bluuebunny/crossref_metadata_2025 huggingface dataset:
Technical feasibility of umbilical cannulation in midgestation lambs supported by the EXTra‐uterine Environment for Neonatal Development (EXTEND)
Authors: Hornick Matthew A. , Mejaddam Ali Y. , McGovern Patrick E. , Hwang Grace , Han Jiancheng , Peranteau William H. , Partridge Emily A. , Davey Marcus G. , Flake Alan W.
Published: June 2019

EXTEND (EXTra‐uterine Environment for Neonatal Development) is a novel system for supporting extremely premature infants that replicates in utero conditions by maintaining a sterile fluid environment and providing gas exchange via a pumpless arteriovenous oxygenator circuit connected to the umbilical vessels. Target gestational age (GA) for EXTEND support in human infants is 23‐27 weeks, when immature lungs are most susceptible to injury in the setting of air ventilation. We previously demonstrated physiologic support of premature lambs cannulated at 105‐117 days GA (lungs developmentally analogous to the 23‐27 week GA human infant) for up to 28 days on EXTEND. In the present study, we sought to determine the technical feasibility of umbilical vessel cannulation in 85‐96 days GA lambs delivered to EXTEND at weights equivalent to the 23‐27 week GA human infant (500‐850 g). Five preterm lambs were cannulated at 85‐96 days GA (term 145 days) and supported on EXTEND for 4‐7 days. All lambs underwent umbilical artery and umbilical vein cannulation. Circuit flows and pressures were monitored continuously, and blood gases were obtained at regular intervals for assessment of oxygen parameters. Systemic pH and lactate were measured at least once daily. Mean body weight at cannulation was 641 ± 71 g (range 480‐850 g). All lambs were cannulated successfully (cannula size varied from 8 to 12 Fr), and mean survival on EXTEND was 140 ± 7 hours. Mean circuit flow was 213 ± 15 mL/kg*min, mean pH was 7.37 ± 0.01, and mean lactate was 1.6 ± 0.2 mmol/L. During the initial 120 hours after EXTEND cannulation, there were no significant differences between 85‐96 days GA lambs and 105‐117 days GA lambs in weight‐adjusted circuit flows, oxygen delivery, pH, or lactate levels. This study demonstrates successful umbilical cord cannulation and adequate circuit flows and oxygen delivery in midgestation lambs size‐matched to the 23‐27 week GA human fetus, which represents an important step in the translation of EXTEND to clinical practice.
Hypothermic oxygenated machine perfusion alleviates liver injury in donation after circulatory death through activating autophagy in mice
Authors: Zeng Xianpeng , Wang Shengjie , Li Shiyi , Yang Yunying , Fang Zehong , Huang Honglei , Wang Yanfeng , Fan Xiaoli , Ye Qifa
Published: June 2019

Hypothermic oxygenated machine perfusion (HOPE) is a safe and reliable method that could alleviate liver injury in donation after circulatory death (DCD). This study focuses on the role of autophagy in HOPE’s protective effect on DCD liver injury. A 30‐minute warm ischemic liver model was established in mice. After 4 hours of cold storage (CS), 1 hour of hypothermic machine perfusion (HMP) with 100% O2 or 100% N2 was employed. During 2 hours of reperfusion, liver tissue and perfusate were collected to evaluate liver function, oxidative stress level, apoptosis, and necrosis. Western blotting was used to explore the level of autophagy. When the liver experienced warm ischemic injury, LC3B‐II expression was significantly enhanced. Compared with the CS, HOPE induced lower release of AST and ALT, as well as lower oxidative stress levels, apoptosis, and necrosis cell numbers, and led to higher tissue ATP content. Meanwhile, expression of autophagy‐related proteins, such as ULK1, Atg5, and LC3B‐II, increased. When oxygen was completely replaced by nitrogen, the washout effect of HMP did not activate autophagy and did not relieve DCD liver injury. When the autophagy inhibitor 3‐methyladenine was used in HOPE, the protective effect of HOPE was attenuated. In conclusion, DCD liver injury activated autophagy compared with healthy liver, while HOPE alleviated DCD liver injury by increasing autophagy levels further in this mouse model. However, HMP with 100% of N2 had no beneficial effect on DCD liver injury or on autophagy levels compared with CS. The research on autophagy may provide a new strategy for alleviating DCD liver injury in clinical practice.
Multiparametric magnetic resonance imaging and follow‐up to avoid prostate biopsy in 4259 men
Authors: Venderink Wulphert , van Luijtelaar Annemarijke , van der Leest Marloes , Barentsz Jelle O. , Jenniskens Sjoerd F.M. , Sedelaar Michiel J.P. , Hulsbergen‐van de Kaa Christina , Overduin Christiaan G. , Fütterer Jurgen J.
Published: June 2019

Objective

To determine the proportion of men avoiding biopsy because of negative multiparametric magnetic resonance imaging (mpMRI) findings in a prostate MRI expert centre, and to assess the number of clinically significant prostate cancers (csPCa) detected during follow‐up.

Patients and methods

Retrospective study of 4259 consecutive men having mpMRI of the prostate between January 2012 and December 2017, with either a history of previous negative transrectal ultrasonography‐guided biopsy or biopsy naïve. Patients underwent mpMRI in a referral centre. Lesions were classified according to Prostate Imaging Reporting And Data System (PI‐RADS) versions 1 and 2. Negative mpMRI was defined as an index lesion PI‐RADS ≤2. Follow‐up until 13 October 2018 was collected by searching the Dutch Pathology Registry (PALGA). Gleason score ≥3 + 4 was considered csPCa. Kaplan–Meier analysis and univariable logistic regression models were used in the cohort of patients with negative mpMRI and follow‐up.

Results

Overall, in 53.6% (2281/4259) of patients had a lesion classified as PI‐RADS ≤2. In 320 patients with PI‐RADS 1 or 2, follow‐up mpMRI was obtained after a median (interquartile range) of 57 (41–63) months. In those patients, csPCa diagnosis‐free survival (DFS) was 99.6% after 3 years. Univariable logistic regression analysis revealed age as a predictor for csPCa during follow‐up (P < 0.05). In biopsied patients, csPCa was detected in 15.8% (19/120), 43.2% (228/528) and 74.5% (483/648) with PI‐RADS 3, 4 and 5, respectively.

Conclusion

More than half of patients having mpMRI of the prostate avoided biopsy. In those patients, csPCa DFS was 99.6% after 3 years.
The Unrested Adolescent Brain
Authors: Galván Adriana
Published: June 2019

Mounting scientific evidence illustrates the detrimental effects of sleep loss on the brain and behavioral functioning. Given the ongoing development of the brain from the onset of puberty into the early 20s, these behavioral and neural effects are particularly concerning for adolescents. In this review, I summarize what we know about the relation among sleep disruption, changes in sleep biology across puberty, and the developing adolescent brain. Although examinations of sleep and the developing brain have been promising, significant gaps in knowledge remain regarding populations sampled and methodological challenges. The field will also benefit from better communication among sleep researchers and developmental neuroscientists to translate the results of studies on the brain into meaningful outcomes.
Cutaneous pseudolymphoma—A review on the spectrum and a proposal for a new classification
Authors: Mitteldorf Christina , Kempf Werner
Published: June 2019

Cutaneous pseudolymphomas (PSLs) belong to a group of lymphocytic infiltrates that histopathologically and/or clinically simulate lymphomas. Different causative agents (e.g., Borrelia sp., injected substances, tattoo, arthropod bite) have been described, but in many cases no cause can be identified, hence the term idiopathic PSL. Clinicopathological correlation is important to make the diagnosis. Four main groups of cutaneous PSL can be distinguished based on histopathologic and/or clinical presentation: (a) nodular PSL; (b) pseudo‐mycosis fungoides (pseudo‐MF) and simulators of other CTCLs; (c) other PSL (representing distinct clinical entities); and (d) intravascular PSL. This article gives an overview of the histopathologic and clinical characteristics of cutaneous PSLs and proposes a new classification.
Many unreported crop pests and pathogens are probably already present
Authors: Bebber Daniel P. , Field Elsa , Gui Heng , Mortimer Peter , Holmes Timothy , Gurr Sarah J.
Published: June 2019

Invasive species threaten global biodiversity, food security and ecosystem function. Such incursions present challenges to agriculture where invasive species cause significant crop damage and require major economic investment to control production losses. Pest risk analysis (PRA) is key to prioritize agricultural biosecurity efforts, but is hampered by incomplete knowledge of current crop pest and pathogen distributions. Here, we develop predictive models of current pest distributions and test these models using new observations at subnational resolution. We apply generalized linear models (GLM) to estimate presence probabilities for 1,739 crop pests in the CABI pest distribution database. We test model predictions for 100 unobserved pest occurrences in the People's Republic of China (PRC), against observations of these pests abstracted from the Chinese literature. This resource has hitherto been omitted from databases on global pest distributions. Finally, we predict occurrences of all unobserved pests globally. Presence probability increases with host presence, presence in neighbouring regions, per capita GDP and global prevalence. Presence probability decreases with mean distance from coast and known host number per pest. The models are good predictors of pest presence in provinces of the PRC, with area under the ROC curve (AUC) values of 0.75–0.76. Large numbers of currently unobserved, but probably present pests (defined here as unreported pests with a predicted presence probability >0.75), are predicted in China, India, southern Brazil and some countries of the former USSR. We show that GLMs can predict presences of pseudoabsent pests at subnational resolution. The Chinese literature has been largely inaccessible to Western academia but contains important information that can support PRA. Prior studies have often assumed that unreported pests in a global distribution database represent a true absence. Our analysis provides a method for quantifying pseudoabsences to enable improved PRA and species distribution modelling.
Impact of warm‐season grass management on feedstock production on marginal farmland in Central Illinois
Authors: Zumpf Colleen , Lee Moon‐Sub , Thapa Santanu , Guo Jia , Mitchell Rob , Volenec Jeffrey J. , Lee DoKyoung
Published: June 2019

The production of dedicated energy crops on marginally productive cropland is projected to play an important role in reaching the US Billion Ton goal. This study aimed to evaluate warm‐season grasses for biomass production potential under different harvest timings (summer [H1], after killing frost [H2], or alternating between two [H3]) and nitrogen (N) fertilizer rates (0, 56, and 112 kg N/ha) on a wet marginal land across multiple production years. Six feedstocks were evaluated including Miscanthus x giganteus, two switchgrass cultivars (Panicum virgatum L.), prairie cordgrass (Spartina pectinata Link), and two polycultures including a mixture of big bluestem (Andropogon gerardii Vitman), indiangrass (Sorghastrum nutans), and sideoats grama (Bouteloua curtipendula [Michx.] Torr.), and a mixture of big bluestem and prairie cordgrass. Across four production years, harvest timing and feedstock type played an important role in biomass production. Miscanthus x giganteus produced the greatest biomass (18.7 Mg/ha), followed by the switchgrass cultivar “Liberty” (14.7 Mg/ha). Harvest in H1 tended to increase yield irrespective of feedstock; the exception being M. x giganteus that had significantly lower biomass when harvested in H1 when compared to H2 and H3. The advantage H1 harvest had over H2 for all feedstocks declined over time, suggesting H2 or H3 would provide greater and more sustainable biomass production for the observed feedstocks. The N application rate played an important role mainly for M. x giganteus where 112 kg N/ha yielded more biomass than no N. Other feedstocks occasionally showed a slight, but statistically insignificant increase in biomass yield with increasing N rate. This study showed the potential of producing feedstocks for bioenergy on wet marginal land; however, more research on tissue and soil nutrient dynamics under different N rates and harvest regimes will be important in understanding stand longevity for feedstocks grown under these conditions.
The experience of hope in families of children and adolescents living with chronic illness: A thematic synthesis of qualitative studies
Authors: Leite Ana Carolina Andrade Biaggi , Garcia‐Vivar Cristina , Neris Rhyquelle Rhibna , Alvarenga Willyane de Andrade , Nascimento Lucila Castanheira
Published: June 2019

Aim

To synthesize qualitative studies on the experience of hope in families of children and adolescents living with chronic illness.

Background

Hope is multidimensional, dynamic, and varies according to experienced events, cultural environments and stage of life. The qualitative synthesis of the experience of hope in the paediatric population with chronic conditions is scarce.

Design

Thematic synthesis of qualitative studies.

Data sources

A systematic literature search in PubMed, CINAHL, LILACS, PsycINFO, Scopus, and Web of Science was performed supplemented by manual search strategies. Thirty‐one studies from fifteen countries, published between 1981‐2018, were included.

Findings

Findings were integrated into an analytical theme “FAMILY HOPE: KEEPING THE DAY‐TO‐DAY BALANCE”, encompassing the following five descriptive themes: Uncertainty; Support; Information; Between “dark thoughts” and positive thoughts; and Hoping to go back to normality.

Conclusion

This thematic synthesis brings a new dimension of hope among families of children and adolescents living with chronic illness. “Family Hope” highlights the influence of the relationships between relatives and the chronically ill child in the balance of hope. It is recommended that health professionals use a family‐focused approach to support these families.

Impact

Shifting the focus to a family dimension of hope is a promising pursuit that has the potential to inform future nursing practices to support the experiences of families living with chronic illness in the paediatric context. A better understanding of the role and characteristics of family hope will promote the development of more effective interventions for families to adapt to long‐term paediatric conditions.
A review of prospective registration of trials published in nursing science journals in 2017
Authors: Gray Richard , Gray George , Brown Ellie
Published: June 2019

Aim

To determine the proportion of trials published in nursing science journals in 2017 that were prospectively registered.

Design

A review of randomized controlled trials published in a Journal Citation Report nursing science journal in 2017.

Data source

Table of contents of included journals.

Review methods

Randomized controlled trials were identified by manually reviewing the title of all papers published in included journals. Included trials were classified as: (a) Prospectively registered; (b) Retrospectively registered; (c) Registered but registration not reported in the manuscript; (d) Indeterminate registration; and (e) Not registered. Additionally, we recorded if the trial registration number was reported in the manuscript abstract.

Results

Of 151 randomized controlled trials published in nursing science journals in 2017, 17 (11%) were prospectively registered. Thirty‐six (24%) trials were retrospectively and 93 (62%) not registered. We could not determine the registration status of five (3%) trials. The registration number was included in the abstract of two prospectively and eight retrospectively registered studies. Compared with the rest of the world, trial registration rates were significantly lower in Asian countries.

Conclusion

Two included trials were prospectively registered and reported a registration number in the abstract. Compared with other disciplines, rates of prospective trial registration are low. Nurse trialists must ensure that they prospectively register all trials.

Impact

We intended to replicate this review in subsequent years with a view to reporting improvements in prospective registration rates over time.
Pain and pain management during induced abortions: A web‐based exploratory study of recollections from previous patients
Authors: Georgsson Susanne , Carlsson Tommy
Published: June 2019

Aims

To explore recollections of pain and pain management during induced abortions.

Design

Mixed‐methods exploratory study in Sweden.

Methods

A web‐based survey was distributed between October 2017 ‐ July 2018 via Swedish discussion boards and social media. Open‐ended questions were asked about recollection of pain and pain management, followed by self‐reported ratings. The survey was answered by 185 participants, responses were analysed with qualitative content analysis.

Findings

Recollections of pain intensity illustrated considerable pain and a traumatic event, described in temporal aspects and likened to other painful conditions such as dysmenorrhoea and childbirth. Recollections of pain management illustrated experiences of insufficient treatment of pain and dissatisfaction with pain management, including inefficient treatment and lack of professional attendance. Psychological aspects and consequences illustrated that participants related psychological distress to physical pain, felt unprepared for the physical pain and emphasized the importance of psychological support. Those who experienced intense pain described long‐term psychological consequences, including fear of childbirth.

Conclusion

Physical pain and psychological distress can manifest as considerable challenges during induced abortion. Abortion‐related pain is a multidimensional phenomenon involving physical and psychological components that needs to be rigorously treated. When physical pain is unsuccessfully treated, women may experience long‐term psychological consequences after an abortion.

Impact

The results illustrate the importance of holistic abortion care where the multidimensional components of abortion‐related pain are considered. Patients need to be offered sufficient preparatory information about potential physical pain and psychological distress. This study indicates that there is room for improvement in pain management. Larger studies are needed.
Expression of toll‐like receptors and their regulatory roles in murine cardiac telocytes
Authors: Li Shinan , Shen Xiaokun , He Shaoheng
Published: June 2019

Telocytes, newly discovered in the last decade, are interstitial cells found in numerous organs, with multiple proposed potential biological functions. Toll‐like receptors (TLRs) play an important role in innate and adaptive immunity by recognizing pathogen‐associated molecular patterns (PAMPs). However, it is still unknown whether telocytes express these innate receptors. We sought to determine the expression and role of TLRs in telocytes. In our study, we primarily detected TLR1‐9 expression in telocytes. The proliferation, apoptosis and immunoregulatory activity of telocytes activated with or without TLR ligands were determined. Our results showed that purified telocytes expressed TLR2, TLR3 and TLR5. In particular, telocytes expressed high levels of TLR2 as observed using flow cytometry. When we stimulated telocytes with TLR2 or TLR3 agonists (Pam3CSK4, PolyI:C), iNOS expression was greatly increased after Pam3CSK4 treatment. Additionally, telocyte proliferation was reduced and cell apoptosis was increased after TLR agonist stimulation. A co‐culture experiment showed that supernatant from telocytes pretreated with Pam3CSK4 inhibited T cell activation much more than that from untreated telocytes and this effect was mediated by iNOS. Overall, our results demonstrated TLR expression on telocytes for the first time and provided evidence of an immunoregulatory role of telocytes, indicating their clinical potential.
Comprehensive proteogenomic analysis of human embryonic and induced pluripotent stem cells
Authors: Parrotta Elvira Immacolata , Scalise Stefania , Taverna Domenico , De Angelis Maria Teresa , Sarro Gianmarco , Gaspari Marco , Santamaria Gianluca , Cuda Giovanni
Published: June 2019

Although the concepts of somatic cell reprogramming and human‐induced pluripotent stem cells (hiPSCs) generation have undergone several analyses to validate the usefulness of these cells in research and clinic, it remains still controversial whether the hiPSCs are equivalent to human embryonic stem cells (hESCs), pointing to the need of further characterization for a more comprehensive understanding of pluripotency. Most of the experimental evidence comes from the transcriptome analysis, while a little is available on protein data, and even less is known about the post‐translational modifications. Here, we report a combined strategy of mass spectrometry and gene expression profiling for proteogenomic analysis of reprogrammed and embryonic stem cells. The data obtained through this integrated, multi‐“omics” approach indicate that a small, but still significant, number of distinct pathways is enriched in reprogrammed versus embryonic stem cells, supporting the view that pluripotency is an extremely complex, multifaceted phenomenon, with peculiarities that are characteristic of each cell type.
Differences between pure desmoplastic melanoma and superficial spreading melanoma in terms of survival, distribution and other clinicopathologic features
Authors: Howard M.D. , Wee E. , Wolfe R. , McLean C.A. , Kelly J.W. , Pan Y.
Published: June 2019

Background

Pure desmoplastic melanoma (pDM) is an uncommon subtype of malignant melanoma with comparative high rates of local recurrence and low rates of sentinel lymph node positivity. The melanoma‐specific survival (MSS) of pDM compared to other melanoma subtypes is unclear, with conflicting reports and lack of multivariable analyses.

Objectives

We aimed to describe clinicopathological characteristics of a cohort of patients with pDM and to compare the MSS of pDM with superficial spreading melanoma (SSM).

Methods

A prospective cohort study was performed of all primary invasive cutaneous pDM with known tumour location and thickness reviewed at a tertiary referral centre over 21 years.

Results

A total of 119 primary cutaneous invasive pDMs from 3570 total invasive cutaneous melanomas were included. Compared to 2272 SSMs, and due largely to their greater average thickness, patients with pDM had worse MSS (unadjusted hazard ratio, HR, 2.56, 95% confidence interval, CI, 1.56–4.22). After adjustment for clinicopathologic factors (including thickness, ulceration, mitotic rate, age and sex), there was evidence that patients with pDM had an improved MSS (adjusted HR, 0.49; 95% CI, 0.28–0.87). Median thickness of head and neck pDM was greater than non‐head and neck pDM (P < 0.001). There was reduced univariable MSS in head and neck pDM compared to the rest of the body.

Conclusions

Decreased univariable MSS of patients with pDM compared to SSM was explained by the increased frequency of adverse clinicopathologic features at diagnosis, in particular the greater Breslow thickness of pDM. After adjustment, patients with pDM had half the chance of melanoma‐specific death compared to SSM. Head and neck pDM were thicker at diagnosis compared to the rest of the body, which may account for its poorer survival compared to the rest of the body.
Identification and Expression Analyses of the Nitrate Transporter Gene (NRT2) Family Among Skeletonema species (Bacillariophyceae)
Authors: Kang Lee‐Kuo , Rynearson Tatiana A.
Published: June 2019

High‐affinity nitrate transporters are considered to be the major transporter system for nitrate uptake in diatoms. In the diatom genus Skeletonema, three forms of genes encoding high‐affinity nitrate transporters (NRT2) were newly identified from transcriptomes generated as part of the marine microbial eukaryote transcriptome sequencing project. To examine the expression of each form of NRT2 under different nitrogen environments, laboratory experiments were conducted under nitrate‐sufficient, ammonium‐sufficient, and nitrate‐limited conditions using three ecologically important Skeletonema species: S. dohrnii, S. menzelii, and S. marinoi. Primers were developed for each NRT2 form and species and Q‐RT‐PCR was performed. For each NRT2 form, the three Skeletonema species had similar transcriptional patterns. The transcript levels of NRT2:1 were significantly elevated under nitrogen‐limited conditions, but strongly repressed in the presence of ammonium. The transcript levels of NRT2:2 were also repressed by ammonium, but increased 5‐ to 10‐fold under nitrate‐sufficient and nitrogen‐limited conditions. Finally, the transcript levels of NRT2:3 did not vary significantly under various nitrogen conditions, and behaved more like a constitutively expressed gene. Based on the observed transcript variation among NRT2 forms, we propose a revised model describing nitrate uptake kinetics regulated by multiple forms of nitrate transporter genes in response to various nitrogen conditions in Skeletonema. The differential NRT2 transcriptional responses among species suggest that species‐specific adaptive strategies exist within this genus to cope with environmental changes.
Selection at behavioural, developmental and metabolic genes is associated with the northward expansion of a successful tropical colonizer
Authors: Bourgeois Yann , Boissinot Stéphane
Published: June 2019

What makes a species able to colonize novel environments? This question is key to understand the dynamics of adaptive radiations and ecological niche shifts, but the mechanisms that underlie expansion into novel habitats remain poorly understood at a genomic scale. Lizards from the genus Anolis are typically tropical, and the green anole (Anolis carolinensis) constitutes an exception since it expanded into temperate North America from subtropical Florida. Thus, we used the green anole as a model to investigate signatures of selection associated with colonization of a new environment, namely temperate North America. To this end, we analysed 29 whole‐genome sequences, covering the entire native range of the species. We used a combination of recent methods to quantify both positive and balancing selection in northern populations, including FST outlier methods, machine learning and ancestral recombination graphs. We naively scanned for genes of interest and assessed the overlap between multiple tests. Strikingly, we identified many genes involved in behaviour, suggesting that the recent successful colonization of northern environments may have been linked to behavioural shifts as well as physiological adaptation. Using a candidate genes strategy, we determined that genes involved in response to cold or behaviour displayed more frequently signals of selection, while controlling for local recombination rate, gene clustering and gene length. In addition, we found signatures of balancing selection at immune genes in all investigated genetic groups, but also at genes involved in neuronal and anatomical development.
Peer‐supported faculty development and workplace teaching: an integrative review
Authors: Campbell Narelle , Wozniak Helen , Philip Robyn L , Damarell Raechel A
Published: June 2019

Context

The use of peer support as a faculty development technique to improve clinical teaching is uncommon in medical education, despite the benefits of situating learning in the workplace. The authors therefore conducted a broad search seeking theoretical and empirical literature describing peer support strategies for clinical teachers in health care workplaces. This included descriptive and non‐experimental studies that are often excluded from reviews. The review aimed to identify and assess existing initiatives and to synthesise key challenges and benefits.

Methods

An integrative literature review was undertaken (2004–2017), based on searches of eight international electronic databases and targeted manual searches. Key concepts, elements and models were mapped using an iterative, constant comparative method. An evaluative framework, drawing on previous research, informed conclusions regarding the quality of evidence.

Results

From a pool of 5735 papers, 34 met the inclusion criteria. The majority referred to studies conducted in the USA (59%) and in the medical profession (71%). Analysis revealed a trend towards using a collaborative model (56%), voluntary participation (59%), and direct workplace observation by a peer clinician (68%). Design features of the peer support strategy were commonly reported (65%), with half providing outcome measures (56%). Few papers reported on process evaluation (15%) or evidence of programme sustainability (15%). Despite logistical and time‐associated challenges, benefits accrued to individuals and the workplace, and included improved teaching practices. Embedding the peer support strategy into routine organisational practice proved effective.

Conclusions

The results indicated that a workplace‐based peer support model is an acceptable and effective faculty development strategy for health care clinical teachers. Conceptualising workplace‐based peer support via a sociocultural model that acknowledges the significance of educational design, peers as collaborators and the importance of workplace context and culture is emphasised. Future research should focus on clarification studies informed by contemporary models of faculty development, in which factors impacting the health care workplace are considered.
Examining unconscious bias embedded in provider language regarding children with autism
Authors: Como Dominique H. , Floríndez Lucía I. , Tran Christine F. , Cermak Sharon A. , Stein Duker Leah I.
Published: June 2019

In healthcare settings, language used by healthcare providers can influence provider–patient encounters with individuals with autism spectrum disorder, impacting feelings of stigma and marginalization. This study highlights the unconscious biases healthcare providers might have regarding their patients with autism spectrum disorder and how those beliefs are articulated. Seven pediatric dentists participated in two focus groups to describe strategies to improve oral care for children with autism spectrum disorder. While completing the primary analyses, additional codes emerged related to healthcare provider biases; these data are the focus of this study. Three themes were identified: (i) “healthcare microaggressions” describe how healthcare providers portray their patients in subtly negative ways; (ii) “marginalization” denotes the use of exclusionary language identifying children with autism spectrum disorder as different; and (iii) “preconceptions” include comments that highlight biases about patients. The findings provide insight into the implicit biases that might be held by healthcare providers and how they manifest in language. Despite increased emphasis on cultural competency, healthcare providers might unconsciously use language that could negatively impact patient–provider rapport and increase stigma in already marginalized populations. Further research is necessary to explore how these biases could relate to quality of care.
Experiences of partners of intensive care survivors and their need for support after intensive care
Authors: Nelderup Maria , Samuelson Karin
Published: June 2019

Background

When a relative with a critical illness is admitted to an intensive care unit (ICU), it can be a life‐changing event for the partner. There is a lack of studies that focus on the partners' experiences of the time after intensive care.

Aims and objectives

The aim of this study was to explore the experiences of partners of intensive care survivors and their need for support after intensive care.

Design

A qualitative descriptive design was used.

Methods

Six semi‐structured interviews was conducted in Sweden and analysed using inductive content analysis with inspiration from Graneheim and Lundman.

Results

Three categories emerged from the data: Being in chaos when a partner needs intensive care, Being the one who everyone depends on, and Life goes on after intensive care. The findings indicate that life goes on after intensive care even if recovery takes time, and during that time, the partners need comforting support from people around them.

Conclusion

Partners need extensive and continuous support from health care staff and others during and after intensive care. Intensive care leads, on the one hand, to a sense of chaos for the partner, but on the other hand, if the family relations are strengthened and the partner receives the right kind of comforting support, it can relieve the chaos and facilitate a smoother recovery path to help them view the future more positively.

Relevance to clinical practice

This study can contribute knowledge that guides nurses in the ICU and at the ICU follow‐up service and could also help nurses in other areas of care in communication with relatives.
Transtracheal jet oxygenation: Comparing the efficacy and safety of two self‐made Y‐connector devices with the ENK oxygen flow modulator™ in an infant animal model
Authors: Lim Evangeline H.L. , Tan Angela Y.J. , Sng David D.W. , Saffari Seyed Ehsan , Tan Josephine S.K.
Published: June 2019

Background

Self‐made Y‐connector jet‐oxygenation devices with wide‐bore expiratory port have been described but not evaluated in infant models. Little is known about the effect of oxygen flow rates on jet oxygenation via transtracheal cannula.

Aims

The aim of this study was to compare two self‐made Y‐connector jet‐oxygenation devices against the ENK oxygen flow modulator™, and the effects of three different oxygen flow rates based on body weight, in both unobstructed and obstructed airways, on the time to re‐oxygenate in a rabbit infant model. The aim was also to assess the effectiveness of an oxygen flow rate of 1 L/min, for re‐oxygenation using ENK oxygen flow modulator™.

Methods

Nine rabbits were grouped in threes: Group 1 had a Y‐connector attached to an intravenous infusion tubing, Group 2 the same Y‐connector attached to a perfusion oxygenator tubing and Group 3, ENK oxygen flow modulator™. From oxygen saturations of 75%, the rabbits were jet oxygenated using their assigned device for 10 minutes at each flow rate of 1 L/kg/min, 1.5 L/kg/min and 2 L/kg/min with their airways unobstructed and later, obstructed. Group 3 had additional experiments involving an absolute oxygen flow rate of 1 L/min.

Results

All devices resulted in rapid re‐oxygenation within 40 seconds at flow rates of 1 L/kg/min. Oxygen flow rates beyond 1 L/kg/min in obstructed airways resulted in high airway pressures. All rabbits in Group 3 with obstructed airways died from barotrauma when jet oxygenated at a flow rate of 1.5 L/kg/min. When an oxygen flow rate of 1 L/min was used in Group 3, there was a failure to re‐oxygenate to SpO2 90% within 120 seconds in some rabbits.

Conclusion

Our animal model results suggest that self‐made Y‐connector jet‐oxygenation devices with wide‐bore expiratory port are efficacious and perhaps safer than ENK oxygen flow modulator™ in obstructed airways, and jet oxygenation with minimal oxygen flow rates starting at 1 L/kg/min or (age [years] + 4) L/min, whichever lower, should be considered.
Germline variants in oculocutaneous albinism genes and predisposition to familial cutaneous melanoma
Authors: Nathan Vaishnavi , Johansson Peter A. , Palmer Jane M. , Howlie Madeleine , Hamilton Hayley R. , Wadt Karin , Jönsson Göran , Brooks Kelly M. , Pritchard Antonia L. , Hayward Nicholas K.
Published: June 2019

Approximately 1%–2% of cutaneous melanoma (CM) is classified as strongly familial. We sought to investigate unexplained CM predisposition in families negative for the known susceptibility genes using next‐generation sequencing of affected individuals. Segregation of germline variants of interest within families was assessed by Sanger sequencing. Several heterozygous variants in oculocutaneous albinism (OCA) genes: TYR, OCA2, TYRP1 and SLC45A2, were present in our CM cohort. OCA is a group of autosomal recessive genetic disorders, resulting in pigmentation defects of the eyes, hair and skin. Missense variants classified as pathogenic for OCA were present in multiple families and some fully segregated with CM. The functionally compromised TYR p.T373K variant was present in three unrelated families. In OCA2, known pathogenic variants: p.V443I and p.N489D, were present in three families and one family, respectively. We identified a likely pathogenic SLC45A2 frameshift variant that fully segregated with CM in a family of four cases. Another four‐case family harboured cosegregating variants (p.A24T and p.R153C) of uncertain functional significance in TYRP1. We conclude that rare, heterozygous variants in OCA genes confer moderate risk for CM.
Photoacidity of the 7‐Hydroxyflavylium Cation
Authors: Aqdas Amna , Siddique Farhan , Nieman Reed , Quina Frank H. , Aquino Adelia J. A.
Published: June 2019

Theoretical descriptions of excited state proton transfer (ESPT) have had various degrees of success. This work presents a theoretical description of the photodissociation of the 7‐hydroxyflavylium cation (7‐HF), the fundamental chromophoric moiety of anthocyanin natural plant pigments. ESPT of 7‐HF is promoted by a significant shift of charge away from the OH group in the first singlet excited state, leading smoothly to the excited conjugate base and a protonated water cluster. Several factors contribute to the consistency of the results of the present study: (1) the theoretical approach (TD‐DFT with the B3‐LYP functional and def2‐TZVP basis set utilizing Grimme's D3 dispersion correction); (2) the modeling of the solvent effect combining hydrogen bonding of the photoacid to a cluster of discrete water molecules in a water‐like continuum solvent (COSMO); (3) the large S1‐S2 energy gap of flavylium cations; and (4) the electrostatics of the ESPT in which a proton is transferred from a cationic photoacid to water without Coulombic interaction between the proton and the conjugate base.
A case of large cell neuroendocrine carcinoma exhibiting rhabdoid features in the esophagogastric junction
Authors: Ichimata Shojiro , Aoyagi Daiju , Takehana Takuo , Uehara Takeshi , Shiozawa Satoshi
Published: June 2019

We report a case of large cell neuroendocrine carcinoma with rhabdoid features in the esophagogastric junction. An 81‐year‐old man presented to Saku Central Hospital Advanced Care Center with a tumor in the esophagogastric junction. During upper gastrointestinal endoscopy, an ulcerative tumor, measuring 4 × 3 cm in diameter, was observed. Computed tomography revealed lymph node metastasis, but no metastasis to other organs was observed. A thoracoscopic subtotal esophagectomy was performed. Histopathologically, anaplastic large cells exhibited a solid growth pattern with focal and geographic necrosis. Approximately half of the tumor cells exhibited large nuclei with conspicuous nucleoli; an eosinophilic “rhabdoid” cytoplasmic inclusion; and a nucleus displaced eccentrically by the cytoplasmic inclusion body. Immunohistochemically, tumor cells, including rhabdoid cells, were focally positive for pan‐cytokeratin and diffusely positive for vimentin and synaptophysin. Additionally, electron microscopy identified dense‐core granules in the tumor cells. Therefore, a diagnosis of large cell neuroendocrine carcinoma with rhabdoid features was made. A few cases of esophageal neuroendocrine tumors with rhabdoid features have been reported in the lung and pancreas; however, this is the first report of large cell neuroendocrine carcinoma with rhabdoid features in the esophagogastric junction.
Distribution and genetic diversity amongAspergillus flavusisolates across three agro‐ecologies essential for maize cultivation in Ghana
Authors: Dadzie M. A. , Oppong A. , Ofori K. , Eleblu J. S. Y. , Ifie B. E. , Blay E. T. , Obeng‐Bio E. , Appiah‐Kubi Z. , Warburton M. L.
Published: June 2019

Fungal mycotoxins are important contaminants of agricultural commodities that pose serious concerns to producers, consumers and exporters. Aflatoxin is a carcinogenic metabolite produced by the fungiAspergillus flavusandA. parasiticus. These fungi and other mould species living in the soil contaminate several crops including maize. This study was undertaken with the following objectives: (i) to assess the presence ofA. flavusand other moulds in Ghanaian soil; (ii) to determine the distribution and density ofA. flavusunder three agro‐ecologies noted for major maize production; and (iii) to assess the effect of percentage of carbon (C) and nitrogen (N) and soil pH onA. flavuspopulation densities and diversity in the isolates found across the agro‐ecologies. The data showed seven moulds that were common across the agro‐ecologies. Significant differences (P < 0.05) were observed in theA. flavusdensity and distribution within and across these agro‐ecologies. Fumesua soils recorded the highest levels ofA. flavus(1.185 × 103 cfu g−1) while Akomadan recorded the least (9.76 × 102 cfu g−1). Percentage available C, N and soil pH did not significantly influenceA. flavusdensity. TheA. flavusisolates identified in this study varied in genetic sequence within the aflatoxin gene cluster, but these differences were not distinguishable by origin.
Reconciling Storegga tsunami sedimentation patterns with modelled wave heights: A discussion from the Shetland Isles field laboratory
Authors: Dawson Alastair G. , Dawson Sue , Bondevik Stein , Costa Pedro J. M. , Hill Jon , Stewart Iain
Published: June 2019

The Shetland Isles represent an ideal field laboratory for tsunami geoscience research. This is due to the widespread preservation of Holocene tsunami sediments in coastal peat deposits. This study uses published accounts of the Holocene Storegga Slide tsunami to illustrate how two different approaches – mapping of tsunami sediments and numerical modelling – produce radically different run‐up heights. The Storegga Slide is one of the world largest submarine slides and took place ca 8150 cal yr bp on the continental slope west of Norway. The tsunami generated by the landslide deposited locally extensive sheets of marine sand and gravel, as well as redeposited clasts of peat across the contemporary land surface. These sediment accumulations have subsequently been buried by peat growth during the Holocene while exposures of the deposits are locally visible in coastal cliff sections. In several areas, the tsunami sediments can be traced upslope and inland within the peat as tapering sediment wedges up to maximum altitudes of between ca 8·1 m and 11·8 m above present sea level. Since reconstructions of palaeo‐sea level for Shetland for ca 8150 cal yr bp suggest an altitude of 20 m below high tide on the day that the tsunami struck, it has been inferred that the minimum tsunami run‐up was locally between 28·1 m (8·1 + 20 m) and 31·8 m (11·8 + 20 m). However, numerical models of the tsunami for Shetland suggest that the wave height may only have reached a highest altitude in the order of +13 m above sea level on the day the tsunami took place. In this paper a description is given of the sedimentary evidence for tsunami run‐up in the Shetland Isles. This is followed by an evaluation of where the palaeo‐sea level was located when the tsunami occurred. Significant differences are highlighted in tsunami inundation estimates between those based on the observed (geological) data and the theoretically‐modelled calculations. This example from the Shetland Isles may have global significance since it exemplifies how two different approaches to the reconstruction of tsunami inundation at the coast can produce radically different results with modelled wave height at the coast being considerably less than the geological estimates of tsunami run‐up.
Assessing soil quality indices based on soil organic carbon fractions in different long‐term wheat systems under semiarid conditions
Authors: Duval Matias E. , Martinez Juan M. , Galantini Juan A.
Published: June 2019

The literature shows a great number of soil quality indices (SQI) based on organic matter and its fractions. Our objectives were to determine the changes in soil organic carbon (SOC), carbon fractions and SQI in three production systems based on winter wheat (Triticum aestivum L.). The three production systems involved wheat monoculture under conventional tillage and no‐tillage (WWCT and WWNT, respectively) and traditional management, wheat under conventional tillage and grazing of natural grasses, alternated one year each (WGCT). In turn, each treatment was divided into N‐P‐fertilized (f) and non‐fertilized (nf). We analysed SOC, labile fractions and their ratios (SQI) at 0–5, 5–10 and 10–20 cm soil depths. SOC was significantly higher in WWNT‐f than in WWCT‐f and WGCT‐f at 0–5 and 0–20 cm range. Conversely, the lowest concentration was found in WWNT and WWCT in non‐fertilized plots. Particulate organic C (POC, 105–2,000 μm) was significantly affected by tillage at 0–5 cm with the greatest concentrations found in WWNT (mean = 3.2 g kg−1) followed by WGCT and WWCT (mean = 2.0 g kg−1). Soils under CT showed the lowest lability index (LI) values, whereas the conversion to NT increased it (0.74–1.28). Carbon management index (CMI) increased significantly at the 0–20 cm seven years after NT establishment compared to WWCT. SQI such as LI, CMI and SOC/silt+clay were more sensitive for differentiating production systems, whereas C pool index and C/N were more sensitive for differentiating the fertilizer application effect. Considering improvement in SQI and carbon fractions as indicators of better soil quality, adoption of NT improved the soil quality in the semiarid rainfed conditions in the short term.
Comparison of sequence‐specific oligonucleotide probe vs next generation sequencing for HLA‐A, B, C, DRB1, DRB3/B4/B5, DQA1, DQB1, DPA1, and DPB1 typing: Toward single‐pass high‐resolution HLA typing in support of solid organ and hematopoietic cell transplant programs
Authors: Smith Anajane G. , Pereira Shalini , Jaramillo Andrés , Stoll Scott T. , Khan Faisal M. , Berka Noureddine , Mostafa Ahmed A. , Pando Marcelo J. , Usenko Crystal Y. , Bettinotti Maria P. , Pyo Chul‐Woo , Nelson Wyatt C. , Willis Amanda , Askar Medhat , Geraghty Daniel E.
Published: June 2019

Many clinical laboratories supporting solid organ transplant programs use multiple HLA genotyping technologies, depending on individual laboratory needs. Sequence‐specific primers and quantitative polymerase chain reaction (qPCR) serve the rapid turnaround necessary for deceased donor workup, while sequence‐specific oligonucleotide probe (SSOP) technology is widely employed for higher volumes. When clinical need mandates high‐resolution data, Sanger sequencing‐based typing (SBT) has been the “gold standard.” However, all those methods commonly yield ambiguous typing results that utilize valuable laboratory resources when resolution is required. In solid organ transplantation, high‐resolution typing may provide critical information for highly sensitized patients with donor‐specific anti‐HLA antibodies (DSA), particularly when DSA involve HLA alleles not discriminated by SSOP typing. Arguments against routine use of SBT include assay complexity, long turnaround times (TAT), and increased costs. Here, we compare a next generation sequencing (NGS) technology with SSOP for accuracy, effort, turnaround time, and level of resolution for genotyping of 11 HLA loci among 289 specimens from five clinical laboratories. Results were concordant except for SSOP misassignments in eight specimens and 21 novel sequences uniquely identified by NGS. With few exceptions, SSOP generated ambiguous results while NGS provided unambiguous three‐field allele assignments. For complete HLA genotyping of up to 24 samples by either SSOP or NGS, bench work was completed on day 1 and typing results were available on day 2. This study provides compelling evidence that, although not viable for STAT typing of deceased donors, a single‐pass NGS HLA typing method has direct application for solid organ transplantation.