bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of cataract surgery on depression and cognitive function: Systematic review and meta‐analysis
Authors: Pellegrini Marco , Bernabei Federico , Schiavi Costantino , Giannaccare Giuseppe
Published: March 2020

Importance

In elderly people, visual impairment is associated with depressive symptoms and cognitive decline. However, the impact of cataract surgery on depression and cognitive impairment is still controversial.

Background

To evaluate the effect of cataract surgery on depression and cognitive status in the elderly.

Design

This study was a meta‐analysis.

Participants

Patients with age‐related cataract who underwent cataract surgery were recruited for this study.

Methods

A literature search was performed on PubMed, Scopus and Web of Science. Data were extracted from selected studies by two independent reviewers. The pooled standardized mean difference (SDM) was estimated using a random‐effects model. Heterogeneity was evaluated using the Q and I2 tests. Multiple sensitivity analyses and assessment of publication bias were performed.

Main Outcome Measures

The main outcome was a report of a measure of depression or cognitive impairment before and after surgery.

Results

Sixteen studies were included: 14 of them reported data on depression and 9 of them on cognitive function. Depression significantly decreased after surgery (SDM = 0.460; 95% CI: 0.223‐0.697; P < .001). In six controlled studies, the reduction of depression was higher in the surgery group than in the control group (SDM = 0.161; 95% CI: 0.027‐0.295; P = .019). Cognitive function significantly improved after surgery (SDM = 0.254; 95% CI: 0.120‐0.388; P < .001). In four controlled studies, the improvement of cognitive function was higher in the surgery group than in the control group (SDM = 0.188; 95% CI: 0.002‐0.374; P = .048). Results were stable after sensitivity analyses.

Conclusions and Relevance

This meta‐analysis provides evidence that cataract surgery has a positive effect on depression and cognitive function in the elderly.
Cytology of an ulceroproliferative cervical mass
Authors: Mitra Suvradeep , Pradhan Ipsita , Chowdhuri Chandan
Published: March 2020

The article describes a case of cervical melanoma diagnosed by cervical cytology. Mucosal melanoma, especially cervical melanoma, is rare and diagnosis in cervical cytology requires awareness of this entity.
Endoscopic submucosal dissection with a hand‐made traction method for a tumor completely covering the post‐appendectomy orifice
Authors: Muramoto Takashi , Sakai Eiji , Ohata Ken
Published: March 2020

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Representativeness of national parks in protecting freshwater biodiversity: A case of Brazilian savanna
Authors: Casarim Ruanny , Caldeira Yuri Malta , Pompeu Paulo Santos
Published: March 2020

The establishment of national parks are an important and often‐used tool to protect biodiversity. However, when considering freshwater ecosystems, many of these areas in Brazil are habitat mosaics in which a small part of the ecosystem is protected and strongly influenced by the surrounding environment. By assessing the fish fauna and their diversity patterns in five national parks (NPs) within the Brazilian savanna, we discuss whether the establishment of new NPs or the expansion of their current conservation limits would potentially conserve additional species. We selected all national parks within the third largest drainage area in Brazil. To sample fish communities, we explored 60 streams through a standardised field protocol. We also simulated the potential impact of the enlargement or implementation of a new national park. Our results reinforce the importance of national parks and their surrounding areas to preserve fish species. The enlargement of national parks would result in an increase of potentially protected species; however, the same achievement would be obtained if their buffer zones were effectively managed and protected. We recommend an alternative conservation approach to increase protection of tropical savanna fish biodiversity, especially in developing countries such as Brazil with scarce financial resources available for management, monitoring and creation of protected areas.
Prophylaxis therapy with bypassing agents in patients with haemophilia A and inhibitors undergoing surgery: A cost analysis in Spain
Authors: Mareque María , Mingot‐Castellano María Eva , López‐Fernández María Fernanda , Álvarez‐Román María Teresa , Oyagüez Itziar
Published: March 2020

Objectives

This study estimated the cost of prophylaxis with activated prothrombin complex concentrate (aPCC) and recombinant activated factor VIIa (rFVIIa) in surgical patients with haemophilia A and inhibitors in Spain.

Methods

A decision‐analytic model was developed to estimate the cost to the Spanish National Health System of providing haemostatic coverage in this haemophilia population, with age distribution and average weight derived from the literature, and the annual number of surgeries (0.33 per patient) from local data. Drug costs were calculated from official ex‐factory prices with a 7.5% mandatory deduction and recommended dosing regimens.

Results

The estimated average costs per patient were €10 100.73 (aPCC) and €14 265.89 (rFVIIa) for dental extraction, €24 043.88 (aPCC) and €62 301.08 (rFVIIa) for minor surgery and €126 595.81 (aPCC) and €347 731.09 (rFVIIa) for major surgery. Assuming an estimated 23 annual surgeries in this population (N = 69), distributed as 19% dental extraction, 50% minor surgery and 31% major surgery, the total annual cost of prophylaxis was €1 209 682.35 with aPCC and €3 221 929.28 with rFVIIa.

Conclusions

aPCC costs were 62.5% lower than rFVIIa. Assuming potential clinical equivalence, aPCC is a potentially cost‐saving option for surgical patients with haemophilia A and inhibitors.
Molecular genetic analysis in 21 Chinese families with congenital insensitivity to pain with or without anhidrosis
Authors: Zhao F. , Mao B. , Geng X. , Ren X. , Wang Y. , Guan Y. , Li S. , Li L. , Zhang S. , You Y. , Cao Y. , Yang T. , Zhao X.
Published: March 2020

Background and purpose

Hereditary sensory and autonomic neuropathies (HSANs) are a group of clinically and genetically heterogeneous neurological disorders characterized by sensory dysfunctions. Here, 21 affected Chinese families are reported, including 19 with congenital insensitivity to pain with anhidrosis (CIPA; namely HSAN IV) and two with congenital insensitivity to pain (CIP; namely HSAN IID) caused by biallelic variations in NTRK1 and SCN9A, respectively, aiming to identify causative variants in these families and compare how different variants in NTRK1 affect the function of tropomyosin receptor kinase A (TrkA).

Methods

Recombinant plasmids harboring the wild‐type and six mutant alleles (p.Gln216*, p.Glu584Lys, p.Leu595Arg, p.Pro684Leu, p.Val709Leu and p.Arg765Cys) of NTRK1 cDNA were constructed and transfected into HEK293 cells.

Results

The results suggested that the five missense variants only presented a subtle influence on the expression level and glycosylation of TrkA but compromised the receptor phosphorylation. Our findings also suggested that a synonymous variant c.219C>T in NTRK1 may cause aberrant splicing, indicating a potential novel pathogenic mechanism of CIPA. Furthermore, gross deletion of SCN9A was first associated with CIP.

Conclusions

This study identified multiple forms of variants responsible for CIPA/CIP in the Chinese population and might provide new insights into the pathogenesis of CIPA.
Estimation of eco‐efficiency and identification of its influencing factors in China's Yangtze River Delta urban agglomerations
Authors: Zhang Xinlin
Published: March 2020

Eco‐efficiency is an important indicator which serves as a helpful instrument for the studies of sustainable development. This paper estimated the eco‐efficiency of 26 cities in China's Yangtze River Delta urban agglomerations. Based on different matrixes, Moran's I was applied to analyze the spatial correlation. The spatial Durbin model was applied to analyze the direct and indirect effect of influencing factors. Some conclusions were drawn. (a) The average eco‐efficiency showed an increasing trend. The regional difference of eco‐efficiency decreased and then increased. Shanghai's eco‐efficiency had been the highest. (b) The eco‐efficiency showed positive spatial autocorrelation and it also exhibited significant characteristic of local spatial autocorrelation. (c) Economic development, fixed assets investment, and technological level of one city had a significant positive impact on the eco‐efficiency of the city itself. Industrial structure, fiscal decentralization, and foreign direct investment of a city had a significant negative impact on the eco‐efficiency of the city itself. Changes in the economic development and technological levels in a city had positive impacts on the eco‐efficiency of its neighboring cities. Foreign direct investment had a negative spatial spillover effect. (d) This paper suggested that it is necessary to pay attention to the interaction of influencing factors among cities.
Characteristics of hepatocellular carcinoma arising from Fontan‐associated liver disease
Authors: Sagawa Takaomi , Kogiso Tomomi , Sugiyama Hisashi , Hashimoto Etsuko , Yamamoto Masakazu , Tokushige Katsutoshi
Published: March 2020

Aim

Hepatocellular carcinoma (HCC) can arise from Fontan‐associated liver disease (FALD); this is known as FALD‐HCC. The clinical features of FALD‐HCC are unclear. Thus, we examined the incidence and clinical characteristics of FALD‐HCC.

Methods

From 1972 to 2019, 122 patients developed liver disease after undergoing Fontan procedures. HCC was diagnosed in 12 (9.8%) FALD patients. We compared FALD‐HCC and non‐HCC patients.

Results

The incidence of HCC was 0.8% and 2.9% in FALD 10 and 20 years after the Fontan procedure, respectively. The median age of patients at diagnosis of HCC was 32.5 years (range 20.6–46.1 years), and seven of the 12 patients were men. Patients with FALD‐HCC had a higher incidence of liver cirrhosis and polysplenia than non‐HCC patients. Liver tumors were detected as single nodules in eight patients, and the median diameter was 47 mm (range 11–105 mm). HCC was treated by surgical resection in two patients, transcatheter arterial chemoembolization or chemotherapy in three patients, and proton beam therapy in four patients. Three patients could not be treated because of their poor condition. Four patients died of liver/cardiac failure and HCC, and HCC was controlled in three patients. The survival rate after 25 years was significantly lower in patients with FALD‐HCC than non‐HCC patients (68.6% vs. 97.9%, respectively; P < 0.01).

Conclusions: Of the 122 patients with FALD, 12 developed HCC 20 years after surgery. Because complications of HCC are associated with poor prognosis, constant surveillance for HCC should begin 10 years after surgery.
Effect of lower extremity amputation on caregiving burden in caregivers of patients with diabetic foot: Prospective cohort study
Authors: Çamur Savaş , Batıbay Sefa G. , Bayram Serkan
Published: March 2020

Lower extremity amputation as a treatment of diabetic foot ulcer is probably a major burden for the patient's family and friends, who typically act as caregivers and support the patient in coping with the physical disabilities and emotional distress. In the present prospective study, we investigated the effects of different lower extremity amputation levels for diabetic foot ulcer treatment on caregivers of patients with diabetes using the Zarit Burden Interview (ZBI‐12) scale. Patients with diabetic foot ulcers who underwent unilateral major amputation (above‐below knee) and minor amputation of foot (heel sparing) and their caregivers were requested to volunteer to participate in this study from June 2016 to December 2018. The ZBI‐12 form was completed immediately preoperatively and 3 and 6 months after postoperatively. In the minor amputation group, the mean age of the 51 patients was 72.1 years. In the major amputation group, the mean age of the 88 patients was 73.7 years. Both groups of caregivers of patients with minor amputation and major amputations showed a significant improvement in ZBI‐12 score when compared preoperatively and at 3‐ and 6‐month follow‐up visits. The mean ZBI‐12 score was significantly higher in the major than in the minor amputation group in preoperative and all postoperative visits. The absence of the ankle joint in the below‐ or above‐knee amputation renders it more difficult for the amputee to quickly learn the use of prosthesis, thereby increasing the burden of the patient and caregivers. We found that lower extremity amputation for the treatment of chronic diabetic foot ulcers has significantly favourable effect on the caregiver burden, and thereby heel sparing was considerably more effective for the caregiver burden.
Rat bite as a cause of diabetic foot ulcer in sub‐Saharan Africa
Authors: Abbas Zulfiqarali G. , Lutale Janet K. , Archibald Lennox K. , Jeffcoate William J.
Published: March 2020

There have been relatively few reports of foot ulcers in diabetes resulting from rat bite. The findings were derived from people attending a single specialist service in Dar es Salaam for diabetic foot ulcers (DFUs) between 1 January 1999 and 31 December 2016. Details from people presenting for the first time with an ulcer judged to be caused by rat bite were compared with those with from other causes of foot ulcer. There were 426 first recorded foot ulcer episodes (in 179 people) judged to be caused by rat bite. The affected population was significantly younger (mean 55.9 vs 57.5 years, P = .037) and had a lower body mass index (26.5 vs 27.9, P = .008) than controls with other types of foot ulcer. They also presented significantly sooner (7.8 vs 18.2 days, P < .001) and were more likely to heal (85.8 vs 5.5%, P < .001), even though there was also a trend towards an increased risk of death (9.1% vs 5.3%, P = .032). Rat bite is an uncommon cause of DFU, but is not rare. Although the incidence of ulcer healing is higher than in a general foot ulcer population, the incidence of death is also higher.
Multiple preoperative biomarkers are associated with incidence of surgical site infection following surgeries of ankle fractures
Authors: Liu Dawei , Zhu Yanbin , Chen Wei , Li Ming , Liu Song , Zhang Yingze
Published: March 2020

The aim of the study was to investigate the epidemiologic characteristics of surgical site infection (SSI) following surgeries of ankle fractures. This was a retrospective study. Patients who underwent surgeries for ankle fractures in our hospital between January 2016 and June 2019 were included. Inpatient medical records were inquired for data collection, including demographics, comorbidities, injury‐related data, laboratory biomarkers, and confirmation of the SSI cases. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Among the 1532 patients, 45 had a postoperative SSI, indicating the incidence rate of 2.9%. About 18% of SSIs were identified after discharge. Twenty percent of SSIs were caused by mixed bacteria, and 39% were caused by drug‐resistant bacteria. In the final multivariate model, 7 factors including 5 biomarkers were identified to be independently associated with SSI: gender (male vs female, OR, 2.69; 95% CI, 1.33‐4.76), perioperative blood transfusion (OR. 3.02; 95% CI, 1.30‐7.04), albumin <35 g/L (OR, 2.87; 95% CI, 1.31‐6.31), lower high‐density lipoprotein cholesterol (HDL‐C) (OR, 2.34; 95% CI, 1.19‐4.60), haemoglobin (OR, 2.16; 95% CI, 1.03‐4.67), elevated alanine aminotransferase (OR, 2.09; 95% CI, 1.10‐3.95) and neutrophile/lymphocyte rate (NLR, OR, 3.45; 95% CI, 1.33‐6.74). These epidemiologic data on SSI may help counsel patients about the risk of SSI, individualised assessment of the risk factors, and accordingly the risk stratification.
Outcomes of convergent atrial fibrillation ablation with continuous rhythm monitoring
Authors: Larson John , Merchant Faisal M. , Patel Akshar , Ndubisi Nnaemeka M. , Patel Anshul M. , DeLurgio David B. , Lloyd Michael S. , El‐Chami Mikhael F. , Leon Angel R. , Hoskins Michael H. , Keeling W. Brent , Halkos Michael E. , Lattouf Omar M. , Westerman Stacy
Published: March 2020

Background

Outcomes of catheter ablation for persistent atrial fibrillation (PeAF) are suboptimal. The convergent procedure (CP) may offer improved efficacy by combining endocardial and epicardial ablation.

Methods

We reviewed 113 consecutive patients undergoing the CP at our institution. The cohort was divided into two groups based on the presence (n = 92) or absence (n = 21) of continuous rhythm monitoring (CM) following the CP. Outcomes were reported in two ways. First, using a conventional definition of any atrial fibrillation/atrial tachycardia (AF/AT) recurrence lasting >30 seconds, after a 90 day blanking period. Second, by determining AF/AT burden at relevant time points in the group with CM.

Results

Across the entire cohort, 88% had either persistent or long‐standing persistent AF, mean duration of AF diagnosis before the CP was 5.1 ± 4.6 years, 45% had undergone at least one prior AF ablation, 31% had impaired left ventricle ejection fraction and 62% met criteria for moderate or severe left atrial enlargement. Mean duration of follow‐up after the CP was 501 ± 355 days. In the entire cohort, survival free from any AF/AT episode >30 seconds at 12 months after the blanking period was 53%. However, among those in the CM group who experienced recurrences, mean burden of AF/AT was generally very low (<5%) and remained stable over the duration of follow‐up. Ten patients (9%) required elective cardioversion outside the 90 day blanking period, 11 patients (9.7%) underwent repeat ablation at a mean of 229 ± 178 days post‐CP and 64% were off AADs at the last follow‐up. Procedural complications decreased significantly following the transition from transdiaphragmatic to sub‐xiphoid surgical access: 23% versus 3.8% (P = .005)

Conclusions

In a large, consecutive series of patients with predominantly PeAF, the CP was capable of reducing AF burden to very low levels (generally <5%), which appeared durable over time. Complication rates associated with the CP decreased significantly with the transition from transdiaphragmatic to sub‐xiphoid surgical access. Future trials will be necessary to determine which patients are most likely to benefit from the convergent approach.
Drivers in AF colocate to sites of electrogram organization and rapidity: Potential synergy between spectral analysis and STAR mapping approaches in prioritizing drivers for ablation
Authors: Honarbakhsh Shohreh , Schilling Richard J. , Keating Emily , Finlay Malcolm , Hunter Ross J.
Published: March 2020

Introduction

Stochastic trajectory analysis of ranked signals (STAR) mapping has recently been used to ablate persistent atrial fibrillation (AF) with high rates of AF termination and long‐term freedom from AF in small, single‐arm studies. We hypothesized that rapidity and organization markers would correlate with early sites of activation (ESA).

Methods

Patients undergoing persistent AF ablation as part of the STAR mapping study were included. Five‐minute unipolar basket recordings used to create STAR maps were used to determine the minimum‐cycle length (Min‐CL) and CL variability (CLV) at each electrode to identify the site of the fastest Min‐CL and lowest CLV across the left atrium (LA). The location of ESA targeted with ablation was compared with these sites. Dominant frequency was assessed at ESA and compared with that of neighboring electrodes to assess for regional gradients.

Results

Thirty‐two patients were included with 83 ESA ablated, with an ablation response at 73 sites (24 AF termination and 49 CL slowing ≥30 ms). Out of these, 54 (74.0%) and 56 (76.7%) colocated to sites of fastest Min‐CL and lowest CLV, respectively. Regional CL and frequency gradients were demonstrable at majority of ESA. ESA colocating to sites of fastest Min‐CL and lowest CLV were more likely to terminate AF with ablation (odds ratio, 34 and 29, respectively, P = .02). These showed a moderate sensitivity (74.0% Min‐CL and 75.3% CLV) and specificity (66.7% Min‐CL and 76.9% CLV) in predicting ESA with an ablation response.

Conclusions

ESA correlate with rapidity and organization markers. Further work is needed to clarify any role for spectral analysis in prioritizing driver ablation.
Systems pharmacology reveals the mechanism of activity of Physalis alkekengi L. var. franchetii against lipopolysaccharide‐induced acute lung injury
Authors: Yang Yanni , Ding Zihe , Wang Yi , Zhong Renxing , Feng Yanlin , Xia Tianyi , Xie Yuanyuan , Yang Bingyou , Sun Xiaobo , Shu Zunpeng
Published: March 2020

Acute lung injury (ALI) is an important cause of mortality of patients with sepsis, shock, trauma, pneumonia, multiple transfusions and pancreatitis. Physalis alkekengi L. var. franchetii (Mast.) Makino (PAF) has been extensively used in Chinese folk medicine because of a good therapeutic effect in respiratory diseases. Here, an integrated approach combining network pharmacology, proton nuclear magnetic resonance‐based metabolomics, histopathological analysis and biochemical assays was used to elucidate the mechanism of PAF against ALI induced by lipopolysaccharide (LPS) in a mouse model. We found that the compounds present in PAF interact with 32 targets to effectively improve the damage in the lung undergoing ALI. We predicted the putative signalling pathway involved by using the network pharmacology and then used the orthogonal signal correction partial least‐squares discriminant analysis to analyse the disturbances in the serum metabolome in mouse. We also used ELISA, RT‐qPCR, Western blotting, immunohistochemistry and TUNEL assay to confirm the potential signalling pathways involved. We found that PAF reduced the release of cytokines, such as TNF‐α, and the accumulation of oxidation products; decreased the levels of NF‐κB, p‐p38, ERK, JNK, p53, caspase‐3 and COX‐2; and enhanced the translocation of Nrf2 from the cytoplasm to the nucleus. Collectively, PAF significantly reduced oxidative stress injury and inflammation, at the same time correcting the energy metabolism imbalance caused by ALI, increasing the amount of antioxidant‐related metabolites and reducing the apoptosis of lung cells. These observations suggest that PAF may be an effective candidate preparation alleviating ALI.
Long non‐coding RNA AK085865 ablation confers susceptibility to viral myocarditis by regulating macrophage polarization
Authors: Zhang Yingying , Li Xueqin , Kong Xiang , Zhang Mengying , Wang Deguo , Liu Yinhua , Lv Kun
Published: March 2020

Accumulating evidence indicates that regulators of macrophage polarization may exert pivotal functions in the development of coxsackievirus B3 (CVB3)‐induced viral myocarditis (VM). However, the mechanisms underlying macrophage polarization remain to be explored. Here, we sought to identify novel and functionally important long non‐coding RNAs (lncRNAs) during macrophage polarization and to investigate their function and contribution to VM. In this study, we identified the lncRNA AK085865 as an important regulator of macrophage polarization. Knock‐down of AK085865 diminished phenotypical expression of M2 macrophages while promoting polarization to the M1 phenotype. Moreover, AK085865−/− mice had increased susceptibility to CVB3‐induced VM. We observed striking bias towards M1 macrophages, whereas the M2 population was decreased in AK085865−/− VM mice. Collectively, our findings uncover a critical role of AK085865 in the regulation of macrophage polarization in vitro and in vivo, identifying a new player in the development of VM and providing a potential clinically significant therapeutic target.
Predictive value of FDG‐PET imaging for relapse in metastatic melanoma patients treated with immunotherapy
Authors: Mesnard C. , Bodet‐Milin C. , Eugène T. , Nguyen J‐M. , Khammari A. , Dréno B.
Published: March 2020

Background

Anti‐PD1 immunotherapy has shown a sustainable clinical activity in patients with metastatic melanoma. However, strong predictive factors of the long‐term response or risk of relapse remain to be identified.

Objectives

To determine whether FDG‐PET imaging could be superior to CT scan in distinguishing residual tumours versus the absence of tumour in patients with a partial response (PR) or stable disease (SD) and whether a complete metabolic response (CMR) was associated with better outcomes.

Methods

Retrospective study conducted in all patients with metastatic melanoma treated with anti‐PD1 immunotherapy between October 2014 and October 2017 considered to be in complete remission. The primary outcome was the occurrence of a relapse during the follow‐up. CT scan and FDG‐PET scan had to be performed within a maximum of 2 months of treatment discontinuation. For CT imaging, the Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 were used and included progressive disease (PD), SD, PR and complete response (CR). For FDG‐PET imaging, the metabolic responses were classified as progressive metabolic disease, stable metabolic disease, residual FDG avidity (RFA) and CMR.

Results

Twenty‐six patients were in complete remission after collegial decision. Two patients had a SD on CT scan and a CMR on FDG‐PET scan, and none of them relapsed. Ten patients had a PR on CT scan and a CMR on FDG‐PET scan, and none of them relapsed. The mean treatment duration to achieve a complete remission was 7 months (3–23). A univariate analysis showed that a RFA assessed on the FDG‐PET scan was significantly associated with a relapse (P = 0.00231).

Conclusions

Most patients with a PR on the CT scan and a CMR on the FDG‐PET scan should be considered with a CR. Our study showed that FDG‐PET imaging could play a crucial role in predicting the long‐term outcome and help to decide whether treatment should be discontinued.
Dignity, privacy, respect and choice—A scoping review of measurement of these concepts within acute healthcare practice
Authors: Bagnasco Annamaria , Zanini Milko , Dasso Nicoletta , Rossi Silvia , Timmins Fiona , Galanti Miss Carolina , Aleo Giuseppe , Catania Gianluca , Sasso Loredana
Published: March 2020

Aims and objectives

To synthesise and review literature related to instruments that measure psychosocial aspects of fundamental care in acute hospital care settings.

Background

Psychosocial aspects of care often receive less priority in terms of care provision in acute care environments. At the same time, if these elements are overlooked, there may be consequences. Despite the availability of many instruments designed to measure specific aspects of care, these concepts are often not studied within the broader context of fundamentals of care, but rather coexist as isolated explorations of specific subelements.

Design

A scoping review was conducted, based on Arksey & O’Malley's (2005) methodological framework and following the PRISMA checklist.

Methods

Using the five recommended steps—identifying the research question; identifying relevant studies; study selection; charting the data; and summarising and reporting the results—three databases were searched: MEDLINE/PubMed, CINAHL and EMBASE, in February 2019.

Results

Following independent screening by two of the authors, 48 papers were included. From these 48 papers, 33 instruments were identified. Only five of these tools thoroughly assessed psychosocial aspects elements of care (dignity, respect, privacy and patients’ choice) through dedicated items.

Conclusions

This review provides nurses with a synthesis of 33 instruments that assess the psychosocial aspects of care. This provides an important resource to guide measurement of dignity, respect, privacy and patients’ choice. The findings also provide guidance to future research in this field.

Relevance to clinical practice

This paper reviews and synthesises these instruments to provide a resource to nurses to inform their decisions and practice around measurement and evaluation of these key aspects of care. This provides a useful guide to measure and monitor the improvement of fundamental care delivery in practice and points to strengths and weaknesses of the instruments concerned.
“You’ve got to keep moving, keep going”: Understanding older patients’ experiences and perceptions of delirium and nonpharmacological delirium prevention strategies in the acute hospital setting
Authors: Lee‐Steere Karen , Liddle Jacki , Mudge Alison , Bennett Sally , McRae Prue , Barrimore Sally E.
Published: March 2020

Aims and objectives

To explore older inpatients’ experiences and perceptions of delirium and nonpharmacological delirium prevention strategies (NDPS).

Background

Delirium is a distressing and serious complication in hospitalised older adults. NDPS (supporting nutrition, mobility and cognitive participation) have strong supporting evidence. Few studies have explored older inpatients’ perspectives of these strategies. This information may assist staff to better support patient participation in NDPS.

Design

Qualitative study using an interpretive descriptive (ID) methodological approach to explore older patient's experience of delirium and NDPS.

Methods

Structured interviews of inpatients aged over 65 years across 6 medical and surgical wards explored patients’ experiences and perceptions of delirium and prevention activities related to nutrition, mobility and cognition; and barriers and enablers to participation. Reporting used COREQ.

Results

Twenty‐three participants were included (12 male, 11 reported delirium experience). Participants reported a range of physiological, emotional and psychological responses to delirium, hearing about delirium was different to experiencing it. Most participants were aware of the benefits of maintaining nutrition and hydration, physical activity and cognitive engagement in hospital. Barriers included poor symptom control, inflexible routines and inconsistent communication, whilst enablers included access to equipment, family involvement, staff encouragement and individual goals. These were organised into themes: outlook, feeling well enough, hospital environment, feeling informed and listened to, and support networks.

Conclusion

A more patient‐centred approach to delirium prevention requires consideration of older people's values, needs, preferences and fit within the hospital environment and routines. Feeling informed, listened to and receiving support from staff and family carers can improve older inpatients’ engagement in NPDS to prevent delirium in hospital.

Relevance to clinical practice

Nurses are ideally placed to improve patient participation in NDPS through holistic assessment and care, addressing symptoms, providing clear information about delirium and delirium prevention, and facilitating family carer support and patient interactions.
Improved quality of care by using the PRISMS form to support self‐management in patients with COPD: A Randomised Controlled Trial
Authors: Zakrisson Ann‐Britt , Arne Mats , Lisspers Karin , Lundh Lena , Sandelowsky Hanna , Ställberg Björn , Thors Adolfsson Eva , Theander Kersti
Published: March 2020

Aims and objective

To investigate the effects on the quality of care of the Patient Report Informing Self‐Management Support (PRISMS) form compared with usual care among patients with chronic obstructive pulmonary disease (COPD) consulting a COPD nurse in primary health care.

Background

Patients with COPD experience symptoms affecting their everyday lives, and there is a need for interventions in self‐management support. The delivery of chronic care in an organised, structured and planned manner can lead to more productive relationships between professionals and patients.

Design

A multicentre randomised controlled trial with a post‐test design, according to the CONSORT checklist, in one intervention group (n = 94) and one control group (n = 108).

Methods

In addition to usual care, the intervention group (n = 94) completed the PRISMS form to indicate areas where they wanted self‐management support before the consultation with the COPD nurse. This form comprises 17 items that patients with COPD commonly experience as problems. The control group received usual care (n = 108). The primary outcome was patients’ satisfaction with quality of care, assessed using the Quality from the Patient's Perspective (QPP) questionnaire. Means and (SD) are presented where applicable. Differences between the intervention and control group were analysed with Student's t test for independent groups for interval data, and the Mann–Whitney U test for ordinal data.

Results

Participants in the intervention group were more satisfied with the QPP domains “personal attention,” regarding both “perceived reality” (p = .021) and “subjective importance” (p = .012). The PRISMS form revealed “shortness of breath” as the most commonly experienced problem and the issue most desired to discuss.

Conclusion

The PRISMS form improved patient satisfaction with quality of care regarding personal attention, which is an important factor in patient participation and improving relationships and communication.

Relevance to clinical practice

The PRISMS form can be a useful tool in improving person‐centred care when delivering self‐management support.

Register Id

192691 at http://www.researchweb.org/is/en/sverige/project/192691.
Convolutional neural networks for pavement roughness assessment using calibration‐free vehicle dynamics
Authors: Jeong Jong‐Hyun , Jo Hongki , Ditzler Gregory
Published: March 2020

Road roughness is a measure of how uncomfortable a ride is, and provides an important indicator for the needs of roadway maintenance or repavement, which is closely tied to the state and federal budget prioritization. As such, accurate and timely monitoring of deteriorating road conditions and following maintenance are essential to improve the overall ride quality on the road. Various technologies, including vehicle‐mounted laser profiling systems, have been developed and adopted for road roughness (e.g., IRI—International Roughness Index) measurement; however, their high cost limits their use. While recent advances in smartphone technologies allow us to use their embedded accelerometers for road roughness monitoring, the complicated process of necessary vehicle calibration hinders the widespread use of the technology in the actual practices. In this work, a deep learning IRI estimation method is proposed with the goal of using anonymous (i.e., calibration‐free) vehicles and their responses measured by smartphones as road roughness sensors. A state‐of‐the‐art deep learning algorithm (i.e., CNN—convolutional neural network) and multimetric vehicle dynamics data (i.e., accelerometer, gyroscope), possibly measured by drivers’ smartphones, are employed for the purpose. Optimized CNN architecture and data configuration have been investigated to achieve the best performance. The efficacy of the proposed method has been numerically validated using real road IRI information (i.e., Speedway, Tucson, AZ), real driving speed profiles, and four different types of vehicle data with associated uncertainties.
Hemiboea yongfuensis (Gesneriaceae): a cryptic and critically endangered new species from North Guangxi, China
Authors: Huang Zhang‐Ping , Li Jia‐Hui , Pan Bo , Qin Xin‐Mei , Zhang Qiang , Lu Yong‐Bin
Published: March 2020

The limestone region of southern China is a biodiversity hotspot from where numerous rare new species have been or are being described. Here, Hemiboea yongfuensis, a new species of Gesneriaceae from a limestone hill in Guilin, North Guangxi, southern China is described and illustrated. It is similar to H. subcapitata and H. pterocaulis in morphology and coexists with both of them in the same limestone hill, but can be distinguished from the latter two by its quadrilateral stem without winged edges, corolla outside light pink and sparsely glandular‐pubescent and pale pink calyx which is 5‐lobed from base, as well as by molecular data from trnL‐F and ITS. We provide detailed information, including morphological descriptions, illustrations, diagnostic comparisons and molecular phylogenetic affinities of the new species.
A taxonomic appraisal on the rare green algal genus Ecballocystopsis M.O.P.Iyengar (Chlorellales: Trebouxiophyceae): morphological and numerical approach
Authors: Das Sudipta Kumar , Rawat Dinesh Singh , Gupta Rajendra Kumar , Adhikary Siba Prasad
Published: March 2020

Ecballocystopsis (Oocystaceae, Chlorellales, Trebouxiophyceae) is a rare green algal genus, represented by only five taxa: E. dichotoma var. dichotoma from China and E. indica, E. desikacharyi, E. himalayensis and E. dichotoma var. minuta from India. Here we propose the novel variety E. dichotoma var. anandii from Jharkhand, synonymization of E. himalayensis with E. dichotoma and erection of E. dichotoma var. minuta to a separate species as E. minuta stat. et comb. nov. These taxonomic changes are well supported by the results of a multivariate analysis based on a numerical taxonomic approach. Cluster analysis (CA), principal component analysis (PCA) and principal coordinates analysis (PCoA) were performed to resolve the species delimitation ambiguity and supplement the morphology‐based classification of the genus. Ecballocystopsis himalayensis and E. dichotoma grouped in a single cluster along with the proposed new variety, while E. indica, E. desikacharyi and E. minuta formed separate clusters. An identification key to the species of the genus Ecballocystopsis is also presented.
What guidance is there on portion size for feeding preschool‐aged children (1 to 5 years) in the United Kingdom and Ireland? A systematic grey literature review
Authors: Porter Alice , Kipping Ruth , Summerbell Carolyn , Dobrescu Anca , Johnson Laura
Published: March 2020

Large portion sizes of food can lead to excessive energy intake and weight gain in young children. Although portion size guidance is available, parents are often unaware it exists. Our systematic grey literature review aimed to identify the portion size guidance resources in the United Kingdom and Ireland, aimed at users (e.g., parents and childcare providers) responsible for feeding preschool‐aged children. We describe who the resources are aimed at, how they are informed and whether the recommended portion sizes are consistent across resources. Resources were identified via advanced Google searches, searching reference lists and contacting experts. Resources that provided quantifiable portion size information (e.g., grammes) were included. Portion sizes (g) were extracted and energy equivalents (kcal) were calculated. Portion sizes were analysed by food group and by eating occasion. Twenty‐two resources were identified. Median portion sizes were consistent across resources for fruit (40 g [IQR = 40–50]) and vegetables (40 g [IQR = 30–40]). Variability was observed in portion size and/or energy content for dairy (60 g [IQR = 25–93]), protein (72 kcal [IQR = 44–106]) and starchy (41 g/71 kcal [IQR = 25–80/56–106]) food groups. The range in size of an average eating occasion was large (90–292 g). This review identifies resources that could help caregivers to choose appropriate portion sizes for preschool‐aged children but also highlights how future resources could be improved.
Treatment change and coronary artery abnormality in incomplete Kawasaki disease
Authors: Nomura Yuichi , Yashiro Mayumi , Masuda Kiminori , Nakamura Yoshikazu
Published: March 2020

Background

Incomplete Kawasaki disease (iKD) showed a higher incidence of coronary artery abnormalities (CAAs) than complete KD. However, the incidence of CAAs among iKD patients may have changed recently.

Methods

We examined KD patients from recent nationwide surveys conducted between 2013 and 2016 and compared them with the results of a previous survey (2001–2002).

Results

Of 63 270 KD patients, 13 770 patients (22%) had iKD. They showed a higher incidence of convalescent‐phase CAAs (cCAAs, 2.8%) than complete KD (2.1%). The incidence of cCAAs in patients with one or two symptoms (6.7%) was significantly higher than those with three or four symptoms (2.6%) (P < 0.0001). Intravenous immunoglobulin (IVIG) treatment was administered to 80% of iKD patients; 30% of them received IVIG before the fifth illness day (early treatment) and 12% of patients received IVIG after the seventh illness day (late treatment). In the previous survey, the incidence of cCAAs was higher in both iKD (5.9%) and cKD (4.4%). Intravenous immunoglobulin was administered to 62% of iKD patients; 26% of them received early treatment, and 16% received late treatment.

Conclusions

The incidence of cCAAs remained higher among iKD patients than cKD patients but this difference was reduced by the increased proportion of iKD patients treated with IVIG and those at an earlier time point. It is important to recognize the possibility that patients may have iKD and perform echocardiography even if they present with a few principal symptoms.
Quality of the caregiving relationship and quality of life in mild Alzheimer's dementia
Authors: Mortazavizadeh Zeinab , Maercker Andreas , Roth Tanja , Savaskan Egemen , Forstmeier Simon
Published: March 2020

Background

The present study aims to investigate the quality of the dyadic relationship between mild Alzheimer patients and their caregivers. The main objective is to evaluate the consistency, agreement and validity of the German version of the Scale for Quality of the Current Relationship in Caregiving (SQCRC). The secondary objective was to examine the association of relationship quality with quality of life (QOL) in patients with mild Alzheimer's disease (AD) and their caregivers.

Methods

In this study, a sample of 50 patients diagnosed with mild AD and their primary caregivers were included. Participants underwent a full neuropsychological evaluation. The quality of the relationship between persons with AD and their caregivers was assessed using the SQCRC. Furthermore, other scales of relationship quality, well‐being of the person with AD, and well‐being of the caregiver were used.

Results

The results showed that the SQCRC has a good internal consistency and high validity. Also, relationship quality as rated by the AD patients (r = 0.37, P < 0.1) and their caregivers (r = 0.51, P < 0.1) was significantly correlated with QOL.

Conclusions

The findings suggest that many persons with mild AD can rate their relationship quality and that the patient's self‐rated relationship quality is a substantial predictor of their QOL.
Roadmapping for innovation management: evidence from Pirelli
Authors: Amati Guido , Motta Virna , Vecchiato Riccardo
Published: March 2020

Despite the growing interest of practitioners and scholars in technology roadmapping (TRM), our knowledge regarding how TRM can be embedded into the overall innovation process of a firm and used to enhance this process is relatively limited. This study aims to fill this gap. We describe an action research project conducted with Pirelli and the innovative approach to TRM this company developed during the 2010s to cope with the increasing complexity and dynamism of the tire industry. We show that TRM is currently fully integrated into the firm’s R&D activities and contributes to increasing the effectiveness of new product development. TRM supports the systematic gathering, sharing, and elaboration of information across the different functions and business units of Pirelli from the basic research to the commercialization of new products.
Maximum‐revenue tariffs versus free trade
Authors: Collie David R.
Published: March 2020

Welfare with the maximum‐revenue tariff is compared to free‐trade welfare under Cournot duopoly with differentiated products; under Bertrand duopoly with differentiated products; and under perfect competition in the case of a large country able to affect its terms of trade. Under Cournot duopoly and Bertrand duopoly, assuming linear demands and constant marginal costs, welfare with the maximum‐revenue tariff is always higher than free‐trade welfare. Under perfect competition, assuming linear demand and supply, welfare with the maximum‐revenue tariff will be higher than free‐trade welfare if the country has sufficient market power.
Implementation of community and facility‐based HIV self‐testing under routine conditions in southern Eswatini
Authors: Pasipamire Lorraine , Nesbitt Robin C. , Dube Lenhle , Mabena Edwin , Nzima Muzi , Dlamini Mduduzi , Rugongo Nozizwe , Maphalala Nomthandazo , Obulutsa Thomas Austin , Ciglenecki Iza , Kerschberger Bernhard
Published: March 2020

Objectives

WHO recommends HIV self‐testing (HIVST) as an additional approach to HIV testing services. The study describes the strategies used during phase‐in of HIVST under routine conditions in Eswatini (formerly Swaziland).

Methods

Between May 2017 and January 2018, assisted and unassisted oral HIVST was offered at HIV testing services (HTS) sites to people aged ≥ 16 years. Additional support tools were available, including a telephone hotline answered 24/7, HIVST demonstration videos and printed educational information about HIV prevention and care services. Demographic characteristics of HIVST users were described and compared with standard blood‐based HTS in the community. HIVST results were monitored with follow‐up phone calls and the hotline.

Results

During the 9‐month period, 1895 people accessed HIVST and 2415 HIVST kits were distributed. More people accessed HIVST kits in the community (n = 1365, 72.0%) than at health facilities (n = 530, 28.0%). The proportion of males and median age among those accessing HIVST and standard HTS in the community were similar (49.3%, 29 years HIVST vs. 48.7%, 27 years standard HTS). In total, 34 (3.9%) reactive results were reported from 938 people with known HIVST results; 32.4% were males, and median age was 30 years (interquartile range 25–36). Twenty‐one (62%) patients were known to have received confirmatory blood‐based HTS; of these, 20 (95%) had concordant reactive results and 19 (95%) were linked to HIV care at a clinic.

Conclusion

Integration of HIVST into existing HIV facility‐ and community‐based testing strategies in Eswatini was found to be feasible, and HIVST has been adopted by national testing bodies in Eswatini.
WHO type 1 anovulation: an update on diagnosis, management and implications for long‐term health
Authors: Talaulikar Vikram , Yasmin Ephia
Published: March 2020

Key content

The World Health Organization (WHO) type 1 anovulatory disorders include hypogonadotrophic hypogonadism, hypothalamic amenorrhoea and hypopituitarism.

These conditions are encountered primarily in endocrine, gynaecology and reproductive medicine clinics, and can result in amenorrhoea/oligomenorrhoea, subfertility or pregnancy loss.

These conditions are associated with estrogen deficiency and therefore have implications for long‐term bone and cardiovascular health.

There is an apparent lack of clarity on diagnostic criteria (including utility of new biomarkers such as anti‐müllerian hormone) and management strategies for these conditions.

Evidence suggests that multidisciplinary care with timely induction of puberty, appropriate hormone replacement, lifestyle modification, counselling and behavioural therapies, and ovulation induction with gonadotrophins/gonadotrophin‐releasing hormone is associated with improved reproductive and other health outcomes in women with these conditions.

Learning objectives

To appreciate the role of the hypothalamo–pituitary–ovarian axis in normal reproductive health and understand the impact of its dysfunction on reproductive and other health outcomes.

To subclassify WHO type 1 anovulation and understand the aetiology, pathogenesis and prognosis of different conditions.

To offer appropriate evaluation and management options to women with WHO type 1 anovulation.