bluuebunny/crossref_metadata_2025 huggingface dataset:
Inbreeding and research collaborations in Portuguese higher education
Authors: Tavares Orlanda , Sin Cristina , Sá Carla , Bugla Sylwia , Amaral Alberto
Published: January 2021

The aim of this paper is to analyse the relationship between academic inbreeding in Portugal and research collaboration, using co‐authored publications as proxies. As previous research has shown that inbreeding is detrimental for research collaborations, it is hypothesised that academic inbreeding will lead to smaller research networks and, consequently, to fewer co‐authored publications outside the institution of affiliation. Relying on a large data set which merged information on academics, their inbreeding status and their publications, binomial negative and fractional models were estimated to test the hypothesis. Findings show that inbred academics have smaller research networks; while they publish most co‐authored papers, the relative weight of publications written in collaboration with institutional colleagues is the highest. In contrast, non‐inbred academics with foreign PhDs have larger co‐authorship networks. However, they publish most single‐authored papers and the weight of their international co‐authorships is heaviest.

Abstrato

Este artigo pretende analisar a relação entre a endogamia académica e a colaboração na investigação, partindo das publicações em coautoria. Dado que alguns estudos mostraram que a endogamia é prejudicial para as colaborações na investigação, a hipótese deste artigo é a de que a endogamia académica está associada a redes de investigação mais pequenas e a menos publicações em coautoria fora da instituição de afiliação. Recorrendo a uma base de dados que combina informação sobre académicos, o seu estatuto de endogamia e as suas publicações, foram estimados modelos binomiais negativos e fracionários para testar a hipótese. Os resultados mostram que os académicos endogâmicos têm redes de investigação menores; embora publiquem a maioria dos artigos em coautoria, o peso relativo das publicações escritas em colaboração com colegas institucionais é superior. Em contraste, os académicos não‐endogâmicos, com doutoramentos obtidos no estrangeiro, têm redes de coautoria maiores. No entanto, são também estes que mais publicam artigos sozinhos e o peso das suas coautorias internacionais é superior.
Loss of ARID1B and SMARCB1 expression are specific for the diagnosis of dedifferentiated/undifferentiated carcinoma in tumours of the upper gynaecological tract and cervix
Authors: Kang Eun‐Young , Tessier‐Cloutier Basile , Duggan Máire A , Stewart Colin J R , Lee Cheng‐Han , Köbel Martin
Published: January 2021

Aims

Genomic inactivation of ARID1B in ARID1A‐inactivated tumour and genomic inactivation of SMARCB1 represent two recurrent mechanisms, core SWItch/sucrose non‐fermentable (SWI/SNF) complex inactivation, that are associated with de‐differentiation in endometrial carcinoma. Approximately one‐third of dedifferentiated/undifferentiated endometrial carcinomas (DDEC/UEC) show loss of ARID1B expression with a minor subset showing loss of SMARCB1 expression, but little is known regarding the specificity of ARID1B or SMARCB1 loss in gynaecological tract tumours in general. The aim of this study was to examine the frequency of ARID1B and SMARCB1 loss by immunohistochemistry in a series of gynaecological tract epithelial/mesenchymal neoplasms.

Methods and results

We evaluated 1849 tumours that included 748 endometrial carcinomas, 101 uterine carcinosarcomas/adenosarcomas, 64 uterine sarcomas, 221 cervical carcinomas and 715 ovarian carcinomas/borderline tumours by tissue microarrays (TMA). We observed ARID1B loss in 35 of 86 (41%) and SMARCB1 loss in three of 86 (3%) DDEC/UEC, but not in any other uterine tumour types examined. ARID1B‐deficient DDEC/UEC also showed concurrent loss of ARID1A expression. All SMARCB1‐deficient tumours showed loss of MLH1 and PMS2, while 29 of 35 ARID1B‐deficient tumours showed loss of MLH1 and PMS2 or loss of MSH6. All ovarian carcinomas/borderline tumours and cervical carcinomas showed intact expression of ARID1B and SMARCB1.

Conclusion

Our findings indicate that the loss of expression of ARID1B or SMARCB1 by immunohistochemistry is highly specific for undifferentiated carcinoma among tumours of the upper gynaecological tract and cervix, and therefore can be used to identify these highly aggressive malignant tumours.
Molecular markers of telomere dysfunction and senescence are common findings in the usual interstitial pneumonia pattern of lung fibrosis
Authors: Lee Joyce S , La Janet , Aziz Sara , Dobrinskikh Evgenia , Brownell Robert , Jones Kirk D , Achtar‐Zadeh Natalia , Green Gary , Elicker Brett M , Golden Jeffrey A , Matthay Michael A , Kukreja Jasleen , Schwartz David A , Wolters Paul J
Published: January 2021

Aims

Idiopathic pulmonary fibrosis (IPF) is a genetically mediated, age‐associated, progressive form of pulmonary fibrosis characterised pathologically by a usual interstitial pneumonia (UIP) pattern of fibrosis. The UIP pattern is also found in pulmonary fibrosis attributable to clinical diagnoses other than IPF (non‐IPF UIP), whose clinical course is similarly poor, suggesting common molecular drivers. This study investigates whether IPF and non‐IPF UIP lungs similarly express markers of telomere dysfunction and senescence.

Methods and results

To test whether patients with IPF and non‐IPF UIP share molecular drivers, lung tissues from 169 IPF patients and 57 non‐IPF UIP patients were histopathologically and molecularly compared. Histopathological changes in both IPF and non‐IPF UIP patients included temporal heterogeneity, microscopic honeycombing, fibroblast foci, and dense collagen fibrosis. Non‐IPF UIP lungs were more likely to have lymphocytic infiltration, non‐caseating granulomas, airway‐centred inflammation, or small airways disease. Telomeres were shorter in alveolar type II (AECII) cells of both IPF and non‐IPF UIP lungs than in those of age‐similar, unused donor, controls. Levels of molecular markers of senescence (p16 and p21) were elevated in lysates of IPF and non‐IPF UIP lungs. Immunostaining localised expression of these proteins to AECII cells. The mucin 5B (MUC5B) gene promoter variant minor allele frequency was similar between IPF and non‐IPF UIP patients, and MUC5B expression was similar in IPF and non‐IPF UIP lungs.

Conclusions

Molecular markers of telomere dysfunction and senescence are pathologically expressed in both IPF and non‐IPF UIP lungs. These findings suggest that common molecular drivers may contribute to the pathogenesis of UIP‐associated pulmonary fibrosis, regardless of the clinical diagnosis.
Lipopolysaccharide induces platelet activation in HIV patients: the role of different viral load patterns
Authors: Nocella Cristina , Mezzaroma Ivano , Cammisotto Vittoria , Castellani Valentina , Milito Cinzia , Rugova Alban , Frati Giacomo , Pignatelli Pasquale , Violi Francesco , Pastori Daniele , Carnevale Roberto
Published: January 2021

Objectives

This study aimed to assess whether gut‐derived lipopolysaccharide (LPS) could affect platelet function in HIV‐1 patients with residual viral load.

Methods

In 23 HIV‐1 patients on effective antiretroviral treatment, 10 treatment‐naïve HIV‐1 subjects and 20 healthy subjects (HS), LPS, zonulin, markers of platelet activation and oxidative stress were evaluated. In vitro, platelets from HS were exposed to plasma from HIV‐1‐infected treated and untreated patients.

Results

Compared with HS, LPS was higher in treated and treatment‐naïve subjects with HIV‐1 (7.7 ± 2.9, 80.9 ± 13.7 and 75.3 ± 22.6 pg/mL, P < 0.001 vs. HS) as well as serum zonulin (1.3 ± 0.5, 6.1 ± 1.5 and 5.3 ± 1.7 ng/mL, P < 0.001 vs. HS). LPS and zonulin were correlated in HIV patients (Spearman correlation coefficient (rS) = 0.73, P < 0.0001). Levels of soluble CD40 ligand (sCD40L), soluble P‐selectin (sP‐selectin) and thromboxane B2 (TxB2) were higher in HIV‐1‐treated and treatment‐naïve subjects compared with HS as well as NADPH oxidase 2 (NOX2) activation and hydrogen peroxide (H2O2) production. In vitro, sCD40L, sP‐selectin and TxB2 production, NOX2 activation and p47phox phosphorylation were higher in platelets exposed to plasma from HIV‐1 patients with different viral load compared with the exposure to plasma from HS. This effect was blunted in platelets pre‐treated with TLR4 or TLR7 inhibitors.

Conclusions

Low‐grade endotoxaemia and persistent viraemia increase platelet function with a mechanism mediated by NOX2 in patients with HIV‐1 infection.
Is there bacterial infection in the intact crowns of teeth with pulp necrosis of sickle cell anaemia patients? A case series study nested in a cohort
Authors: Costa C. P. S , Alves M. S. , Lima‐Neto L. G. , Valois E. M. , Monteiro‐Neto V. , Souza S. F. C.
Published: January 2021

Aim

To evaluate the presence of bacteria in permanent teeth with intact crowns (without caries, periodontal disease or dental trauma) in patients with sickle cell anaemia (HbSS genotype) by analysing their clinical, imaging and microbiological parameters.

Methodology

This is a case series study nested in a cohort. In the first follow‐up of this cohort study (Journal of Endodontics, 2013, 39, 177), 10 HbSS patients with at least one tooth with an intact crown and clinically diagnosed with pulp necrosis by pulse oximetry adapted for dentistry and a cold pulp sensitivity test (n = 27 teeth) were selected. Changes in the pulp chamber, root and periodontal ligament were identified in the tomographic analysis. Bacterial culture, staining for live and dead bacteria, and real‐time polymerase chain reaction with 16S rRNA primers were used to identify the presence of bacteria. Culture sample collection was performed immediately after access to the pulp chamber. The microbiome was analysed with a MiSeq sequencer (Illumina, San Diego, CA).

Results

The diagnosis of pulp necrosis was confirmed clinically in 82% (22/27) of the teeth. The amount of bacterial load identified was less than 100 copies μL−1 in 23% (5/22) of the teeth with intact crowns and pulp necrosis. Thirteen bacterial species were identified that are commonly found in urinary tract infections, septicaemia and infective endocarditis. Only one of these species, Granulicatella adjacens, has also be found in primary endodontic infections.

Conclusion

Prospective clinical, imaging and microbiological analyses suggest that pulp necrosis of teeth with intact crowns in HbSS patients is not associated with the presence of bacteria.
Acne vulgaris: role of the immune system
Authors: Bernales Salinas Andrea
Published: January 2021

Acne vulgaris is a worldwide condition that has a complex pathophysiology. The knowledge of this pathology is clear in its four classic principles based on the pilosebaceous unit; there exists hyperkeratinization of its duct, increase of sebum production, anaerobic bacterias, and inflammatory response. However, new findings have explained the relationship that occurs inside the acne lesion. The immune system has a key role since it is stimulated by the other participants involved, such as phylotypes of Propionibacterium acnes (P. acnes), antimicrobial peptides (AMPs), sebaceous glands (SGs), matrix metalloproteinases (MMPs), and other immune system pathways.
The Re(production) of Restless Bodies: Freedom of Movement and Social Reproduction
Authors: Apostolova Raia
Published: January 2021

The article develops the notion of restless bodies to explore the interaction between regimes of social reproduction and freedom of movement. The notion captures the methodological difficulty to account for ‘return migration’ and goes beyond the isolation of a singular migration determinant. The author relies on two empirical cases. The first draws on one hundred interviews with ‘return migrants’ in Bulgaria. The second is based on fieldwork conducted between 2013 and 2015 in Germany. Both show how the political economy of movement is characterised by a contradiction between fixity and motion in the context of capital accumulation and fading welfare state. The concerns at hand are raised both because of their methodological importance but also as a potential instrument that could supplement ongoing policy debates in the field of EU social security portability coordination.
Fatty acid potassium improves human dermal fibroblast viability and cytotoxicity, accelerating human epidermal keratinocyte wound healing in vitro and in human chronic wounds
Authors: Masunaga Akihiro , Kawahara Takayoshi , Morita Hayato , Nakazawa Kohji , Tokunaga Yuto , Akita Sadanori
Published: January 2021

Effective cleaning of a wound promotes wound healing and favours wound care as it can prevent and control biofilms. The presence of biofilm is associated with prolonged wound healing, increased wound propensity to infection, and delayed wound closure. Anionic potassium salts of fatty acids are tested with commonly used anionic surfactants, such as sodium laureth sulphate (SLES) and sodium lauryl sulphate/sodium dodecyl sulphate (SLS/SDS). The normal human dermal cells demonstrated significantly greater viability in fatty acid potassium, including caprylic acid (C8), capric acid (C10), lauric acid (C12), oleic acid (C18:1), and linoleic acid (C18:2), than in SLES or SLS after a 24‐hour incubation. Cytotoxicity by LDH assay in a 5‐minute culture in fatty acid potassium was significantly lower than in SLES or SLS. in vitro wound healing of human epidermal keratinocytes during the scratch assay in 24‐hour culture was more significantly improved by fatty acid treatment than by SLES or SLS/SDS. In a live/dead assay of human epidermal keratinocytes, C8K and C18:1K demonstrated only green fluorescence, indicating live cells, whereas synthetic surfactants, SLES and SLS, demonstrated red fluorescence on staining with propidium iodide, indicating dead cells after SLES and SLS/SDS treatment. Potassium salts of fatty acids are useful wound cleaning detergents that do not interfere with wound healing, as observed in the scratch assay using human epidermal keratinocytes. As potassium salts of fatty acids are major components of natural soap, which are produced by natural oil and caustic potash using a saponification method, this may be clinically important in wound and peri‐wound skin cleaning. In human chronic wounds, natural soap containing fatty acid potassium increased tissue blood flow based on laser speckle flowgraphs after 2 weeks (P < .05), in addition to removing the eschars and debris. Wound cleansing by natural soap of fatty acid potassium is beneficial for wound healing.
Assessment of Arequipa's Hydrometeorological Monitoring Infrastructure to Support Water Management Decisions
Authors: de Lima Moraes André Geraldo , Bocardo‐Delgado Edwin , Bowling Laura C. , Daneshvar Fariborz , Pinto José , Watkins Alec Hale , Cherkauer Keith Aric
Published: January 2021

Hydrometeorological monitoring of weather, streamflow, and water quality is essential for understanding available water resources, protecting populations from hazard, and identifying changes in environmental conditions over time. To meet such competing goals, monitoring networks require representative parameters, uniform sampling protocols, and stable locations, selected to reliably measure the phenomenon of interest. However, budgets are always limited, and immediate operational needs and short‐term decisions often influence monitoring decisions. Here, the hydrometeorological monitoring systems in Arequipa, Peru, are examined with respect to established criteria for their ability to support these competing goals. The Arequipa Department in Peru has a well‐established, stable, weather monitoring program, although reliance on manual observers results in variable data quality. The lack of observations in high altitude areas limits estimation of water availability, and high temporal resolution, automatic stations are needed to improve flash flood warnings. The streamflow monitoring system is designed to quantify water transfers throughout this heavily managed system. Twenty‐one discharge monitoring stations were identified to serve as Historic Hydrologic Reference Stations, but many were only operational in the 1960s and 1970s and cannot be used to evaluate environmental trends. Twelve stations are identified that should be maintained for establishment of a future reference network. State sponsored water quality monitoring in the Department is fairly new, and a stratified sampling method has been used to maximize sample locations. Uniform sampling in fewer locations along intermediate sized tributaries, at least two times per year, would improve the reliability of the system and allow better detection of change over time.
Beyond the Tower of Babel: A Nomenclature for Suicidology
Authors: O'Carroll Patrick W. , Berman Alan L. , Maris Ronald W. , Moscicki Eve K. , Tanney Bryan L. , Silverman Morton M.
Published: January 2021

Suicidology finds itself confused and stagnated for lack of a standard nomenclature. This paper proposes a nomenclature for suicide‐related behavior in the hope of improving the clarity and precision of communications, advancing suicidological research and knowledge, and improving the efficacy of clinical interventions.
Plant growth rate after, and not during, waterlogging better correlates to yield responses in wheat and barley
Authors: Ciancio Nicolás , Miralles Daniel J. , Striker Gustavo G. , Abeledo Leonor G.
Published: January 2021

Waterlogging is a stress that affects wheat (Triticum aestivum L.) and barley (Hordeum vulgare L. ssp. distichum) yield. This work aimed at analysing the impact of a waterlogging event during pre‐anthesis (critical period) on yield, its numerical components and their relationships with plant growth rate in wheat and barley. Two pot experiments were carried out under contrasting environmental conditions (early and late sowing date), in which six wheat and six barley cultivars were exposed to control and waterlogging conditions imposed c. 18 days prior to anthesis. Measurements included total above‐ground biomass at the beginning and at the end of the waterlogging treatment and at maturity, when grain yield and its numerical components were also measured. Wheat showed higher yield losses (−76%) due to waterlogging than barley (−49%). Grain yield was explained by both numerical components (the number of grains per plant and grain weight), which better correlated with the relative growth rate of plants during the post‐stress recovery than during the waterlogging period. Plant growth during the recovery period should be targeted as a key factor to estimate yield losses from waterlogging in these cereals.
Hydrostatic‐pressure‐induced depolarization of (Pb1‐1.5xLax)(Zr0.80Ti0.20)O3 ferroelectric ceramics
Authors: Xie Meng , Bao Yizheng , Li Song , Nie Hengchang , Wang Genshui , Dong Xianlin
Published: January 2021

Pulse power energy conversion materials with ultrafast discharge processes and ultrahigh power densities have been widely used in the defense, energy, medical, and mining fields. The pressure‐driven depolarization in ferroelectric materials is significant and accounts for the discharge processes. In this study, we focus on pressure‐induced depolarization in (Pb1‐1.5xLax)(Zr0.80Ti0.20)O3 (PLZT) (x = 0‐0.07) ceramics, and their corresponding phase structure, dielectric properties, ferroelectric properties, and thermal depolarization performances. Although a satisfactory pulse power energy conversion performance has been achieved in Pb(Zr0.95Ti0.05)O3 materials, poor temperature stability negatively influences their application. The static charge densities of PLZT (x = 0.04, 0.06) decreased from 29.11 μC/cm2 and 31.53 μC/cm2 to 19.76 μC/cm2 and 6.56 μC/cm2 under 400 MPa hydrostatic pressure, respectively, which is attributed to a pressure‐driven ferroelectric‐antiferroelectric phase structural transition. In particular, the temperature stability of PLZT (x = 0.06) materials is up to 87°C. This study may guide the further development pulse power energy conversion devices.
Qualified Satisfaction: First‐Year Architecture Student Perceptions of Teamwork
Authors: Thompson James , Teba Tarek , Braglia Roberto
Published: January 2021

Across disciplines, skills associated with collaboration are now ubiquitously considered requisite graduate attributes. Despite decades of studies on the various dimensions of academic teamwork, challenges for both students and staff remain. For this year‐long study at a UK school of architecture, we considered teamwork as a thread woven through the first‐year curriculum, traversing course modules and project types. The primary aim of the study was to evaluate the collective impact of teamwork activities on the incoming cohort of 200+ undergraduate students and how the structuring and coordination of such activities might improve the holistic student experience. Across two rounds of online questionnaires and focus group sessions, student participants articulated the benefits of collaboration for learning, socialisation and professional development. However, resentment towards teamwork increased throughout the year, as frustration with disengaged cohort mates grew, and student sought greater structure and oversight from tutors. On the other hand, when given the chance to reflect on the multidimensional nature of teamwork in focus group discussions, many students adopted a productively nuanced perspective toward the topic. This implies that, whether students like or dislike certain aspect of collaborative projects, opportunities for critical conversation can promote or prompt an appreciation for the educational value of including teamwork projects in curricula. The results of this study should be relevant to educators seeking to improve the implementation and effectiveness of team‐based learning, particularly those in design‐based fields and those in higher and professional education contexts.
A model of culturally‐informed integrated diabetes education and eye screening in indigenous primary care services and specialist diabetes clinics: Study protocol
Authors: Atkinson‐Briggs Sharon , Jenkins Alicia , Keech Anthony , Ryan Christopher , Brazionis Laima ,   the Centre of Research Excellence in Diabetic Retinopathy Study Group
Published: January 2021

Aims

To improve diabetes management in Indigenous Australians using an integrated nurse‐led model of diabetes education and eye screening in indigenous primary care and specialist diabetes clinics.

Design

A pre–post study.

Methods

This study will be implemented in indigenous primary care and specialist diabetes clinics in Victoria, Australia. Participants recruited to the study will be existing adult patient with diagnosed diabetes attending study sites. A nurse‐credentialled diabetes educator and certified retinal imager will deliver three study components: (a) retinal photography as a diabetic retinopathy screening and patient engagement tool; (b) lifestyle and behaviour surveys, administered at baseline and at the final visit, in 12 months. Findings from the surveys and participants’ retinal images will be used to guide; and (c) personalized diabetes education. The primary outcomes are participant adherence to diabetic eye screening recommendations and health service diabetic retinopathy screening coverage. Secondary outcomes are baseline DR prevalence and changes in clinical and lifestyle risk factor levels, diabetes knowledge and satisfaction with diabetes care.

Discussion

Compared with non‐indigenous Australians, Indigenous Australians have a high prevalence of diabetic retinopathy and blindness, low adherence to eye screening recommendations and suboptimal health literacy. Nurse‐credentialled diabetes educators can be trained to incorporate retinal imaging and eye screening into their clinical practice to give image‐based diabetes education to facilitate diabetic retinopathy management.

Impact

Credentialled nurse diabetes educators who integrate eye screening and diabetes education can facilitate timelier diabetic retinopathy screening, referral pathways and treatment of sight‐threatening retinopathy. We believe that this model of integrated diabetes education and eye screening will also improve adherence to eye screening recommendations, population screening coverage, health literacy, risk factor levels and diabetes self‐care.

Clinical Trial Registration: ANZCTRN1261800120435.
A systematic review and meta‐analysis of mindfulness‐based interventions for patients with coronary heart disease
Authors: Zou Huijing , Cao Xi , Chair Sek Ying
Published: January 2021

Aims

To assess the effects of mindfulness‐based interventions for patients with coronary heart disease.

Design

A systematic review with meta‐analysis.

Data sources

Eight mainstream databases, including Ovid MEDLINE, Embase, Ovid Emcare, PsycInfo, CINAHL complete, Web of Science, CENTRAL and PubMed, were searched from January 1979–March 2020.

Review methods

Randomized controlled trials that evaluated mindfulness‐based interventions on psychological outcomes, cardiovascular risk factors and quality of life in adults with coronary heart disease were considered. We conducted meta‐analyses using the random‐effects model.

Results

Nine studies involving 644 participants were included. Compared with inactive controls (e.g. usual care), mindfulness‐based interventions significantly reduced depression (SMD −0.72, 95% CI −1.23 to −0.21, p < .01) and stress (SMD −0.67, 95% CI −1.00 to −0.34, p < .01), but not anxiety and blood pressure. There were no significant psychological effects compared with active controls (e.g. other psychological interventions). In one of three studies that assessed generic quality of life, mindfulness‐based interventions significantly improved psychological and social domains compared with active control. The intervention effects on other cardiovascular risk factors were inconclusive given that only one study assessed each outcome with non‐significant findings. Subgroup analyses suggest that intervention type and participants’ depression and anxiety status may influence intervention effects.

Conclusions

Mindfulness‐based interventions may benefit patients with coronary heart disease in reducing depression and stress, but the effects on cardiovascular risk factors and quality of life are inconclusive.

Impact

This review offers preliminary evidence for the potential of mindfulness‐based interventions as an effective complementary approach to addressing psychological distress among people with coronary heart disease. Given the limitations in current studies, further rigorously designed and well‐reported research is necessary to give robust evidence. Studies exploring the intervention effects on cardiovascular risk factors and quality of life are warranted to remedy the research and knowledge gap.
An empowerment‐based cognitive behavioural therapy for persons with mild cognitive impairment and insomnia: Protocol for a mixed‐method pilot study
Authors: Li Polly W. C. , Yu Doris S. F. , Wong Cathy W. Y.
Published: January 2021

Aim

This study aims to examine the feasibility and effects of an empowerment‐based cognitive behavioural therapy for insomnia on sleep, cognitive outcomes, and health‐related quality of life in persons with mild cognitive impairment and insomnia.

Study design

This mixed‐methods study comprises a pilot randomized controlled trial and an exploratory qualitative study.

Methods

A total of 60 community‐dwelling patients aged ≥50 years with mild cognitive impairment and self‐reported sleep complaints will be recruited from the community centres for older people operated by two non‐governmental organizations in Hong Kong. The participants will be randomly allocated to intervention or control groups, which will receive the empowerment‐based cognitive behavioural therapy for insomnia and usual care respectively. We hypothesize that the cognitive behavioural therapy for insomnia intervention featuring an empowerment‐based approach can improve sleep and cognitive function among patients with mild cognitive impairment. A subsample of 10 participants from the intervention group will be invited to take part in a qualitative interview to obtain more in‐depth comments about the feasibility and acceptability of the intervention. Ethical approval was obtained on 2 November 2020. This study is supported by the Seed Fund for Basic Research from the University of Hong Kong on 4 September 2020.

Discussion

This study will address a neglected risk factor for cognitive decline in persons with mild cognitive impairment. The theoretical integration of empowerment and cognitive model of behavioural changes may inform a wider and more successful application of cognitive behavioural therapy techniques for people with compromised cognitive ability and insomnia.

Impact

This study will also advance our knowledge on the role of sleep on persons with mild cognitive impairment and generate relevant empirical evidence to inform the care of this vulnerable cohort to affect a worldwide reduction in social, economic and healthcare burdens associated with cognitive impairment.

Clinical Trial Registration

This study has been registered at ClinicalTrials.gov (NCT04635085).
Nursing‐sensitive outcomes in adult inflammatory bowel disease: A systematic review
Authors: Spagnuolo Rocco , Corea Alessandro , Napolitano Daniele , Nisticò Eleonora , Pagnotta Raffaele , Pagliuso Caterina , Schiavoni Elisa , Turchini Laura , Fiorino Gionata , Radice Simona , Armuzzi Alessandro , Doldo Patrizia
Published: January 2021

Aims

To evaluate nursing activity through outcomes that are affected, provided, and/or influenced by nurses and defined as nursing‐sensitive outcomes in adult IBD patients.

Design

Systematic review without meta‐analysis.

Data Sources

PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library databases on August 2019.

Review Methods

Peer‐reviewed articles published between 2000–2020 were reviewed. The outcome measures were contextualized and presented by OMERACT Filter 2.0.

Results

Twenty‐four studies were included. Eighteen nursing‐sensitive outcomes were identified. These outcomes defined eight domains for health intervention, fitting into three core areas (resource use/economic impact, life impact, pathophysiological manifestations). Fifty‐three measurement instruments were identified.

Conclusions

Through 53 measurement tools, with use of OMERACT framework, 18 nursing‐sensitive outcomes in the main 3 core areas were identified, highlighting the multidimensional role of nursing. Further insights are to be carried out to define nursing outcomes included in IBD nursing intervention studies.

Impact

These results could serve as a cornerstone for further investigations and validation by a panel of experts to standardizing nursing activity in a multidisciplinary context.
Finding a balance in family caregiving for people with dementia: A correlational longitudinal study
Authors: Liu Hsin‐Yun , Hsu Wen‐Chuin , Shyu Yea‐Ing L. , Wang Yu‐Nu , Huang Tzu‐Hsin , Lin Yueh‐E , Huang Chun‐Hsia
Published: January 2021

Aims

The “Finding a Balance Point” framework was used to explore the caregiving process over time for family caregivers of people with dementia in Taiwan. This study aimed to: (a) identify Taiwanese caregivers’ different balance trajectories; (b) explore predictors of trajectory group membership; and (c) examine associations of different balance trajectories with caregiving outcomes.

Design

A correlational longitudinal design was used.

Methods

Data were collected from 200 family caregivers’ self‐completed questionnaires and they were followed over 2 years (June 2015–May 2017). Discrete balance trajectories were identified by group‐based trajectory modelling. Predictors of trajectory group membership were identified from potential predictors of caregiving characteristics and caregiving factors using multivariate logistic regression. Associations of trajectory groups with caregiving outcomes (depressive symptoms and health‐related quality of life) were explored using the generalized estimating equation.

Results

Balance trajectories best fit a two‐group trajectory model (poor and good). Caregivers with a poor sense of balance between competing needs were more likely to have more depressive symptoms (b = 11.71, 95% CI [9.04, 14.38], p < .001), worse physical health (b = −6.22, 95% CI [−8.71, −3.74], p < .001), and worse mental health (b = −11.1, 95% CI [−13.58, −8.63], p < .001) than caregivers with a good sense of balance. Caregivers experiencing lower role strain (b = −1.45, SE = 0.48, p = .003) or higher predictability (b = 2.83, SE = 0.76, p < .001) were more likely to belong to the good‐balance group.

Conclusions

Caregivers with poor balance between competing needs are more likely to have worse caregiving outcomes. Role strain and predictability significantly predicted balance trajectory groups. Family caregivers with lower caregiving task difficulty and/or better knowledge of the care receiver were more likely to be in the good balance trajectory group.

Impact

Our findings support the framework, “Finding a Balance Point,” and clarify the family caregiving process for people with dementia. This framework could be used to tailor interventions for home care nurses to improve family caregivers’ caregiving outcomes.
Ecological niche modelling and phylogeography reveal range shifts of pawpaw, a North American understorey tree
Authors: Wyatt Graham E. , Hamrick J.L. , Trapnell Dorset W.
Published: January 2021

Aim

Predictions of species' responses to accelerating global climate change require an understanding of historical range shifts. However, large‐scale phylogeographical studies of Eastern North American understorey plant taxa are relatively scarce. Here we employ ecological niche modelling and genetic analyses for inference of optimal pawpaw habitat in the past and future.

Location

In all, 26 states in the eastern United States.

Taxon

Asimina triloba (L.) Dunal (Annonaceae).

Methods

The present‐day niche of Asimina triloba was modelled in Maxent using seven bioclimatic variables, elevation and location data from field samples and herbarium specimens. To model historically optimal habitats, the present‐day model was projected onto rasters of seven bioclimatic variables and elevation representing the last glacial maximum (~22,000 years before present [YBP]) and the mid‐Holocene (~6,000 YBP). Predicted habitat suitability for 2070 was also modelled. Additionally, 62 populations were genotyped with nine nuclear microsatellite loci and statistically analysed. Levels and partitioning of genetic variation within and among populations were estimated within a geographical context.

Results

Models indicate that optimal habitat 22,000 YBP was severely restricted to mostly now‐submerged Gulf of Mexico and southeastern US coastlines. By 2070, models suggest that optimal habitat will expand substantially northward relative to the present. Species‐level genetic diversity (HE = 0.765) is high and genetic structure among populations is moderate (GST = 0.202). Structure indicates that there are two population clusters straddling the Appalachian Mountains.

Main conclusions

Models suggest that 22,000 YBP A. triloba was restricted to two major refugia in narrow bands of mostly now‐submerged habitat and possibly several small inland refugia. Molecular data are consistent suggesting that the eastern refugia expanded to give rise to the eastern cluster which is characterized by higher genetic diversity. The Gulf of Mexico refugium likely gave rise to populations in the western cluster, which is characterized by lower genetic diversity.
VT ablation in geriatric patients with structural heart disease: Should there still be an age limit?
Authors: Darma Angeliki , Bertagnolli Livio , Dinov Borislav , Torri Federica , Dagres Nikolaos , Bollmann Andreas , Hindricks Gerhard , Arya Arash
Published: January 2021

Introduction

This study sought to examine the feasibility and outcome of ablation of ventricular tachycardias (VTs) in a contemporary cohort of geriatric patients with structural heart disease (SHD).

Background

Geriatric patients are often underrepresented in large studies. As frailty is becoming an increasing problem, we need to examine the best course of action for this population.

Methods and Results

We investigated 68 SHD‐patients ≥ 75 years old undergoing VT‐ablation (men 88%, ischemic cardiomyopathy 77%, electrical storm 72%, mean left ventricular ejection fraction 31%) and divided the cohort into two groups: 75–79 years old (n = 51) and ≥80 years old (n = 17). The two groups showed similar results regarding noninducibility as ablation endpoint (p = .693), major procedure‐related complications (p = .488), and VT‐recurrence (p = .882) during the 39‐month follow‐up. At the end of the follow‐up, 10 patients in the octogenarian group (59%) versus 16 patients of the other group (31%) died.

Conclusion

Geriatric patients with SHD including octogenarians showed similar results regarding procedural endpoints, freedom of VT, and major procedure‐associated complications after VT‐ablation. When ablation is indicated, age alone should not be an inhibiting factor to treat these patients.
Reclassification of adolescent hypertension by ambulatory blood pressure monitoring using adult norms and association with left ventricular hypertrophy
Authors: Campbell Jessica Fallon , Shah Shweta , Srivaths Poyyapakkam , Acosta Alisa A.
Published: January 2021

2017 pediatric blood pressure (BP) guidelines applied adult BP norms to define clinic hypertension (HTN) in patients ≥ 13 years. 2014 pediatric ambulatory BP monitor (ABPM) guidelines recommend age‐ and sex‐specific percentile norms for patients < 18 years. The authors evaluated reclassification of HTN when applying adult ABPM norms in patients ≥ 13 years and assessed the association of left ventricular hypertrophy (LVH) with HTN. Charts of patients 13–17 years with ABPM 9/2018–5/2019 were reviewed for sex, age, height, weight, BP medication, ABPM results, and left ventricular mass index (LVMI). American Heart Association 2005 (AHA 2005), AHA 2017 (AHA 2017), and European Society of Hypertension 2018 (ESH 2018) guidelines for adult ABPM were compared with 2014 AHA pediatric norms (pABPM). HTN was defined by each guideline using only ABPM. ABPM and clinic BP were used to classify white coat hypertension (WCH) and masked hypertension (MH). LVH was defined as LVMI > 51 g/m2.7. 272 patients had adequate ABPM. 124 patients also had echocardiogram. All adult norms resulted in significant reclassification of HTN. LVMI correlated significantly with systolic BP only. The odds of a patient with HTN having LVH was significant using AHA 2005 (OR: 8.75 [2.1, 36.4], p = .03) and ESH 2018 (OR: 4.94 [1, 24.3], p = .002). Significant reclassification of HTN occurs with all adult norms. HTN is significantly associated with LVH using AHA 2005 and ESH 2018. Applying pediatric norms for ABPM while using adult norms for clinic BP causes confusion. Guideline selection should balance misdiagnosis with over‐diagnosis.
Effect of emodin on long non‐coding RNA‐mRNA networks in rats with severe acute pancreatitis‐induced acute lung injury
Authors: Xu Caiming , Luo Yalan , Ntim Michael , Quan Weili , Li Zhaoxia , Xu Qiushi , Jiang Liu , Zhang Jingwen , Shang Dong , Li Lei , Zhang Guixin , Chen Hailong
Published: January 2021

Long non‐coding RNAs (lncRNAs) contribute to disease pathogenesis and drug treatment effects. Both emodin and dexamethasone (DEX) have been used for treating severe acute pancreatitis‐associated acute lung injury (SAP‐ALI). However, lncRNA regulation networks related to SAP‐ALI pathogenesis and drug treatment are unreported. In this study, lncRNAs and mRNAs in the lung tissue of SAP‐ALI and control rats, with or without drug treatment (emodin or DEX), were assessed by RNA sequencing. Results showed both emodin and DEX were therapeutic for SAP‐ALI and that mRNA and lncRNA levels differed between untreated and treated SAP‐ALI rats. Gene expression profile relationships for emodin‐treated and control rats were higher than DEX‐treated and ‐untreated animals. By comparison of control and SAP‐ALI animals, more up‐regulated than down‐regulated mRNAs and lncRNAs were observed with emodin treatment. For DEX treatment, more down‐regulated than up‐regulated mRNAs and lncRNAs were observed. Functional analysis demonstrated both up‐regulated mRNA and co‐expressed genes with up‐regulated lncRNAs were enriched in inflammatory and immune response pathways. Further, emodin‐associated lncRNAs and mRNAs co‐expressed modules were different from those associated with DEX. Quantitative polymerase chain reaction demonstrates selected lncRNA and mRNA co‐expressed modules were different in the lung tissue of emodin‐ and DEX‐treated rats. Also, emodin had different effects compared with DEX on co‐expression network of lncRNAs Rn60_7_1164.1 and AABR07062477.2 for the blue lncRNA module and Nrp1 for the green mRNA module. In conclusion, this study provides evidence that emodin may be a suitable alternative or complementary medicine for treating SAP‐ALI.
FoxM1 promotes Wnt/β‐catenin pathway activation and renal fibrosis via transcriptionally regulating multi‐Wnts expressions
Authors: Xie Hongyan , Miao Naijun , Xu Dan , Zhou Zhuanli , Ni Jiayun , Yin Fan , Wang Yanzhe , Cheng Qian , Chen Panpan , Li Jingyao , Zheng Peiqing , Zhou Li , Liu Jun , Zhang Wei , Wang Xiaoxia , Lu Limin
Published: January 2021

The activation of Wnt/β‐catenin pathway plays a pivotal role in promoting renal fibrosis. The activation of Wnt/β‐catenin pathway relies on the binding of Wnts to Frizzled receptors on cell membrane. However, the factor regulating Wnts production remains unclear. Here, we demonstrated that transcriptional factor FoxM1 was significantly increased in obstructed kidneys and patients' kidneys with fibrosis. The up‐regulation of FoxM1 mainly distributed in tubular epithelial cells. Pharmacological inhibition of FoxM1 down‐regulated multi‐Wnts elevation in UUO mice and attenuated renal fibrosis. In cultured renal tubular epithelial cells, overexpression of FoxM1 promoted 8 Wnts expression, while knock‐down on FoxM1‐suppressed multi‐Wnts including Wnt1, Wnt2b and Wnt3 expression induced by Ang II. Chromatin immunoprecipitation PCR confirmed that FoxM1 bound to Wnt1, Wnt2b, Wnt3 promoters and luciferase assay further identified that the transcriptions of Wnt1, Wnt2b and Wnt3 were regulated by FoxM1. Thus, our findings show that multi‐Wnt family members were regulated by transcriptional factor FoxM1. FoxM1 might be a key switch for activating β‐catenin pathway and renal fibrosis. Therefore, FoxM1 might be a potential therapeutic target in manipulating renal fibrosis.
The HIF‐1α/p53/miRNA‐34a/Klotho axis in retinal pigment epithelial cells promotes subretinal fibrosis and exacerbates choroidal neovascularization
Authors: Xie Laiqing , Wang Ying , Li Quan , Ji Xiaoyan , Tu Yuanyuan , Du Shu , Lou Hui , Zeng Xinwei , Zhu Linling , Zhang Ji , Zhu Manhui
Published: January 2021

Wet age‐related macular degeneration (wAMD), characterized by choroidal neovascularization (CNV), is a leading cause of irreversible vision loss among elderly people in developed nations. Subretinal fibrosis, mediated by epithelial‐mesenchymal transition (EMT) of retinal pigment epithelium (RPE) cells, leads to unsuccessful anti‐vascular endothelial growth factor (VEGF) agent treatments in CNV patients. Under hypoxic conditions, hypoxia‐inducible factor‐1α (HIF‐1α) increases the stability and activation of p53, which activates microRNA‐34a (miRNA‐34a) transcription to promote fibrosis. Additionally, Klotho is a target gene of miRNA‐34a that inhibits fibrosis. This study aimed to explore the role of the HIF‐1α/p53/miRNA‐34a/Klotho axis in subretinal fibrosis and CNV. Hypoxia‐induced HIF‐1α promoted p53 stability, phosphorylation and nuclear translocation in ARPE‐19 cells (a human RPE cell line). HIF‐1α‐dependent p53 activation up‐regulated miRNA‐34a expression in ARPE‐19 cells following hypoxia. Moreover, hypoxia‐induced p53‐dependent miRNA‐34a inhibited the expression of Klotho in ARPE‐19 cells. Additionally, the HIF‐1α/p53/miRNA‐34a/Klotho axis facilitated hypoxia‐induced EMT in ARPE‐19 cells. In vivo, blockade of the HIF‐1α/p53/miRNA‐34a/Klotho axis alleviated the formation of mouse laser‐induced CNV and subretinal fibrosis. In short, the HIF‐1α/p53/miRNA‐34a/Klotho axis in RPE cells promoted subretinal fibrosis, thus aggravating the formation of CNV.
Donor to recipient ratios in the surgical treatment of vitiligo and piebaldism: a systematic review
Authors: Narayan V.S. , van den Bol L.L.C. , van Geel N. , Bekkenk M.W. , Luiten R.M. , Wolkerstorfer A.
Published: January 2021

Stabilized vitiligo resistant to conventional therapy (e.g. segmental vitiligo) and piebaldism lesions can be treated with autologous cellular grafting techniques, such as non‐cultured cell suspension transplantation (NCST) and cultured melanocyte transplantation (CMT). These methods are preferred when treating larger surface areas due to the small amount of donor skin needed. However, the donor to recipient expansion ratios and outcomes reported in studies with cellular grafting vary widely, and to date, no overview or guideline exists on the optimal ratio. The aim of our study was to obtain an overview of the various expansion ratios used in cellular grafting and to identify whether expansion ratios affect repigmentation and colour match. We performed a systematic literature search in MEDLINE and EMBASE to review clinical studies that reported the expansion ratio and repigmentation after cellular grafting. We included 31 eligible clinical studies with 1591 patients in total. Our study provides an overview of various expansion ratios used in cellular grafting for vitiligo and piebaldism, which varied from 1:1 up to 1:100. We found expansion ratios between 1:1 and 1:10 for studies investigating NCST and from 1:20 to 1:100 in studies evaluating CMT. Pooled analyses of studies with the same expansion ratio and repigmentation thresholds showed that when using the lowest (1:3) expansion ratio, the proportion of lesions achieving >50% or >75% repigmentation after NCST was significantly better than when using the highest (1:10) expansion ratio (χ2 P = 0.000 and χ2 P = 0.006, respectively). Less than half of our included studies stated the colour match between different expansion ratios, and results were variable. In conclusion, the results of our study indicate that higher expansion ratios lead to lower repigmentation percentages after NCST treatment. This should be taken into consideration while determining which expansion ratio to use for treating a patient.