with CYP2C19*2 (rs4244285) accounting for ~ 7% of observed PRU variation (p < 0.001). PON1 rs662, ABCB1/MDR1 rs2032582, PEAR1 rs12041331 carrier status, and the interaction between African ancestry and rs12041331 carriers also predicted PRU among the participants (p ≤ 0.05). A clear gene‐dose effect was detected between PRU and CYP2C19*2 genotype, consistent with previous studies in European patient populations, as well as rs12777823. Importantly, a significant positive correlation was detected between our novel wPGxRS (4 variants) and PRU among the Hispanic patient population (rp = 0.35, p < 0.001). Moreover, the wPGxRS discriminated between nonresponders and responders (p = 0.003), indicating that this multigene‐based score is a useful predictor of clopidogrel resistance among Caribbean Hispanics. Taken together, these results help close the gap of knowledge on clopidogrel pharmacogenomics and its potential clinical implementation in this under‐represented population.
A protocol for the first episode psychosis outcome study (FEPOS): ≥15 year follow‐up after treatment at the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia
Authors: Cotton Sue , Filia Kate , Watson Amity , Mackinnon Andrew J. , Hides Leanne , Gleeson John F. M. , Berk Michael , Conus Philippe , Lambert Martin , Schimmelmann Benno , Herrman Helen , Rayner Victoria , Ratheesh Aswin , McGorry Patrick D.
Published: August 2021

Background

Specialist early intervention (SEI) service models are designed to treat symptoms, promote social and vocational recovery, prevent relapse, and resource and up‐skill patients and their families. The benefits of SEI over the first few years have been demonstrated. While early recovery can be expected to translate to better long‐term outcomes by analogy with other illnesses, there is limited evidence to support this from follow‐up studies. The current study involves the long‐term follow‐up of a sub‐set of first episode psychosis (FEP) patients, with a range of diagnoses, who were first treated at Orygen's Early Psychosis Prevention and Intervention Centre (EPPIC) between 1998 and 2000. The aim of this paper is to present the methodology for this follow‐up study.

Methods

Between January 1998 and December 2000, 786 patients between the ages of 15–29 years were treated at EPPIC, located in Melbourne, Australia. Our cohort consists of 661 people (82 were transferred/discharged and 43 were not diagnosed with a psychotic disorder at time of discharge). The 18‐month treatment characteristics of this cohort have been extensively examined in the First Episode Psychosis Outcome Study (FEPOS). The ≥15 year outcomes of this cohort are being examined in this study, known as FEPOS15.

Results

Participant follow‐up is ongoing. In order to extend and assess broader outcomes of the cohort, data linkage with health‐related databases will be conducted.

Conclusion

This study will provide a comprehensive evaluation of the long‐term trajectory of psychotic disorders after treatment for FEP in a SEI service.
A qualitative study on the experiences of haemophilia carriers before, during and after pregnancy
Authors: Punt Marieke C. , Teela Lorynn , Fischer Kathelijn , Bloemenkamp Kitty W. M. , Lely A. Titia , Driessens Mariette H. E. , Pekel Lynnda , Haverman Lotte , van Galen Karin P. M.
Published: August 2021

Introduction

Haemophilia carriers (HCs) face considerable haemostatic and psychological challenges during reproduction.

Aim

To explore the perspectives of HCs on healthcare in the current standard of haemophilia treatment during all reproductive phases: preconception, pregnancy, childbirth and the postpartum period. In addition, we examined the psychological impact of haemophilia during these phases.

Material and methods

Focus group discussions (FGDs) and semi‐structured interviews were conducted with HCs in January/February 2020 until data saturation was reached. All sessions were recorded, transcribed verbatim and analysed by two independent researchers through thematic content analysis using MAXQDA® software. The results were then discussed within the research team until consensus was reached. The constructed themes were shared with and reviewed by the HCs.

Results

Fifteen HCs were included in three FGDs and four interviews. Five central themes were constructed: (1) communication by healthcare professionals, (2) lack of knowledge, (3) feeling insecure, (4) autonomy and (5) family experiences with haemophilia. Desired improvements in care mainly concerned counselling during preconception and pregnancy. This included timely access to comprehensive information during each consecutive phase, acceptance of HCs’ choices by healthcare providers and healthcare tailored to the HC's family experience with haemophilia.

Conclusions

In recent years, haemophilia treatment has seen major advances, which could impact general and reproductive care for HCs. HCs indicated that reproductive care would benefit from a more personal and informative approach. Healthcare professionals could use these insights to adapt their consultations to meet the needs of these women when they are preparing for having children.
Integrative proteomic and metabolomic analyses reveal the mechanism by which bismuth enables Helicobacter pylori eradication
Authors: Yao Xingyu , Xiao Shiyu , Zhou Liya
Published: August 2021

Background

Bismuth‐based drugs are used to treat Helicobacter pylori infection; however, the antibacterial activity of bismuth, especially against H. pylori, has not been fully elucidated. In this study, the mechanisms by which bismuth exerts its detrimental effects on H. pylori were evaluated.

Methods

Six H. pylori strains isolated from different patients were cultured with or without bismuth; proteins and metabolites differentially expressed in these two sets of bacteria were detected via data independent acquisition proteomic and gas chromatography‐mass spectrometry metabolic approaches, respectively. Gene ontology functional analysis and Kyoto Encyclopedia of Genes and Genomes database were used to identity pathway enrichment.

Results

Bismuth inhibited H. pylori growth in vitro via the following mechanisms: downregulation of virulence proteins CagA and VacA; disruption of flagella assembly responsible for bacterial colonization; and inhibition of antioxidant enzymes, including catalase, catalase‐related peroxidase, and superoxide dismutase. Diverse metabolic pathways related to growth and RNA translation in H. pylori were disrupted by bismuth. Bismuth treatment impaired many biological processes in H. pylori, including antioxidant response and purine, pyrimidine, amino acid, and carbon metabolism.

Conclusions

The findings of this study suggest that motility, virulence factors CagA and VacA, antioxidant defense system, and many important metabolic pathways associated with bacterial growth, including nucleotide and amino acid metabolism and translation in H. pylori, are inhibited by bismuth. This study provides novel insights into the mechanism by which bismuth eradicates H. pylori upon being incorporated into quadruple therapy.
Onychophagia: detailed clinical characteristics
Authors: Shin Jun‐Oh , Roh Dongyoung , Son Jin‐Hwa , Shin Kihyuk , Kim Hoon‐Soo , Ko Hyun‐Chang , Kim Byung‐Soo , Kim Moon‐Bum
Published: August 2021

Background

Onychophagia is a common disorder affecting 20% to 30% of the general population. It is defined as habitual nail biting and can cause various changes in the nail units. However, to date, there has been a paucity of data focusing on nail deformities related to onychophagia. This study was performed to investigate the clinical characteristics of onychophagia in Korea.

Methods

This study included 53 patients with onychophagia who visited the Pusan National University Hospital (Busan and Yangsan) over a 10‐year period (2011–2020). We retrospectively reviewed medical records and clinical and dermoscopic photographs.

Results

All 10 fingernails were affected in 37.7% of the patients. The left thumbnail was the most predominantly affected site (81.1%). Clinical findings showed that short nails with ragged distal borders were the most common presentation (100.0%), followed by generalized or patchy rough areas (50.9%), linear and pinpoint hemorrhage (32.1%), longitudinal melanonychia (30.2%), transverse groove (28.3%), brittleness (28.3%), macrolunula (24.5%), washboard nail (13.2%), and pterygium (3.8%). Of the patients, 88.7% had periungual complications, such as periungual exfoliation (77.4%), absent or ragged cuticle (52.8%), hyponychial hyperkeratosis (37.7%), and paronychia (15.1%).

Conclusions

Although onychophagia is a common disorder, its clinical characteristics have not been reported in the literature. The results of this study may be helpful in managing patients with onychophagia.
Evaluation of antioxidant activity of olive leaf extract obtained by ultrasound‐assisted extraction and their antimicrobial activity against bacterial pathogens from food
Authors: Giacometti Jasminka , Milovanović Sanja , Jurc\̌ić Momc\̌ilović Diana , Bubonja‐S\̌onje Marina
Published: August 2021

The aim of the present study was to evaluate and compare the phenolic content and antioxidant and antimicrobial properties of olive leaf extracts obtained by ultrasound‐assisted extraction (UAE) and conventional extraction (CSE). UAE of olive leaf extracts yielded a higher total phenolic content (TPC) and total flavonoid content (TFC) of 14.31% and 19.50%, respectively. Higher antioxidant activities were found from the extracts prepared with UAE (for 18.5%, 12.5%, 10.9% and 17.6% higher determined by DPPH, ABTS, FRAP and CUPRAC methods, respectively). Good antibacterial inhibitory activity (as MIC and MBC) was observed against both Y. enterocolitica and S. aureus (1.40 ± 0.40 mg mL−1 and 4.00 ± 1.60 mg mL−1, respectively) with the extract prepared with UAE. In conclusion, olive leaf extracts prepared with UAE exhibited higher antioxidant and antimicrobial activities against common food‐borne pathogens than CSE extracts and thus could be beneficial in ensuring food quality and food safety.
Integrating training and performance management of civil aviation inspectors: A pilot study of the mediating role of competency‐based training
Authors: Vaskova Kjulavkovska Maja , Serafini Giovanni Oscar , Szamosi Leslie Thomas
Published: August 2021

Competency‐based training (CBT) is gaining popularity as an approach towards creating a highly skilled workforce while reducing the skill gaps faced by industry. Integrated within an organisation's management systems, it can lead to benefits such as increased productivity and strengthened employee engagement. While CBT of aviation industry personnel is well‐researched, CBT of civil aviation inspectors is surprisingly under‐researched. To better understand the role that CBT plays as a link between organisational training and performance management, a pilot study was carried out involving eleven European Civil Aviation Authorities (CAAs) to establish the feasibility of conducting a larger‐scale study. This research examines CBT elements which were then benchmarked against the Framework for integrating training and performance management systems of CAAs through CBT. The results indicate that the elements of CBT applied by CAAs in Europe are generally consistent; however, not all the recommended elements are included and applied harmoniously, leading to inconsistencies in implementing the approach. Implications of the study for training and performance management, as well as for future research, are identified.
Patients living ≥25 years with a non‐continent urinary diversion: What can we learn?
Authors: Cobussen‐Boekhorst Hanny J. G. L. , Janssen Vera A. C. T. , Smits‐van de Camp Anita , Aarts Marloes , Verberk Maartje M. W. , Martens Frank M. J. , Feitz Wout F. J. , Heesakkers John P. F. A.
Published: August 2021

How is quality of life (QoL) experienced in patients living with a non‐continent urinary diversion (NCUD) for more than 25 years. The NCUD still is important in patients who suffer from congenital anomaly, urinary malignancy, end‐stage functional voiding or storage disorders. Various complications can occur having a NCUD and can influence psychological and social well‐being. In literature the importance of ostomy self‐care is described. Limited information is available about living ≥25 years with a NCUD. A mixed‐method (quantitative and qualitative) was used. Twenty‐one patients, who were using NCUD appliances were selected, from a cohort of 43. Data was collected using a validated questionnaire supplemented with some questions. Additionally, semi‐structured narrative‐based interviews were conducted. Informed consent was obtained. Questionnaire response was 71% (n = 15). One was invalid. Ratio female/male was equal. Mean age 62 (range 42–83) years. Mean time living with a NCUD 40 (range 25–56) years. Although results per question vary, a mean score of 63 for QoL was experienced. Eleven patients had a good QoL (mean 66). There were no differences between gender and for the age‐groups. Five patients were interviewed. Characteristics were comparable with the quantitative group. The results of the mixed method study strengthened each other and are consistent with the (limited) results described in literature. The QoL is generally experienced as good. The QoL is not so much influenced by the NCUD itself, but by the underlying disease and/or complications of the NCUD. During the first years information and guidance is important to secure good QoL. The guidance patients receive nowadays is generally experienced as very good in our group, however it remains important to discuss sexuality, involve partners, caregivers and the help of peers. Multi‐center studies and prospective follow‐up regarding QoL might give more insight in the QoL over the years.
Reproduction in the spider crab Maiopsis panamensis (Decapoda: Majoidea) in the Gulf of California
Authors: Rodríguez‐Jaramillo Carmen , López‐Martínez Juana , Herrera‐Valdivia Eloísa , Rábago‐Quiroz Carlos H.
Published: August 2021

The spider crab Maiopsis panamensis is the largest brachyuran crab in the Gulf of California and is found mainly in deep water. This study of the spider crab reproductive cycle in Mexican coastal waters used histological and chemical methods to describe oogenesis in detail and to define a scale of maturity based on visible characteristics for the different stages of gonial cells. The criteria used in the description of oogenesis were oocyte diameter, nucleus morphology, ooplasm characteristics, and degree of yolk accumulation, as well as lipid, protein, and carbohydrate content. These results showed that maturation and spawning are continuous in this species during most of the year, with small variations in the proportion of ovigerous females. The lowest frequency of mature females was found in spring (March to May) and summer (June to August). The organisms migrate to greater depths in the second half of the year. Maiopsis panamensis was found to have high reproductive potential because each female can produce multiple generations of oocytes in the ovaries while carrying the ovigerous mass. These characteristics mean that females spawn and hatch larvae numerous times throughout the year. Studies on the biology of this spider crab combined with study of techniques for catching them would allow informative strategies towards the sustainable use of this species in the Mexican Pacific Ocean and the Gulf of California.
Nurses' experience of handoffs on four Canadian medical and surgical units: A shared accountability for knowing and safeguarding the patient
Authors: Lavoie Patrick , Clausen Christina , Purden Margaret , Emed Jessica , Frunchak Valerie , Clarke Sean P.
Published: August 2021

Aims

To explore nurses' experience and describe how they manage various contextual factors affecting the nurse‐to‐nurse handoff at change of shift.

Design

Qualitative descriptive study.

Methods

A convenience sample of 51 nurses from four medical and surgical care units at a university‐affiliated hospital in Montreal, Canada, participated in one of the 19 focus group interviews from November 2017 to January 2018. Data were analysed through a continuous and iterative process of thematic analysis.

Results

Analysis of the data generated a core theme of ‘sharing accountability for knowing and safeguarding the patient’ that is achieved through actions related to nurses' role in the exchange. Specifically, the outgoing nurse takes actions to ensure continuity of care when letting go, and the incoming nurse takes actions to provide seamless care when taking over. In both roles, nurses navigate each handoff juncture by mutually adjusting, ensuring attentiveness, managing judgements, keeping on track, and venting and debriefing. Handoff is also shaped by contextual conditions related to handoff norms and practices, the nursing environment, individual nurse attributes and patient characteristics.

Conclusions

This study generated a conceptualization of nurses' roles and experience that details the relationship among the elements and conditions that shape nurse‐to‐nurse handoffs.

Impact

Nursing handoff involves the communication of patient information and relational behaviours that support the exchange. Although many factors are known to influence handoffs, little was known about nurses' experience of dealing with these at the point of care. This study contributed a comprehensive conceptualization of nursing handoff that could be useful in identifying areas for quality improvement and guiding future educational efforts.
The effort investment theory of power
Authors: Schmid Petra C.
Published: August 2021

The powerful are often more successful in pursuing their goals, as shown in many studies. Does this mean that the powerful try harder? Current theories on power do not provide a clear answer to this question. Based on recent findings in the power literature and integrating theories from motivation psychology and neuroscience, the present paper presents the effort investment theory of power. The effort investment theory proposes that power determines the investment of effort following a resource conservation principle; that is, power affects people’s evaluation of a goal in terms of its importance and feasibility, and based on their evaluation, they mobilize effort. Importantly, the theory also considers a time perspective. It highlights the role of experiences during the process of pursuing a goal (i.e., facing signals of success and failure) as well as previous experiences (i.e., performing a different task/goal before) in the power effect on effort investment, and argues that such experiences affect individuals’ judgments of importance and feasibility. Finally, the theory discusses possible consequences of the power effect on effort investment for performance and efficiency. The relevance of these propositions for theory and practice are discussed, as well as ideas for future research.
Increased airway epithelial cell–derived exosomes activate macrophage‐mediated allergic inflammation via CD100 shedding
Authors: Yu Yi , Zhou Yao , Di Caixia , Zhao Caiqi , Chen Jie , Su Wen , Wu Qun , Wu Min , Su Xiao , Xia Zhenwei
Published: August 2021

Airway epithelial cells (AECs) participate in allergic airway inflammation by producing mediators in response to allergen stimulation. Whether ovalbumin (OVA) challenge promotes exosome release from AECs (OVA‐challenged AEC‐derived exosomes (OAEs)), thereby affecting airway inflammation, as well as the underlying mechanisms, is unknown. Our study showed that AECs released an increased number of exosomes after OVA challenge, and the expression of Plexin B2 (PLXNB2; a natural CD100 ligand) was increased by a massive 85.7‐fold in OAEs than in PBS‐treated AEC‐derived exosomes (PAEs). CD100+F4/80+ macrophages engulfed OAEs to trigger the transcription of pro‐inflammatory chemokines and cytokines. Plxnb2 transcripts increased in asthmatic lungs, and similarly, PLXNB2 protein was highly enriched in exosomes purified from asthmatic bronchoalveolar lavage (BAL) fluid. Furthermore, aspiration of PLXNB2 or OAEs increased the recruitment of lung neutrophils, monocytes, eosinophils and dendritic cells in OVA‐challenged mice. Mechanistically, OAE aspiration enhanced the cleavage of CD100 by MMP14, which manifested as an increase in the soluble CD100 (sCD100) level in BAL fluid and lung homogenates. Knockdown of Mmp14 in macrophages prevented the cleavage of CD100 and reduced Ccl2, Ccl5 and Cxcl2 transcription. These data indicate that PLXNB2‐containing OAEs aggravate airway asthmatic inflammation via cleavage of CD100 by MMP14, suggesting potential therapeutic targets of OAE‐mediated asthma exacerbations.
Cannabinoid receptor 2 plays a central role in renal tubular mitochondrial dysfunction and kidney ageing
Authors: Zhou Shan , Ling Xian , Meng Ping , Liang Ye , Shen Kunyu , Wu Qinyu , Zhang Yunfang , Chen Qiyan , Chen Shuangqin , Liu Youhua , Zhou Lili
Published: August 2021

Kidney is one of the most important organs in maintaining the normal life activities. With the high abundance of mitochondria, renal tubular cell plays the vital role in functioning in the reabsorption and secretion of kidney. Reports have shown that mitochondrial dysfunction is of great importance to renal tubular cell senescence and subsequent kidney ageing. However, the underlying mechanisms are not elucidated. Cannabinoid receptor 2 is one of the two receptors responsible for the activation of endocannabinoid system. CB2 is primarily upregulated in renal tubular cells in chronic kidney diseases and mediates fibrogenesis. However, the role of CB2 in tubular mitochondrial dysfunction and kidney ageing has not been clarified. In this study, we found that CB2 was upregulated in kidneys in 24‐month‐old mice and d‐galactose (d‐gal)‐induced accelerated ageing mice, accompanied by the decrease in mitochondrial mass. Furthermore, gene deletion of CB2 in d‐gal‐treated mice could greatly inhibit the activation of β‐catenin signalling and restore the mitochondrial integrity and Adenosine triphosphate (ATP) production. In CB2 knockout mice, renal tubular cell senescence and kidney fibrosis were also significantly inhibited. CB2 overexpression or activation by the agonist AM1241 could sufficiently induce the decrease in PGC‐1α and a variety of mitochondria‐related proteins and trigger cellular senescence in cultured human renal proximal tubular cells. CB2‐activated mitochondrial dysfunction and cellular senescence could be blocked by ICG‐001, a blocker for β‐catenin signalling. These results show CB2 plays a central role in renal tubular mitochondrial dysfunction and kidney ageing. The intrinsic mechanism may be related to its activation in β‐catenin signalling.
Clinicopathological characteristics and treatment outcomes of fibrosing alopecia in a pattern distribution: A retrospective cohort study
Authors: Jerjen R. , Pinczewski J. , Sinclair R. , Bhoyrul B.
Published: August 2021

Background

Fibrosing alopecia in a pattern distribution (FAPD) is a primary cicatricial alopecia considered a subtype of lichen planopilaris (LPP).

Objective

The clinical and histopathological features, and treatment response of 24 female patients with FAPD were evaluated.

Methods

Demographic, clinical, histopathological and treatment data of patients with FAPD were retrospectively collected.

Results

Twenty‐four women were included (mean age 60.7 years). The mean Lichen Planopilaris Activity Index score was 1.50, and the median Sinclair grade was 3. Twelve patients had diffuse alopecia in the centroparietal region, four had frontal accentuation and eight had vertex accentuation of hair loss. Eight had associated loss of facial hair. Predominant trichoscopic features included hair shaft diameter variability (100%), perifollicular erythema and/or scaling (95%) and loss of follicular ostia (95%). Histopathological examination revealed features of scarring alopecia with interface changes in follicular epithelia mainly targeting terminal and intermediate hairs, and less frequently, vellus hairs. Treatment with hair growth‐promoting, anti‐inflammatory and anti‐androgen agents arrested disease progression in 14 patients and resulted in hair regrowth in two patients. Six patients had progression of their hair loss in spite of treatment.

Limitations

Referral bias to a specialist hair clinic, retrospective design and small sample size.

Conclusions

We present clinicopathological features of FAPD which can aid in the diagnosis of this insidious scarring alopecia. Our findings suggest a more favourable outcome if treatment is initiated in early stages of the disease.
New perspectives on the role of the neurosteroid pregnenolone as an endogenous regulator of type‐1 cannabinoid receptor (CB1R) activity and function
Authors: Raux Pierre‐Louis , Drutel Guillaume , Revest Jean‐Michel , Vallée Monique
Published: August 2021

Pregnenolone is a steroid with specific characteristics, being the first steroid to be synthesised from cholesterol at all sites of steroidogenesis, including the brain. For many years, pregnenolone was defined as an inactive precursor of all steroids because no specific target had been discovered. However, over the last decade, it has become a steroid of interest because it has been recognised as being a biomarker for brain‐related disorders through the development of metabolomic approaches and advanced analytical methods. In addition, physiological roles for pregnenolone emerged when specific targets were discovered. In this review, we highlight the discovery of the selective interaction of pregnenolone with the type‐1 cannabinoid receptor (CB1R). After describing the specific characteristic of CB1Rs, we discuss the newly discovered mechanisms of their regulation by pregnenolone. In particular, we describe the action of pregnenolone as a negative allosteric modulator and a specific signalling inhibitor of the CB1R. These particular characteristics of pregnenolone provide a great strategic opportunity for therapeutic development in CB1‐related disorders. Finally, we outline new perspectives using innovative genetic tools for the discovery of original regulatory mechanisms of pregnenolone on CB1‐related functions.
Continuous clinical improvement of mild‐to‐moderate seborrheic dermatitis and rebalancing of the scalp microbiome using a selenium disulfide–based shampoo after an initial treatment with ketoconazole
Authors: Massiot Philippe , Clavaud Cécile , Thomas Marie , Ott Alban , Guéniche Audrey , Panhard Ségolène , Muller Benoît , Michelin Céline , Kerob Delphine , Bouloc Anne , Reygagne Pascal
Published: August 2021

Objective

Scalp seborrheic dermatitis (SD) is a chronic, relapsing, and inflammatory scalp disease. Studies indicate a global bacterial and fungal microbiota shift of scalp SD, as compared to healthy scalp. Ketoconazole and selenium disulfide (SeS2) improve clinical signs and symptoms in both scalp dandruff and SD.

Aim

The main objective of this study was to investigate the changes in the scalp microbiota diversity and counts in subjects with scalp SD during a two‐phase treatment period.

Material and methods

The scalp microbiota and clinical efficacy were investigated in 68 subjects with mild‐to‐moderate scalp SD after an initial one‐month treatment with 2% ketoconazole, and after a 2‐month maintenance phase, either with a 1% SeS2‐based shampoo or its vehicle.

Results

Thirty one subjects in the active and 37 subjects in the vehicle group participated. Ketoconazole provided an improvement of clinical symptoms (adherent (−1.75 p < 0.05), non‐adherent (−1.5, p < 0.05)) flakes and erythema (scores 1.67–0.93, p < 0.001), in an increased fungal diversity and in a significant (p < 0.005) decrease of Malassezia spp. SeS2 provided an additional clinical improvement (−0.8; p = 0.0002 and −0.7; p = 0.0081 for adherent and non‐adherent flakes, respectively, at Day 84) compared to the vehicle associated with a low Malassezia spp. count and an additional significant (p < 0.001) decrease of the Staphylococcus spp. level.

Conclusion

Selenium disulfide provides an additional benefit on the scalp microbiota and in clinical symptoms of SD and dandruff after treatment with ketoconazole. The results confirm the role of Staphylococcus spp. in scalp SD and open possible perspectives for preventing relapses.
Treatment of Axillary hyperhidrosis
Authors: Arora Gulhima , Kassir Martin , Patil Anant , Sadeghi Payam , Gold Michael H. , Adatto Maurice , Grabbe Stephan , Goldust Mohamad
Published: August 2021

Background

Axillary hyperhidrosis characterized by excessive sweating in the axillary regions is a frustrating chronic autonomic disorder leading to social embarrassment, impaired quality of life and usually associated with palmoplantar hyperhidrosis. Identifying the condition and its cause is central to the management.

Aim

The aim of this article is to discuss treatment options for axillary hyperhidrosis.

Methods

Comprehensive literature search using PubMed and Google Scholar was performed to review relevant published articles related to diagnosis and treatment of axillary hyperhidrosis.

Results

Treatment modalities for axillary hyperhydrosis vary from topical and systemic agents to injectables, newer devices and surgical measures. None except for physical measures using devices or surgery, which destroys the sweat glands to remove them, is possibly permanent and most are associated with attendant side effects.

Conclusion

Several treatments including medical and surgical option are available for the treatment of axillary hyperhydrosis. Patient education is important component of its management. Individualized approach of management is necessary for optimal outcome of treatment.
Effect of estrogen in malignant melanoma
Authors: Bhari Neetu , Schwaertz Robert A. , Apalla Zoe , Salerni Gabriel , Akay Bengu Nisa , Patil Anant , Grabbe Stephan , Goldust Mohamad
Published: August 2021

Background

Melanoma is associated with poor prognosis in its advanced stages. Potential influence of estrogen and its metabolites on melanoma growth has been suggested.

Aims

The objective of this review was to provide an overview on the evidence related to estrogen in malignant melanoma.

Materials and Methods

Literature search using PubMed, Google Scholar and relevant cross‐references of the retrieved articles was performed to review relevant published articles related to estrogen and its effects in malignant melanoma.

Results

Effect of estrogen signaling on a tissue largely depends on the relative expression of estrogen receptors (ER) α and β. Gender differences in melanoma may be explained by the difference in expression of these receptors. ERβ is the principal ER in melanoma.

Discussion

Although there is uncertainty about role of estrogen in pathogenensis and progression of melanoma, evidence suggests that its growth and metastasis are influenced by estrogen stimulation. Role ER on the proliferation of melanoma cells is well described.

Conclusion

There is a need of safe and effective therapy for melanoma, especially for advanced cases. After the establishment of specific role of estrogen and its receptor, analysis of specific genetic mutation can be performed for proper utilization of targeted therapies.
TMC8 mutation in a Turkish family with epidermodysplasia verruciformis including laryngeal papilloma and recurrent skin carcinoma
Authors: Esenboga Saliha , Cagdas Deniz , Alkanat Nazli Eylem , Güler Tezel Gaye , Ersoy Evans Sibel , Boztug Kaan , Tezcan Ilhan
Published: August 2021

The vast majority of primary immunodeficiencies (PIDs) occur due to the defects in cells originating from hematopoietic stem cells, while in some PIDs, there are defects in various genes responsible for non‐leucocyte immune response such as seen in epidermodysplasia verruciformis (EV). EV caused by the mutations in TMC6, TMC8, and CIB1 genes is called “typical.” “Atypical” EV may develop in patients with primary immunodeficiencies originating from hematopoietic stem cells, which include severe T‐cell failure, caused by inactivating biallelic mutations of STK4, RHOH, CORO1A, ITK, TPP2, DCLRE1C, LCK, RASGRP1, or DOCK8 genes. Here, we present a family with TMC8 gene mutation leading to disseminated epidermodysplasia verruciformis including laryngeal papilloma and recurrent cutaneous squamous cell carcinomas. Typical EV with impaired local, keratinocyte‐intrinsic immune response should be considered when routine immunological examinations are normal in patients presenting with clinical signs of EV. Although it is not possible to prevent EV lesions, early and appropriate surveillance for malignancy is mandatory.
Bridging Caste Divides: Middle‐Status Ambivalence, Elite Closure, and Lower‐Status Social Withdrawal
Authors: Bhardwaj Arjun , Mishra Sushanta Kumar , Qureshi Israr , Kumar Kunal Kamal , Konrad Alison M. , Seidel Marc‐David L. , Bhatt Babita
Published: August 2021

Network theory and research have identified the powerful dynamic of homophily whereby individuals are more likely to connect with similar rather than dissimilar others. However, less is known about when individuals might connect with dissimilar others to enhance organizational diversity benefits and mitigate social exclusion. This study builds upon prior evidence linking homophily to both elite group closure and lower‐status self‐segregating social withdrawal to propose a new dynamic of middle‐status ambivalence toward homophily, generating a greater propensity toward diversity. Indian society offers a unique context of a legally codified, stable, three‐tiered status hierarchy to test the idea that middle‐status individuals will develop the most diverse networks. Using a unique longitudinal friendship network dataset, we find empirical support for our prediction, a novel contribution extending classic homophily theory. In addition, due to potent status dynamics we theorize and find that lowest‐status group members initiate more ties over time but also exhibit lower tie stability and greater losses of early ties than higher‐status group members, resulting in the appearance of lowest‐status group homophilous withdrawal. Overall, we advance homophily theory and offer practical suggestions for organizations seeking to enhance social ties across diversity and improve the effectiveness of social inclusion policies.