bluuebunny/crossref_metadata_2025 huggingface dataset:
Socio‐spatial and quality of life themes in aged care architecture: A qualitative methods protocol
Authors: Mcgann Sarah , Bulsara Caroline , Farley Holly
Published: September 2020

Aim

To evaluate the connection between residential aged care architecture, the residents’ ability to find home and Quality of Life themes.

Design

This study uses convergent qualitative mixed methods approach across the three phases of the research project to explore the lived experience of residential aged care residents, their family members, and direct care staff.

Methods

The chosen qualitative methodology is based on a constructionist paradigm and uses a combination of observations, photo production and prompted discussions, and architectural visual data collection methods. Funding was approved in March 2018.

Discussion

This research will provide a novel approach to understanding ways by which residents of residential aged care facilities engage with their surrounding environments and make those surroundings into a place they ‘called home’. The research will serve to articulate the core elements of residential aged care building types which lead to an enhanced quality of life and sense of place for residents.

Impact

There is little contemporary socio‐spatial, lived experience research on the implications of new building types, such as small household aged care facilities on residents quality of life. This research contributes and is significant, to the disciplines of aged care, nursing, architecture, and user studies. The research will provide new knowledge about the influences of the physical environment on resident's quality of life and their ability to find home across different building types, while providing insight into how quality of life might be improved through spatial strategies.
Inhibition of BRD4 triggers cellular senescence through suppressing aurora kinases in oesophageal cancer cells
Authors: Xu Jian‐Ling , Yuan Ya‐Jiao , Lv Jiao , Qi Di , Wu Meng‐Di , Lan Jing , Liu Sheng‐Nan , Yang Yong , Zhai Jing , Jiang Han‐Ming
Published: September 2020

Oesophageal cancer is one of the most frequent solid malignancies and the leading cause of cancer‐related death around the world. It is urgent to develop novel therapy strategies to improve patient outcomes. Acetylation modification of histones has been extensively studied in epigenetics. BRD4, a reader of acetylated histone and non‐histone proteins, has involved in tumorigenesis. It has emerged as a promising target for cancer therapy. BRD4 inhibitors, such as JQ1, have exerted efficacious anti‐proliferation activities in diverse cancers. However, the effects of JQ1 on oesophageal cancer are still not fully described. Here, we demonstrate that JQ1 suppresses cell growth and triggers cellular senescence in KYSE450 cells. Mechanistically, JQ1 up‐regulates p21 level and decreases cyclin D1 resulting in G1 cycle arrest. The inhibitory effects of JQ1 on KYSE450 cells are independent on apoptosis. It activates cellular senescence by increasing SA‐β‐gal activity. BRD4 knockdown by shRNA recapitulates cellular senescence. We also display that administration of JQ1 decreases recruitment of BRD4 on the promoter of aurora kinases A and B. Inhibitors targeting at AURKA/B phenocopy JQ1 treatment in KYSE450 cells. These results identify a novel action manner of BRD4 in oesophageal cancer, which strengthens JQ1 as a candidate drug in oesophageal cancer chemotherapy.
The injectable resin composite restorative technique: A case report
Authors: Ypei Gia Nathalia Ramos , Sampaio Camila Sobral , Higashi Cristian , Sakamoto Antonio , Hirata Ronaldo
Published: September 2020

Objective

To describe the use of the injectable resin composite restorative technique with a flowable resin material, in a clinical case with esthetic problems associated with irregular tooth anatomies, allied with a finishing, and polishing protocol due to staining after 1 year of use.

Clinical Considerations

The presented case report helped to achieve an immediate highly esthetic restoration with appropriate width proportions based on a previous wax‐up. After 1 year of use, restorations presented staining; therefore, finishing and polishing procedures were required to re‐achieve acceptable esthetic results and thus increase restoration's survival.

Conclusions

The use of the presented technique allowed to obtain a simple and predictable workflow; however, care must be taken on the follow up of the restorations due to intrinsic characteristics of the flowable resin material.

Clinical Significance

The use of the presented injectable technique helped on obtaining a precise anatomy replicating a diagnostic wax‐up, thus improving marginal precision and achieving a highly esthetic and functional immediate outcome, with an easy workflow when appropriately planned and executed. However, it also presented low color stability after 1 year of use only, thus, requiring attention from clinicians in regard to its maintenance over time.
Cathelicidins enhance protection of channel catfish, Ictalurus punctatus, and channel catfish ♀ × blue catfish, Ictalurus furcatus ♂ hybrid catfish against Edwarsiella ictaluri infection
Authors: Simora Rhoda Mae C. , Li Shangjia , Abass Nermeen Y. , Terhune Jeffery S. , Dunham Rex A.
Published: September 2020

Cathelicidins are a class of antimicrobial peptides (AMPs) known to possess rapid and direct antimicrobial activities against a variety of microorganisms. Recently identified cathelicidins derived from alligator and sea snake were found to be more effective in inhibiting microbial growth than other AMPs previously characterized. The ability of these two cathelicidins along with the peptides, cecropin and pleurocidin, to protect channel catfish (Ictalurus punctatus, Rafinesque) and hybrid catfish (I. punctatus ♀ × blue catfish, Ictalurus furcatus, Valenciennes ♂) against Edwardsiella ictaluri, one of the most prevalent pathogens affecting commercial catfish industry, was investigated. Cathelicidin‐injected fish (50 µg ml−1 fish−1) that were simultaneously challenged with E. ictaluri through bath immersion at a concentration of ~1 × 106 CFU/ml had increased survival rates compared with other peptide treatments and the infected control. Bacterial numbers were also reduced in the liver and kidney of channel catfish and hybrid catfish in the cathelicidin treatments 24 hr post‐infection. After 8 days of challenge, serum was collected to determine immune‐related parameters such as bactericidal activity, lysozyme, serum protein, albumin and globulin. These immune‐related parameters were significantly elevated in fish injected with the two cathelicidins as compared to other peptide treatments. These results indicate that cathelicidins derived from alligator and sea snake can stimulate immunity and enhance the resistance to E. ictaluri infection in channel catfish and hybrid catfish.
Irsogladine maleate alters expression of a tight junction protein in portal hypertensive gastropathy
Authors: Yokoyama Keiji , Irie Makoto , Tsuchiya Naoaki , Yamauchi Eri , Kawashima Motoko , Miyayama Takashi , Fukuda Hiromi , Yamauchi Ryo , Umeda Kaoru , Takata Kazuhide , Tanaka Takashi , Inomata Shinjiro , Morihara Daisuke , Takeyama Yasuaki , Shakado Satoshi , Sakisaka Shotaro , Hirai Fumihito
Published: September 2020

Background and Aim

Portal hypertensive gastropathy (PHG) is characterized by noninflammatory edema and vasodilatation of the lamina propria of the mucosal epithelium. In addition, the alterations of intercellular junction proteins and dilatation of the endothelial gaps have been reported. In this study, we examined whether irsogladine maleate (IM), a gastric mucosal protective agent, has the potential to improve PHG by restoration of tight junctions (TJs).

Methods

Twenty‐four patients with PHG were registered and randomly assigned into two groups: 12 patients in the IM‐administration group and 12 patients in the non‐administration group. In the administration group, IM (4 mg/day) was administered orally for 12 weeks. Gastric mucosa with a red color in patients with PHG were obtained endoscopically on the registration day and 12 weeks later. The endoscopic findings were evaluated, an immunohistochemical analysis of claudin‐3 (a TJ protein) expression in gastric mucosal tissues by a laser microscope was performed, and claudin‐3 expression was quantified by western blot analysis.

Results

Irsogladine maleate improved the degree of PHG in 2/12 patients endoscopically, in contrast to none of the 12 patients in the non‐administration group. Immunohistochemical analysis showed that expression of claudin‐3 increased in 8/12 patients in the IM‐administration group and 2/12 patients in the non‐administration group (P = 0.036). Western blot analysis revealed that the increase in claudin‐3 after 12 weeks was significantly higher in the IM‐administration group than in the non‐administration group (P = 0.010).

Conclusions

The present pilot study suggested that IM might improve the gastric mucosa in PHG through restoration of TJ‐protein claudin‐3.
COVID‐19 Pandemic in Assisted Living Communities: Results from Seven States
Authors: Temkin‐Greener Helena , Guo Wenhan , Mao Yunjiao , Cai Xueya , Li Yue
Published: September 2020

OBJECTIVE

To describe variations in COVID‐19 confirmed cases and deaths among assisted living (AL) residents and examine their associations with key AL characteristics.

DESIGN

Observational study employing data on confirmed COVID‐19 cases and deaths in ALs from seven states, through May 29, 2020.

SETTING

Information on COVID‐19 cases/deaths in ALs was obtained from state government websites. A national inventory of ALs was used to identify communities with and without COVID‐19 cases/deaths. Medicare Beneficiary Summary File identifying AL residents was employed to develop AL characteristics. County‐level COVID‐19 laboratory‐confirmed cases/deaths were obtained from publicly available data.

PARTICIPANTS

We found 4,865 ALs (2,647 COVID‐19 cases and 777 deaths) in the seven states. After excluding missing data, the sample consisted of 3,994 ALs (82.1%) with 2,542 cases (96.0%) and 675 deaths (86.9%).

MAIN OUTCOMES AND MEASURES

Outcomes were AL‐level counts of cases and deaths. Covariates were AL characteristics and county‐level confirmed COVID‐19 cases/deaths. Multivariable two‐part models determined the associations of independent variables with the likelihood of at least one case and death in the AL, and with the count of cases (deaths).

RESULTS

State case fatality ranged from 3.32% in North Carolina to 9.26% in Connecticut, but for ALs in these states it was 12.89% and 31.59%, respectively. Among ALs with at least one case, midsize communities had fewer cases (incidence rate ratio (IRR) = 0.829; P = .004) than small ALs. ALs with higher proportions of racial/ethnic minorities had more COVID‐19 cases (IRR = 1.08; P < .001), as did communities with higher proportions of residents with dementia, chronic obstructive pulmonary disease, and obesity.

CONCLUSIONS AND RELEVANCE

ALs with a higher proportion of minorities had more COVID‐19 cases. Many of the previously identified individual risk factors are also present in this vulnerable population. The impact of COVID‐19 on ALs is as critical as that on nursing homes, and is worth equal attention from policy makers.
Efficacy and safety of intralesional injection of vitamin D3 versus tuberculin PPD in the treatment of plantar warts: A comparative controlled study
Authors: Elsayed Ghaly Nahla , El‐Ashmawy Amal Ahmad , Abou Zeid Mai , E. Shaker Engi Seif
Published: September 2020

Background

Several destructive and immunotherapeutic methods are used in treatment of plantar warts, but an effective method with no or reduced recurrence has not been found till now.

Objectives

To evaluate the efficacy and safety of intralesional (IL) vitamin D3 (Vit.D3) injection vs IL tuberculin purified protein derivative (PPD) injection in the treatment of plantar warts.

Methods

Sixty patients with plantar warts were randomized into 3 equal groups: group I treated using IL tuberculin PPD every 2 weeks, group II treated using IL Vit.D3 every 4 weeks, and group III treated with IL saline every 2 weeks till complete clearance or for a maximum of 3 sessions. The follow‐up period was 6 months.

Results

There was a statistically significant improvement in therapeutic groups than control with more significant improvement in group II than I. Regarding number of sessions required for complete response, there was a positive significant correlation in both groups, but more significant in group I. There was a negative correlation between the number of lesions and the response to treatment in both groups. Group II showed significantly better response to treatment in male patients. Both modalities were well tolerated, with no remarkable side effects and no recurrence in cured patients of both groups.

Conclusions

Both IL PPD and Vit.D3 injection are safe and effective for treatment of plantar warts even recalcitrant or multiple, with no postprocedural downtime, better results, and patient satisfaction. IL Vit.D3 injection has a superior advantage than PPD.
Survey of nurses’ knowledge and practice regarding medication administration using enteral tubes
Authors: Tillott Harry , Barrett Diane , Ruan Jingjing , Li Vincent , Merrick Susan , Steed Helen , Morrissey Hana , Anthony Ball Patrick
Published: September 2020

Aim and objectives

To identify the practice variation of the individual practitioners in medications’ formulation modification for patients using enteral feeding tubing and to support health practitioners involved in this process.

Background

Blockage of enteral tubes is a common problem that can sometimes be resolved but may require replacement of the tube. Medications are a common culprit.

Design

A survey of 73 registered nurses’ practices around medication administration via enteral feeding tubes.

Methods

A questionnaire study was undertaken within a district general hospital across a broad variety of wards to explore nurses’ experiences of medication administration via enteral tubes. The study is reported in accordance with the squire 2.0 guidelines from the EQUATOR network.

Results

Seventy‐three nurses responded. Twenty‐six per cent reported never checking about drug modification for administration via a tube, 12% check every time and 61% when unsure about a new drug. The volume of fluid flushes administered after medication ranged from 7.5–150 ml. Seventy‐one per cent of participants reported stopping feed when medications are required, varying from 1–60 min. Sixty per cent had experienced a blocked tube and 52% the tube being removed for these reasons. The clinical nurse specialist was the commonest first point of call to help. Staff named 15 medications as the most problematic to administer, lactulose and omeprazole were the top two.

Conclusions

Practice varies significantly amongst nurses around medication administration. Theoretically, this may contribute to blocked tubes and excessive fluid administration to some patients. Barriers to medication administration were thematically grouped into: time, difficulty modifying medication, medication interactions and knowledge. Areas identified to support staff include training, devices to crush medications, medication suitability, multidisciplinary approach to streamline care and quick reference guides.

Relevance to clinical practice

Health professionals may use these results to reduce and ultimately avoid problems with administering medications through feeding tubes. Organisations may use these results to develop their local practice pathways for prescribing, dispensing and training around administration of medications through enteral tubes. In a community setting, this paper may improve the awareness of patients, caregivers and prescribers of the possible implications of tubing blockages.
Fidelity challenges while implementing an intervention aimed at increasing eating performance among nursing home residents with cognitive decline: A multicentre, qualitative descriptive study design
Authors: Palese Alvisa , Achbani Btissam , Hayter Mark , Watson Roger
Published: September 2020

Aims and objectives

To increase the knowledge on fidelity challenges in intervention studies promoting eating independence in residents with cognitive decline living in nursing homes (NHs).

Background

A few studies have documented to date factors affecting fidelity in intervention studies performed in NH settings. Moreover, fidelity issues in intervention studies aimed at promoting eating independence among NH residents with cognitive decline have not been studied to date.

Design

A hybrid study design was performed in 2018 and reported here according to the COnsolidated criteria for REporting Qualitative research.

Methods

In a clustered multicentre before/after intervention study design, a nested, multicentre qualitative descriptive design was performed. Four researchers with a nursing background, who received appropriate training, implemented the designed intervention. This consisted in intentional rounds in the dining rooms during lunchtime and was based on supportive, prescriptive and informative prompts delivered to residents with cognitive decline aimed at stimulating eating independence. A momentary assessment method was used, based on daily diary filled in by participant researchers after every session of intervention delivery on the following five dimensions of fidelity: (a) adherence, (b) dose (or exposure), (c) intervention quality, (d) participant responsiveness and (e) programme differentiation. A direct content analysis of the narratives reported on the diaries was performed.

Results

Factors increasing or hindering intervention fidelity during its implementation emerged at the NH, staff, family caregivers, resident, researchers and at the intervention itself levels.

Conclusions

Several factors emerged and all reported potentially both positive and negative influences on fidelity while implementing an intervention aimed at promoting eating independence among NH residents. Fidelity challenges should be considered as dynamic in NH intervention studies, where continuous adjustments of the intervention delivered are required.

Relevance to clinical practice

A calm environment, with staff members showing a caring behaviour, and researchers having achieved good familiarity with the NH setting, the residents, their family carers and the staff members, can all increase intervention fidelity.
The clinical findings and outcomes of symptomatic pregnant women diagnosed with or suspected of having coronavirus disease 2019 in a tertiary pandemic hospital in Istanbul, Turkey
Authors: Alay Ismail , Yildiz Sukru , Kaya Cihan , Yasar Kadriye Kart , Aydin Ozlem Altuntas , Karaosmanoglu Hayat Kumbasar , Aydeniz Banu , Salihoglu Ozgul , Yaşar Levent , Ekin Murat
Published: September 2020

Aim

To observe the clinical course of symptomatic pregnant women diagnosed with or suspected of having COVID‐19.

Methods

This study analyzed the clinical and laboratory results of 27 patients with real‐time polymerase chain reaction (RT‐PCR)‐confirmed COVID‐19 and 25 patients with a suspected COVID‐19 diagnosis based on their symptoms and chest computed tomography (CT) findings. The patients' coagulation parameters and acute‐phase reactants were evaluated both before and after treatment. The maternal and neonatal outcomes were also reviewed.

Results

The mean duration of hospitalization was 6.1 ± 3 days. The gestational age of the patients ranged from 6w2d to 40w2d. Thirty‐five patients' CT scan findings suggested viral pneumonia. Four patients delivered vaginally, and 10 patients underwent a cesarean section during the study period. Four of the cesarean deliveries were indicated due to COVID‐19 hypoxemia‐related fetal distress. Four patients were admitted to the intensive care unit (ICU) after the cesarean section.

Conclusion

Early hospitalization and medical treatment can alleviate symptoms, improve the clinical course and reduce the need for ICU in symptomatic pregnant patients with suspected or confirmed COVID‐19. Chest CT scans are a suitable option for suspected but unconfirmed COVID‐19 infection.
Introduction The 99th Berzelius symposium: the Cardiac Patient from Birth to Adulthood
Authors: Johansson B.
Published: September 2020

Content List ‐ Read more articles from the symposium: “The 99th Berzelius symposium: The Cardiac Patient from Birth to Adulthood”.
Protease inhibitors, inflammatory markers, and their association with outcome in dogs with naturally occurring acute pancreatitis
Authors: Kuzi Sharon , Mazaki‐Tovi Michal , Suchodolski Jan S. , Rimer Dar , Lidbury Jonathan A. , Steiner Joerg M. , Buono Agostino , Nivy Ran , Segev Gilad , Aroch Itamar
Published: September 2020

Background

Acute pancreatitis (AP) presumably is associated with pancreatic protease activation, protease inhibitor (PI) depletion, and inflammatory mediator secretion.

Objectives

Examine PIs and inflammatory mediator concentrations in dogs with AP and their association with death.

Animals

Thirty‐one dogs diagnosed with AP based on clinical signs, ultrasonographic findings, and increased canine pancreatic lipase immunoreactivity (cPLI) and 51 healthy control dogs.

Methods

Antithrombin and α2‐antiplasmin activity (ATA and α2AP, respectively) and concentrations of α1‐proteinase inhibitor (α1PI), α2‐macroglobulin (α2MG), C‐reactive protein (CRP), interleukins (ILs)‐2,6,8 and tumor necrosis factor‐α (TNF‐α) were prospectively measured. Severity of AP was assessed by clinical severity scoring systems.

Results

Mortality rate was 19%. Antithrombin activity was lower (P= .004) and maximal CRP, IL‐6, and TNF‐α concentrations higher (P < .04) in the AP group compared to the controls, whereas IL‐2, IL‐8, α1PI, and α2AP concentrations did not differ between groups. Serum α2MG concentration was not reliably detected. Serum cPLI, CRP, and IL‐6 concentrations were significantly and positively correlated. The ATA was lower (P= .04), and canine acute pancreatitis severity (CAPS) scores higher (P= .009) in nonsurvivors compared to survivors. Higher CAPS scores were associated (P <.05) with decreased ATA and increased cPLI, CRP, and IL‐6 concentrations.

Conclusions and Clinical Importance

Systemic inflammation in dogs with AP is manifested by increased inflammatory mediator concentrations, correlating with cPLI and CRP concentrations. Hypoantithrombinemia is associated with death. Serum concentrations of α2AP and α1PI are less useful prognostic markers. The CAPS score is a useful prognostic marker in dogs with AP.
Achieving clinically meaningful quality of life benefits in nocturia takes time: Results from a long‐term, multicenter phase 3 study of desmopressin in Japanese patients
Authors: Juul Kristian V. , Andersson Fredrik L. , Yamaguchi Osamu
Published: September 2020

Objectives

To investigate the long‐term efficacy, quality of life (QoL), and safety of desmopressin orally disintegrating tablets (ODTs) in Japanese patients with nocturia.

Methods

A long‐term, multicenter phase 3 study was conducted that enrolled Japanese male and female patients with nocturia (NCT03051009). Male patients received desmopressin 25‐ or 50‐μg ODTs, and female patients received desmopressin 25‐μg ODTs for up to 1 year. The primary endpoint was safety. Secondary endpoints included change from baseline in number of nocturnal voids, time to first awakening to void, and QoL assessments (nocturia‐specific zQoL [N‐QoL], Insomnia Severity Index [ISI], and Hsu bother score).

Results

Overall, 503 patients were enrolled. Reductions from baseline in mean number of nocturnal voids were observed in all treatment groups from week 1 (−0.62 to −1.00), with improvements continuing through week 52 (−1.39 to −1.71). Changes from baseline above or approximating a clinically meaningful improvement were seen by week 52 in the disease‐specific N‐QoL total score (improved by 11.5‐22.6), ISI (improved by −3.9 to −7.1), and Hsu bother scores (improved by −1.5 to −2.0). Adverse events (AEs) were reported in 54.9% of desmopressin‐treated patients. Most AEs were mild or moderate in severity.

Conclusions

Desmopressin ODTs (25 and 50 μg) demonstrated long‐term efficacy, improved QoL, and were well tolerated in Japanese male and female patients with nocturia treated for up to 1 year. Clinically meaningful improvements in patients’ QoL, assessed by N‐QoL, sleep quality, and bother, occur later than objective symptom improvements, such as voids.
Mid‐infrared reflectance spectroscopy of aubrite components
Authors: Morlok Andreas , Weber Iris , Stojic Aleksandra N. , Sohn Martin , Bischoff Addi , Martin Dayl , Hiesinger Harald , Helbert Joern
Published: September 2020

Aubrites Peña Blanca Spring and Norton County were studied in the mid‐infrared reflectance as part of a database for the MERTIS (Mercury Radiometer and Thermal Infrared Spectrometer) instrument on the ESA/JAXA BepiColombo mission to Mercury. Spectra of bulk powder size fractions from Peña Blanca Spring show enstatite Reststrahlen bands (RB) at 9 µm, 9.3 µm, 9.9 µm, 10.4 µm, and 11.6 µm. The transparency feature (TF) is at 12.7 µm, the Christiansen feature (CF) at 8.1–8.4 µm. Micro‐FTIR of spots with enstatite composition in Norton County and Peña Blanca Spring shows four types: Types I and II are similar to the bulk powder spectra but vary in band shape and probably display axis orientation. Type III has characteristic strong RB at 9.2 µm, 10.4 µm, and 10.5 µm, and at 11.3 µm. Type IV is characterized by a strong RB at 10.8−11.1 µm. Types III and IV could show signs of incipient shock metamorphism. Bulk results of this study confirm earlier spectral studies of aubrites that indicate a high degree of homogeneity and probably make the results of this study representative for spectral studies of an aubrite parent body. Spectral types I and II occur in all mineralogical settings (mineral clasts, matrix, melt, fragments in melt vein), while spectral type III was only observed among the clasts, and type IV in the melt. Comparison with surface spectra of Mercury does not obtain a suitable fit, only type IV spectra from quenched impact glass show similarity, in particular the 11 µm feature. Results of this study will be available upon request or via the IRIS database (Münster) and the Berlin Emissivity Database (BED).
Ordinary chondrite shock stage quantification using in situ 2‐D X‐ray diffraction of olivine
Authors: Rupert Alexandra N. , McCausland Phil J.A. , Flemming Roberta L.
Published: September 2020

Ordinary chondrites record shock metamorphism resulting from hypervelocity collisions on small bodies, and underpin the petrographic assessment of shock stage, a scale of progressive stages of shock metamorphism from S1 (unshocked) to S7 (shock melted). In this work, olivine grains in 11 L and LL chondrites (S1–S5) were investigated in thin section and hand sample using in situ two‐dimensional X‐ray diffraction (2‐D XRD). Olivine grains were measured under a 300 µm X‐ray beam for multiple lattice reflections, by measuring diffracted streak length along the chi (χ) dimension (Debye ring dimension), to examine their strain‐related mosaicity. Olivine strain‐related mosaicity was observed to increase with greater shock deformation, with more complex multi‐peak streaks apparent at higher shock levels. The full width at half maximum (FWHMχ) of the simple peak shapes along χ was measured to quantify petrographic shock stage for comparison with that described optically. The average FWHMχ values for simple peaks in olivine show an increase with increasing shock stage: S1 (0.44°± 0.06°), S2 (0.58°± 0.11°), S3 (0.67°± 0.15°), S4 (0.76°± 0.13°), and S5 (0.86°± 0.12°). This method complements optical petrographic methods and offers a ±1 shock stage accuracy in determining shock stage. In particular, 2‐D XRD analysis of strain‐related mosaicity allows quantitative analysis of shock stage in shock‐darkened samples that are difficult to work with petrographically, and for hand samples without need for thin section preparation.
Conformation control of the histidine kinase BceS of Bacillus subtilis by its cognate ABC‐transporter facilitates need‐based activation of antibiotic resistance
Authors: Koh Alan , Gibbon Marjorie J. , Van der Kamp Marc W. , Pudney Christopher R. , Gebhard Susanne
Published: September 2020

Bacteria closely control gene expression to ensure optimal physiological responses to their environment. Such careful gene expression can minimize the fitness cost associated with antibiotic resistance. We previously described a novel regulatory logic in Bacillus subtilis enabling the cell to directly monitor its need for detoxification. This cost‐effective strategy is achieved via a two‐component regulatory system (BceRS) working in a sensory complex with an ABC‐transporter (BceAB), together acting as a flux‐sensor where signaling is proportional to transport activity. How this is realized at the molecular level has remained unknown. Using experimentation and computation we here show that the histidine kinase is activated by piston‐like displacements in the membrane, which are converted to helical rotations in the catalytic core via an intervening HAMP‐like domain. Intriguingly, the transporter was not only required for kinase activation, but also to actively maintain the kinase in its inactive state in the absence of antibiotics. Such coupling of kinase activity to that of the transporter ensures the complete control required for transport flux‐dependent signaling. Moreover, we show that the transporter likely conserves energy by signaling with sub‐maximal sensitivity. These results provide the first mechanistic insights into transport flux‐dependent signaling, a unique strategy for energy‐efficient decision making.
Nursing perspectives and strategies in patients with respiratory insufficiency
Authors: Leonardsen Ann‐Chatrin , Gulbrandsen Tove , Wasenius Catrin , Fossen Linn Therese
Published: September 2020

Background

Approximately 30% of patients admitted to an intensive care unit experience respiratory distress. The COVID‐19 pandemic has led to an enormous increase in patients with respiratory symptoms. Nurse competence is essential for ensuring quality treatment and care for these patients; however, research on nursing strategies for patients with respiratory insufficiency is limited.

Aim

This study explored nurses' perspectives on and nursing strategies in patients with respiratory insufficiency when admitted to three different intensive care units.

Design

The study had an exploratory, descriptive, qualitative design.

Methods

Four focus group interviews with a total of 20 nurses, critical care nurses, and critical care nursing students were conducted. Data were analysed using content analysis.

Results

Participants' perspectives fell into two main themes: “nurse competence” and “the art of balancing.” “Nurse competence” incorporated the sub‐themes “observations and assessments,” “to make decisions,” and “collaboration.” The theme ‘the art of balancing’ incorporated the sub‐themes “nursing interventions,” “patients feeling safe,” and “patient participation.”

Conclusion

This study contributes new knowledge about nurses' perspectives on patients with respiratory insufficiency. Nurse competence was assumed essential to observe, assess, and treat patients with respiratory insufficiency. Nursing strategies included balancing nursing interventions, conducting medical treatment, and taking a whole‐person approach to patients' needs.

Relevance to clinical practice

The COVID‐19 pandemic has shown the need for nurse competence in caring for patients with respiratory insufficiency. This study adds to existing literature emphasizing the need for competence in health care services. Caring for patients with respiratory insufficiency requires nurses with experience; competence in observation, assessment, and medical treatment; and a whole‐person approach to patients' needs.
The impact of providing third molar extraction patients with pre‐consultation internet guidance upon their knowledge, anxiety, decision‐making and consultation outcomes: a pilot randomized controlled trial
Authors: Hanna K. , Sambrook P. , Armfield J.M. , Brennan D.S.
Published: September 2020

Aims

Identifying whether providing third molar extraction (TME) patients with pre‐consultation internet guidance influences: (1) shared decision‐making (SDM); (2) TME knowledge, dental anxiety, clinicians’ satisfaction and count of TME.

Methodology

Equal arm, parallel groups randomized controlled trial. Participants were public TME patients with internet access. The Study group received best online resources identified in a previous study before the consultation. SDM was measured using the dyadic SDM‐9Q‐Pt (Patient) and SDM‐9Q‐Doc (Doctor). TME knowledge and dental anxiety (using the IDAF‐4C) were collected before the consultation. Other outcomes were collected during the consultation.

Results

We randomized 120 eligible participants and we did not observe any difference at the baseline. At the consultation, we followed‐up 37 patients from the study group (61%) and 35 from the control group (58%). TME knowledge was associated with SDM‐9Q‐Pt and SDM‐9Q‐Doc (P < 0.05). Resources used did not improve TME knowledge (t = −.32,P = 0.753) which resulted in no difference in SDM‐9Q‐Pt (t = 1.76,P = 0.083) or SDM‐9Q‐Doc (t = −0.78,P = 0.436). IDAF‐4C scores were significantly higher than Australian norms (mean = 17.0, SD = 9.0, 95% CI: 16.2, 20.5). Resources used did not influence the IDAF‐4C scores (t = −.32,P = 0.753). No differences were observed in clinicians’ satisfaction with consultation time, patients’ knowledge and the count of TME.

Conclusion

TME knowledge is associated with SDM. The best available online resources used as an intervention did not improve the participants’ knowledge and therefore, the RCT outcomes were not affected. This suggests a need for developing patient‐centred resources. The high levels of dental anxiety among TME patients need clinicians’ attention.

Trial registration:ACTRN12614000593639.
Relational and psychological mediators of change in low‐income couples' perceived health
Authors: Roddy McKenzie K. , Doss Brian D.
Published: September 2020

Experimental tests of the association between relationship functioning and physical health are limited. Although associations are hypothesized to be partially mediated through improved psychological functioning, tests are mostly limited to lab‐based studies. The present study evaluated relational and psychological mediators of change in perceived health in a sample of 742 low‐income couples (1,484 individuals) who participated in a randomized controlled trial of two online relationship education programs and a waitlist control group. Results partially supported the Strengths and Strains Model of Relationships and Physical Health. Relationship functioning and some psychological functioning were mediators of change in perceived health. Future research is needed to understand how relationship functioning improved perceived health through mediators other than psychological functioning tested here.
Development of mesothelioma in situ and its progression to invasive disease observed in a patient with uncontrolled pleural effusions for 15 years
Authors: Hidaka Kouko , Takeda Tetsushi , Kinoshita Yoshiaki , Nabeshima Kazuki , Tamiya Sadafumi , Yoshikawa Yoshie , Tsujimura Tohru
Published: September 2020

Mesothelioma in situ (MIS) has recently been investigated as a distinct phase of mesothelioma carcinogenesis. The diagnostic criteria proposed for MIS include a loss of BRCA1‐associated protein 1 (BAP1) expression detected by immunohistochemistry (IHC). However, the length of time that MIS typically remains an in situ lesion before progression to invasive disease is still unclear. Herein, we report a case of a Japanese woman in her early seventies who had suffered from recurrent pleural effusions for 15 years, during which MIS developed and progressed to invasive mesothelioma. Retrospective diagnosis of partial MIS, fully developed MIS, and invasive disease was made using BAP1 IHC on three biopsy specimens and via clinical observations with radiological images. MIS and invasive lesions revealed BAP1 loss. The interval from partial or full MIS to invasive disease was 14 and 7 years, respectively. These results support a diagnostic strategy combining histomorphology with genomic‐based assays including BAP1 IHC in biopsy tissues from a patient with recurrent pleural effusions.
Multiplex gene‐panel testing for lung cancer patients
Authors: Yatabe Yasushi , Sunami Kuniko , Goto Koichi , Nishio Kazuto , Aragane Naoko , Ikeda Sadakatsu , Inoue Akira , Kinoshita Ichiro , Kimura Hideharu , Sakamoto Tomohiro , Satouchi Miyako , Shimizu Junichi , Tsuta Koji , Toyooka Shinichi , Nishino Kazumi , Hatanaka Yutaka , Matsumoto Shingo , Mikubo Masashi , Yokose Tomoyuki , Dosaka‐Akita Hirotoshi
Published: September 2020

The year 2019 was considered to be the first year of cancer genome medicine in Japan, with three gene‐panel tests using next‐generation sequencing (NGS) techniques being introduced into clinical practice. Among the three tests, the Oncomine CDx Target test was approved under the category of regular molecular testing for lung cancer, which meant that this test could be used to select patients for molecularly targeted drugs. Conversely, the other two tests, NCC OncoPanel and FoundationOne CDx, were assigned to be used under the National Cancer Genome Medicine Network, and implementation was restricted to patients for whom standard treatment was completed or expected to be completed. These NGS tests can detect a series of genetic alterations in individual tumors, which further promotes the development of therapeutic agents and elucidates molecular pathways. The NGS tests require appropriate tissue size and tumor cell content, which can be accessed only by pathologists. In this report, we review the current reimbursement schema in our national healthcare policy and the requirements of the specimens for NGS testing based on the recently published ‘Guidance of Gene‐panel Testing Using Next‐Generation Sequencers for Lung Cancer’, by the Japanese Society of Lung Cancer.
Public employment services: Building social resilience in youth?
Authors: Assmann Marie‐Luise , Tolgensbakk Ida , Vedeler Janikke S. , Bøhler Kjetil K.
Published: September 2020

It is contested to what extent public employment services (PES) help build resilience in young unemployed people. Drawing on qualitative interviews with 19 people born in Germany and Norway between 1990 and 1995, the article examines stories about how PES, in two different activation regimes, help young people find meaningful work. The analysis and discussion are carried out within a theoretical framework that combines the capability approach with social resilience literature in a novel way. The findings show that PES are portrayed as being more present in young Germans' lives. The German informants seem to feel undue pressure from PES and they describe differences between personal aims and the “placement priority” of PES. Sanctions imposed by PES were also a much more predominant topic among the German informants. The Norwegian data were dominated by stories about young people in activation programmes who had been demotivated by being trapped in a cycle of programme participation, which did not result in employment. Across the two countries, our data suggest that PES rarely build social resilience: PES provided young people with a means to survive, but rarely helped to build their capacity to overcome their difficult situation. In line with previous research, the stories of young Germans and Norwegians also emphasise the need for a PES that provides tailor‐made services that build on young people's motivation and ambition. The article demonstrates that combining the capability approach with social resilience theory enables a dynamic perspective on the development of people's capabilities.
Effect of timing of cattle urine deposition and pasture composition on nitrogen leaching losses
Authors: Talbot William D. , Malcolm Brendon J. , Cameron Keith C. , Di Hong J. , Whitehead David
Published: September 2020

A lysimeter experiment using undisturbed monoliths from a stony silt loam soil was carried out to quantify the effects different pasture types on N losses from urine applied to soil on different dates. Three pasture types were tested: (a) perennial ryegrass (Lolium perenne)/white clover (Trifolium repens) (PRG/WC), (b) perennial ryegrass/white clover/plantain (Plantago lanceolata) (PRG/WC/P) and (c) Italian ryegrass (Lolium multiforum)/white clover/plantain (IRG/WC/P), with four different urine applications dates (late summer, early autumn, mid‐autumn and late autumn). Cattle urine was applied at the equivalent of 700 kg N−1 ha−1. There was a significant reduction in total amount of nitrate (NO3−‐N) leached under the PRG/WC/P (14% reduction) and IRG/WC/P (24% reduction) compared with the PRG/WC. High NO3−‐N leaching losses were found at each urine application date (>181 kg NO3−‐N/ha), suggesting there may be higher than expected N leaching losses when urine is deposited onto shallow stony soils, during warmer months (late summer and early autumn). There was no significant interaction between pasture type and urine timing on NO3−‐N leaching losses.
Two novel HLA‐DQA1*03:03:01 variants identified in Brazilian individuals: DQA1*03:03:01:13 and DQA1*03:03:01:14
Authors: Vianna Romulo , Lopes Giovanna , Pôrto Luís Cristóvão
Published: September 2020

Characterization of two novel HLA‐DQA1*03:03:01 variants, HLA‐DQA1*03:03:01:13 and ‐DQA1*03:03:01:14.
(+)‐Sesamin‐oxidising CYP92B14 shapes specialised lignan metabolism in sesame
Authors: Harada Erisa , Murata Jun , Ono Eiichiro , Toyonaga Hiromi , Shiraishi Akira , Hideshima Kosuke , Yamamoto Masayuki P. , Horikawa Manabu
Published: September 2020

Sesamum spp. (sesame) are known to accumulate a variety of lignans in a lineage‐specific manner. In cultivated sesame (Sesamum indicum), (+)‐sesamin, (+)‐sesamolin and (+)‐sesaminol triglucoside are the three major lignans found richly in the seeds. A recent study demonstrated that SiCYP92B14 is a pivotal enzyme that allocates the substrate (+)‐sesamin to two products, (+)‐sesamolin and (+)‐sesaminol, through multiple reaction schemes including oxidative rearrangement of α‐oxy‐substituted aryl groups (ORA). In contrast, it remains unclear whether (+)‐sesamin in wild sesame undergoes oxidation reactions as in S. indicum and how, if at all, the ratio of the co‐products is tailored at the molecular level. Here, we functionally characterised SrCYP92B14 as a SiCYP92B14 orthologue from a wild sesame, Sesamum radiatum, in which we revealed accumulation of the (+)‐sesaminol derivatives (+)‐sesangolin and its novel structural isomer (+)‐7´‐episesantalin. Intriguingly, SrCYP92B14 predominantly produced (+)‐sesaminol either through ORA or direct oxidation on the aromatic ring, while a relatively low but detectable level of (+)‐sesamolin was produced. Amino acid substitution analysis suggested that residues in the putative distal helix and the neighbouring heme propionate of CYP92B14 affect the ratios of its co‐products. These data collectively show that the bimodal oxidation mechanism of (+)‐sesamin might be widespread across Sesamum spp., and that CYP92B14 is likely to be a key enzyme in shaping the ratio of (+)‐sesaminol‐ and (+)‐sesamolin‐derived lignans from the biochemical and evolutionary perspectives.
One‐year conditional survival of dogs and cats with invasive mammary carcinomas: A concept inspired from human breast cancer
Authors: Chocteau Florian , Mordelet Valentin , Dagher Elie , Loussouarn Delphine , Abadie Jérôme , Nguyen Frédérique
Published: September 2020

Numerous studies have described the prognostic factors of canine and feline mammary carcinomas (MCs), that is, variables that predict patient survival after diagnosis. But how does survival estimation evolve in patients that escaped early death from their cancer? In human oncology, conditional survival (CS), the probability of surviving X further years when cancer patients have already survived Y years, is used to analyse cancer outcomes in a long‐term perspective. In this cohort of 344 dogs and 342 cats with surgically removed stage I to III invasive MCs, with a minimal follow‐up of 2 years, we calculated the 1‐year CS, that is, the probability for patients that have survived 1 year, to survive or to die from cancer during the subsequent year. The 1‐year conditional specific survival probabilities were 59% and 48% at diagnosis of invasive MC respectively in dogs and cats, and 80% and 52% in 1‐year surviving dogs and cats respectively, suggesting that 1‐year surviving dogs were relatively protected from cancer‐related death, whereas feline MCs remained life‐threatening cancers for longer periods of time. Among the most significant parameters associated with CS in surviving dogs and cats were the nodal stage and lymphovascular invasion, as well as patient age, cancer stage and margin status in surviving dogs. By comparison, tumour size and the histological grade did not significantly alter CS probabilities in surviving dogs and cats. Conditional survival may be considered a very interesting tool for veterinary practitioners to estimate the likely outcome of cancer survivors.
The Post-excavation Analysis and Archiving of Outputs from Complex, Multi-period Landscape Investigations: the example of Heslington East, York
Authors: Roskams Steve
Published: September 2020

This article discusses the post-excavation analysis and archiving of data generated by fieldwork undertaken at Heslington East near York in the UK. This project, stretching over two decades, involved two commercial companies and a student training and local community element, and recently concluded with a thematic publication (Roskams and Neal 2020). The article has twin objectives. First, on a theoretical level, it reflects on the complex challenges that arise when attempting to combine diverse stratigraphic, spatial and assemblage data from different sources to reach meaningful interpretations of an extensive, multi-period landscape. Second, on a practical level, it aims to act as an introduction to the project's archives to make them accessible to future audiences, something that is essential if we are to enable any re-interpretation of the site. I suggest that such archives embody a series of transformations. These comprise first the interpretation of reconnaissance and evaluation procedures, converted to generate an excavation strategy, something briefly summarised here. I then discuss at greater length: the processes of post-excavation analysis of stratigraphic and spatial data, and their relationship with the MoRPHE requirement (Historic England 2006) to select particular assemblages for detailed analysis; linking the latter, specialist reports on selected assemblages to preliminary interpretations of site evidence, an iterative process that creates more soundly based understanding; and the recasting of summaries of the most significant evidence in these secondary interpretations to fit the thematic organisation of the published report. I argue that each of these hierarchically ordered transformations needs to be understood if we are to facilitate effective re-use of site archives.
Perspectivas jurídico-canónicas para la protección del patrimonio cultural eclesial en Colombia
Authors: Flórez Sandra Lidia
Published: September 2020

Este artículo busca mostrar la importancia que ha tenido el patrimonio cultural eclesiástico en la labor de la Iglesia, su evolución histórica y su desarrollo legislativo en materia tanto eclesial como civil.

La sociedad actual ha ido estableciendo diferentes marcos legislativos civiles para su protección, elementos que deben ser aprovechados por la Iglesia, según el llamado de los romanos pontífices en los últimos tiempos. Por este motivo, se quiere dar a conocer herramientas legislativas tanto en el derecho civil como en el canónico que permitan una mayor eficacia en la protección de este patrimonio, referido principalmente al caso colombiano.