bluuebunny/crossref_metadata_2025 huggingface dataset:
Fusobacterium necrophorum, a major provider of sinus thrombosis in acute mastoiditis: A retrospective multicentre paediatric study
Authors: Coudert Aurélie , Fanchette Julia , Regnier Gaëlle , Delmas Justine , Truy Eric , Nicollas Richard , Akkari Mohamed , Couloignier Vincent , Ayari‐Khalfallah Sonia
Published: November 2019

Objective

To evaluate in children the clinical severity and evolution of otogenic lateral sinus thrombosis (OLST) due to Fusobacterium necrophorum compared with other bacterial otogenic thrombosis and propose a specific management flowchart for Fusobacterium OLST.

Design

A retrospective multicentre cohort study.

Settings

Four French ENT paediatric departments.

Participants

A total of 260 under 18 years old admitted for acute mastoiditis were included. Initial imaging was reviewed to focus on complicated mastoiditis and 52 OLST were identified. Children were then divided into two groups according to bacteriological results: 28 in the “OLST Fusobacterium group” and 24 in the “OLST other bacteria group”.

Results

There was a significant association between F necrophorum and OLST (P < .001). When compared to the OLST other bacteria group, children in the OLST Fusobacterium group were significantly younger (61 months vs 23 months, P < .01) and had a more severe clinical presentation: higher CRP (113 mg/L vs 175.7 mg/L, P = .02) and larger subperiosteal abscess (14 mm vs 21 mm, P < .01). Medical management was also more intensive in the OLST Fusobacterium group than in the OLST other bacteria group: increased number of conservative surgeries (66.7% vs 92.9%, P = .03) and longer hospital stay (13.7 days vs 19.8 days, P = .02). At the end of follow‐up, the clinical course was good in both groups without any neurological sequelae.

Conclusions

Thrombotic complications are very frequent in case of Fusobacterium mastoiditis and clinicians should be aware of the initial severity of the clinical presentation. Under appropriate management, the clinical course of Fusobacterium OLST is as good as that of other bacterial otogenic thrombosis.
A survey of members of the European Surveillance System on Contact Allergy and the EU project “StanDerm” to identify allergens tested in cosmetic series across Europe
Authors: Horton Emma , Wilkinson Mark , Aalto‐Korte Kristiina , Pesonen Maria , Bauer Andrea , Chowdhury Mahbub M.U. , Cooper Susan , Cousen Philippa , Crépy Marie‐Noëlle , Larese Filon F Francesca , Gallo Rosella , Geier Johannes , Giménez‐Arnau Ana , Gonçalo Margarida , Goossens An , Green Cathy , Guarneri Fabrizio , Ljubojević Hadžavdić Suzana , Johansen Jeanne D. , Johnston Graham A. , Rustemeyer Thomas , Sánchez‐Pérez Javier , Thyssen Jacob P. , Schuttelaar Marie‐Louise A. , Stone Natalie , Uter Wolfgang
Published: November 2019

Background

There is currently no agreed cosmetic series for use across Europe.

Objectives

To establish allergens currently tested in local and national cosmetic series.

Method

Members of the European Surveillance System on Contact Allergy and the European Cooperation in Science and Technology project TD1206 ("StanDerm") were surveyed to establish their current practice.

Results

A wide range of allergens was tested but there was significant variation between centres on the allergens considered to be important in screening for allergy to cosmetics. The number of allergens tested in addition to the baseline series varied between 2 and 50.

Conclusions

There is a need for further investigation to establish the frequency and relevance of reactions to cosmetic allergens to enable an agreed evidence‐based cosmetic series to be produced. Criteria for inclusion need to be established.
(‐)‐Epigallocatechin gallate‐loaded polycaprolactone scaffolds fabricated using a 3D integrated moulding method alleviate immune stress and induce neurogenesis
Authors: Qian Yun , Yao Zhixiao , Wang Xu , Cheng Yuan , Fang Zhiwei , Yuan Wei‐En , Fan Cunyi , Ouyang Yuanming
Published: November 2019

Objectives

In peripheral neuropathy, the underlying mechanisms of nerve and muscle degeneration include chronic inflammation and oxidative stress in fibrotic tissues. (‐)‐Epigallocatechin gallate (EGCG) is a major, active component in green tea and may scavenge free radical oxygen and attenuate inflammation. Conservative treatments such as steroid injection only deal with early, asymptomatic, peripheral neuropathy. In contrast, neurolysis and nerve conduit implantation work effectively for treating advanced stages.

Materials and methods

An EGCG‐loaded polycaprolactone (PCL) porous scaffold was fabricated using an integrated moulding method. We evaluated proliferative, oxidative and inflammatory activity of rat Schwann cells (RSCs) and rat skeletal muscle cells (RSMCs) cultured on different scaffolds in vitro. In a rat radiation injury model, we assessed the morphological, electrophysiological and functional performance of regenerated sciatic nerves and gastrocnemius muscles, as well as oxidative stress and inflammation state.

Results

RSCs and RSMCs exhibited higher proliferative, anti‐oxidant and anti‐inflammatory states in an EGCG/PCL scaffold. In vivo studies showed improved nerve and muscle recovery in the EGCG/PCL group, with increased nerve myelination and muscle fibre proliferation and reduced macrophage infiltration, lipid peroxidation, inflammation and oxidative stress indicators.

Conclusions

The EGCG‐modified PCL porous nerve scaffold alleviates cellular oxidative stress and repairs peripheral nerve and muscle structure in rats. It attenuates oxidative stress and inflammation in vivo and may provide further insights into peripheral nerve repair in the future.
Conservation beyond protected areas: Using vertebrate species ranges and biodiversity importance scores to inform policy for an east African country in transition
Authors: Tyrrell Peter , du Toit Johan T. , Macdonald David W.
Published: November 2019

Conservation in eastern and southern Africa has historically centered on megafauna and protected areas (PAs), yet, in the face of rapid change, biodiversity outside of PAs is under threat. With policy changes underway in Kenya, we have performed an analysis that (a) quantifies how inclusive the current PA network is of the country's vertebrate diversity, and (b) identifies wildlife policy areas that need reform to achieve conservation targets. We found that species richness of mammals, birds, and amphibians is highest in areas of intermediate human pressures, whereas Kenya's current wildlife conservation policy focuses on land use (LU) types with the least human pressure. Percentage of range overlap for amphibians, mammals, and birds were all highest in rangelands followed by agricultural (cultivated) areas and then national PAs. Out of 1,535 terrestrial vertebrate species, 80 had no range overlap with national PAs. The current wildlife PA network adequately covers only 16% of amphibians, 45% of birds, and 41% of mammals. In addition, we used a biodiversity importance score which demonstrated the importance of rangelands and agricultural areas for biodiversity conservation. Finally, we observed that the distribution of current PAs, and the focus of Kenya's wildlife policy in general, is in areas of lowest human pressure, often with the highest large mammal densities. However, other biodiversity indicators ‐ such as bird and plant species richness ‐ show that areas under human‐dominated LU currently support substantial biodiversity. Overall, our analysis demonstrates that formal PAs and wildlife policy presently cover only a small fraction of national biodiversity, which resides mainly in human‐dominated landscapes that are undergoing rapid change. These findings echo global calls for a landscape‐based approach to conservation policy and practice that promotes the coexistence of people and wildlife within social‐ecological systems.
Effects of landscape modification on species richness patterns of fruit‐feeding butterflies in Brazilian Atlantic Forest
Authors: Santos Jessie P. , Sobral‐Souza Thadeu , Brown Keith S. , Vancine Maurício Humberto , Ribeiro Milton C. , Freitas André V. L.
Published: November 2019

Aim

To assess the distributional patterns of fruit‐feeding butterfly species richness in Atlantic Forest (AF) based on stack species distribution models (SSDM); to evaluate the relative contribution of climate and landscape in the patterns of butterfly species richness; and to recommend conservation guidelines for AF regions based on the obtained results.

Location

Brazilian Atlantic Forest.

Methods

We used SSDMs to generate potential distribution maps of butterfly species richness in AF. Our dataset comprises 7,062 records of 279 species, distributed across 122 local communities. We built richness maps based on climate and landscape models and analysed them separately to understand their contribution to the pattern of richness distribution. Then, we combined both models to build a consensus map. Finally, we designed specific conservation strategies based on richness categories distributed on the consensus map.

Results

The regions with high‐predicted species richness for both climate and landscape models supported the main endemism locations described for other AF taxa in previous studies. Both models predicted intermediate values of species richness for most regions, but the patterns of richness distribution were not fully congruent. High species richness based on landscape metrics was frequently concentrated in the south. Furthermore, locations suitable for high species richness according to climate are near to the endemism centres, but also to dense urban centres, highlighting the potential impacts of the landscape modification on butterfly species richness.

Main conclusions

The distribution of fruit‐feeding butterfly species richness and endemism reflect the classic division of AF in different sub‐regions according to the endemism centres proposed by previous authors for other taxa. The availability of forested habitats seems to be a determining factor for the maintenance of high species richness in AF. Therefore, the loss of natural forest remnants due to landscape modification is the primary threat to butterfly diversity.
Climate change and the future restructuring of Neotropical anuran biodiversity
Authors: Menéndez‐Guerrero Pablo A. , Green David M. , Davies T. Jonathan
Published: November 2019

Climate change is likely to impact multiple dimensions of biodiversity. Species range shifts are expected and may drive changes in the composition of species assemblages. In some regions, changes in climate may precipitate the loss of geographically restricted, niche specialists and facilitate their replacement by more widespread, niche generalists, leading to decreases in β‐diversity and biotic homogenization. However, in other regions climate change may drive local extinctions and range contraction, leading to increases in β‐diversity and biotic heterogenization. Regional topography should be a strong determinant of such changes as mountainous areas often are home to many geographically restricted species, whereas lowlands and plains are more often inhabited by widespread generalists. Climate warming, therefore, may simultaneously bring about opposite trends in β‐diversity in mountainous highlands versus relatively flat lowlands. To test this hypothesis, we used species distribution modelling to map the present‐day distributions of 2669 Neotropical anuran species, and then generated projections of their future distributions assuming future climate change scenarios. Using traditional metrics of β‐diversity, we mapped shifts in biotic homogenization across the entire Neotropical region. We used generalized additive models to then evaluate how changes in β‐diversity were associated with shifts in species richness, phylogenetic diversity and one measure of ecological generalism. Consistent with our hypothesis, we find increasing biotic homogenization in most highlands, associated with increased numbers of generalists and, to a lesser extent, losses of specialists, leading to an overall increase in alpha diversity, but lower mean phylogenetic diversity. In the lowlands, biotic heterogenization was more common, and primarily driven by local extinctions of generalists, leading to lower α‐diversity, but higher mean phylogenetic diversity. Our results suggest that impacts of climate change on β‐diversity are likely to vary regionally, but will generally lead to lower diversity, with increases in β‐diversity offset by decreases in α‐diversity.
Detection of hepatitis E virus genotypes 3 and 4 in donkeys in northern China
Authors: Rui P. , Zhao F. , Yan S. , Wang C. , Fu Q. , Hao J. , Zhou X. , Zhong H. , Tang M. , Hui W. , Li W. , Shi D. , Ma Z. , Song T.
Published: November 2019

Background

Hepatitis E virus (HEV) is the causative agent of acute self‐limiting hepatitis in humans in developing countries. Hepatitis E virus RNA was first detected in donkeys in Spain, but little is known about the possible presence of HEV in donkeys in China.

Objectives

To investigate the prevalence of HEV in donkeys in northern China.

Study design

Investigation of the prevalence of HEV in donkeys using serological, molecular and phylogenetic approaches.

Methods

A total of 401 donkey serum specimens were tested for serological and molecular detection of HEV via enzyme‐linked immunosorbent assay and quantitative reverse transcription polymerase chain reaction. The amplified products were cloned in pMD18‐T vector and sequenced. The alignment and phylogenetic analysis of partial HEV ORF2 genes were compared with the corresponding sequences of the obtained HEV representative strains.

Results

Serological results showed that 49 donkeys (12.22%, 95% CI: 9.18–15.83%) were positive for anti‐HEV‐specific antibodies, and 17 donkeys (4.24%, 95% CI: 2.49–6.70%) were positive for HEV viral RNA. On the basis of sequence alignment and phylogenetic analysis, all isolated HEV strains belonged to genotype 3 (HEV‐3) or HEV‐4, sharing more than 76.2–96.3% identities with 67 other HEV representative strains of HEV‐1 to HEV‐8.

Main limitations

Further studies about the prevalence of HEV in organs or faecal samples from donkeys are needed to evaluate the possible role of HEV reservoir and to determine the risk factors associated with the transmission of this zoonotic virus in donkeys in China.

Conclusions

This is the first report documenting the molecular analysis of donkey HEV strains worldwide and the serological evidence of HEV infection in donkeys in northern China. The results suggest that young donkeys are more susceptible to HEV infection compared with older donkeys. Further investigation is required to determine whether donkeys should be considered reservoirs for zoonotic HEV.

The Summary is available in Chinese ‐ see Supporting information
The Critical Need to Recognize That Families Matter for Adult Health: A Systematic Review of the Literature
Authors: Woods Sarah B. , Bridges Kate , Carpenter Erica N.
Published: November 2019

A systemic approach to researching families and health should capture the complex network within which family members are embedded, including multiple family relationships and larger systems of health care. However, much of the families and health research focused on adult family members has focused solely on intimate partnerships, usually the marital relationship. This neglects the remainder of the powerfully influencing family relationships adults retain, and may increasingly focus on as they age. We conducted a systematic review of the families and adult health literature, retaining 72 articles which were subsequently thematically coded to highlight main foci of this area of research. Results highlight six themes, which include family relationship quality, family composition, behavioral factors in health and health care, psychophysiological mediators, caregiving, and aging health. Findings support an underrepresentation of family members, other than the intimate partner, in research on adult health.
Destabilization of β‐amyloid aggregates by thrombin derived peptide: plausible role of thrombin in neuroprotection
Authors: De Debashree , Bhattacharjee Payel , Das Hrishita , Kumar Karri Suresh , Biswas Subhas Chandra , Bhattacharyya Debasish
Published: November 2019

β‐amyloid (Aβ) aggregates involved in Alzheimer’s disease (AD) are resistant to proteases but could be destabilized by small peptides designed to target specific hydrophobic regions of Aβ that take part in aggregate assembly. Since thrombin and AD are intricately connected, and elastase modulates thrombin activity, elastase‐digested thrombin peptides were verified for intervention in the Aβ–aggregation pathway. Intact or elastase‐digested thrombin destabilized Aβ fibril, as demonstrated by thioflavin T assay. Peptides were synthesized employing thrombin as a template, of which, a hexapeptide (T3) showed maximum destabilization at 1 µm. ExPASy peptide cutter software coupled with mass spectrometric analysis confirmed the generation of T3 peptide from elastase‐digested thrombin. TEM micrographs revealed that 30‐day incubation of preformed Aβ fibrils or monomers with T3 resulted in destabilization or inhibition, respectively, leading mostly to particles of 1.74 ± 0.17 nm, which roughly corresponded to Aβ monomer. Surface plasmon resonance employing CM5 chip coupled with Aβ40 mouse monoclonal antibody showed a drop in response when T3 was incubated with Aβ fibrils between 2 and 8 h. 3‐[4,5‐dimethylthiazol‐2‐yl]‐2,5‐diphenyltetrazolium bromide and confocal microscopy demonstrated the ability of T3 to rescue neuroblastoma cells from Aβ oligomer‐induced cytotoxic damage. Although no [Aβ‐T3] adduct could be detected by mass spectrometry, an initial interaction appeared to facilitate the process of destabilization/inhibition of aggregation. T3 was comparable to standard β‐sheet breaker peptides, LPFFD and KLVFF in terms of Aβ aggregate destabilization. High hydrophobicity values coupled with recognition and breaking elements make T3 a potential candidate for future therapeutic applications.
Research priorities for natural ecosystems in a changing global climate
Authors: Williams Stephen E. , Hobday Alistair J. , Falconi Lorena , Hero Jean‐Marc , Holbrook Neil J. , Capon Samantha , Bond Nick R. , Ling Scott D. , Hughes Lesley
Published: November 2019

Climate change poses significant emerging risks to biodiversity, ecosystem function and associated socioecological systems. Adaptation responses must be initiated in parallel with mitigation efforts, but resources are limited. As climate risks are not distributed equally across taxa, ecosystems and processes, strategic prioritization of research that addresses stakeholder‐relevant knowledge gaps will accelerate effective uptake into adaptation policy and management action. After a decade of climate change adaptation research within the Australian National Climate Change Adaptation Research Facility, we synthesize the National Adaptation Research Plans for marine, terrestrial and freshwater ecosystems. We identify the key, globally relevant priorities for ongoing research relevant to informing adaptation policy and environmental management aimed at maximizing the resilience of natural ecosystems to climate change. Informed by both global literature and an extensive stakeholder consultation across all ecosystems, sectors and regions in Australia, involving thousands of participants, we suggest 18 priority research topics based on their significance, urgency, technical and economic feasibility, existing knowledge gaps and potential for cobenefits across multiple sectors. These research priorities provide a unified guide for policymakers, funding organizations and researchers to strategically direct resources, maximize stakeholder uptake of resulting knowledge and minimize the impacts of climate change on natural ecosystems. Given the pace of climate change, it is imperative that we inform and accelerate adaptation progress in all regions around the world.
Prospective clinical trial evaluating vulnerability and chemotherapy risk using geriatric assessment tools in older patients with lung cancer
Authors: Tsubata Yukari , Shiratsuki Yohei , Okuno Takae , Tanino Akari , Nakao Mika , Amano Yoshihiro , Hotta Takamasa , Hamaguchi Megumi , Okimoto Tamio , Hamaguchi Shunichi , Kurimoto Noriaki , Nishiyama Yumi , Kimura Tomohiro , Iwata Haruko , Tsumoto Shusaku , Isobe Takeshi
Published: November 2019

Aim

In Japan, the number of older patients with cancer has been increasing. Assessment of performance status, cognitive function and social background is necessary for the treatment of older patients. The aims of the present study were: (i) to establish an evaluation system using electronic medical records; and (ii) to distinguish older patients as fit versus vulnerable or frail according to a geriatric assessment (GA) system score.

Methods

We incorporated GA tools in our electronic medical records system and carried out comprehensive assessments for patients with newly diagnosed lung cancer aged ≥65 years. The decision about primary treatment followed consultation with the clinical team and was not guided by GA scores. Subsequent treatment and outcomes were recorded.

Results

A total of 100 patients had completed GA. The average age was 75 years (range 65–94 years). Regarding GA results, 63% were positive on the Comprehensive Geriatric Assessment 7, 39% on the Vulnerable Elderly Survey‐13 and 84% on the Geriatric 8. The percentage of vulnerable patients (positive on all three GA) was significantly higher in the non‐standard therapy group (n = 19) than in the standard therapy group (n = 81; 78.9% vs 21.0%, P < 0.001). Among vulnerable patients who received standard therapy, 47% discontinued chemotherapy as a result of toxicity. Even if a patient was considered vulnerable based on GA scores, chemotherapy is possibly safe for those with EGFR mutations.

Conclusions

We confirmed the feasibility of this system. During decision‐making for older patients with cancer, a combination of GA helps prevent undertreatment or overtreatment. Geriatr Gerontol Int 2019; 19: 1108–1111.
Effects of different feeding regimens on milk fatty acid composition and milk flavor from the perspective of regional resource utilization
Authors: Yayota Masato , Tsukamoto Mana , Kato Rie , Ohtani Shigeru
Published: November 2019

Feed is a primary factor affecting different milk components and creating a specific milk flavor. Dairy farms in different regions often depend on different feed resources and feeding regimens. This study aimed to evaluate the effect of completely different feeding regimens on the milk fatty acid (FA) profile and milk flavor. Eight lactating Holstein cows were assigned to one of two distinct feeding regimens, one grass silage‐based diet (GS) and one by‐product‐based diet (BP), using a switchback design with three periods of 28 days each. A sensory test of the pasteurized milk was conducted using the paired preference method. Dry matter, crude protein and total digestible energy intake were similar between the groups. There was also no difference in daily milk yields, milk fat, protein, lactose and solids‐not‐fat contents between the groups. Milk FA content with chain lengths C12–C14:1, C16and C16:1cisand the saturated fatty acid (SFA) content were significantly higher in the GS group than in the BP group. In contrast, the milk FA content with chain lengths C18and C18:1cis–C18:2and the unsaturated fatty acid (UFA) content, including mono‐UFA (MUFA) and poly‐UFA (PUFA), were significantly higher in the BP group than in the GS group. The different feeding regimens did not affect milk sensory properties, including aroma, palatability, aftertaste, texture, body and sweetness. Using food by‐products that contain relatively high levels of PUFAs resulted in PUFA‐rich milk. However, even if using a distinct feeding regimen based on conserved or by‐product feeds, it may be difficult to create characteristic milk with an original flavor that is clearly identified by consumers.
Perceptions of people with respiratory problems on physician performance evaluation—A qualitative study
Authors: Sehlbach Carolin , Govaerts Marjan J. B. , Mitchell Sharon , Teunissen Truus G. J. , Smeenk Frank W. J. M. , Driessen Erik W. , Rohde Gernot G. U.
Published: November 2019

Background

Despite increasing calls for patient and public involvement in health‐care quality improvement, the question of how patient evaluations can contribute to physician learning and performance assessment has received scant attention.

Objective

The objective of this study was to explore, amid calls for patient involvement in quality assurance, patients' perspectives on their role in the evaluation of physician performance and to support physicians’ learning and decision making on professional competence.

Design

A qualitative study based on semi‐structured interviews.

Setting and Participants

The study took place in a secondary care setting in the Netherlands. The authors selected 25 patients from two Dutch hospitals and through the Dutch Lung Foundation, using purposive sampling.

Methods

Data were analysed according to the principles of template analysis, based on an a priori coding framework developed from the literature about patient empowerment, feedback and performance assessment.

Results

The analysis unearthed three predominant patient perspectives: the proactive perspective, the restrained perspective and the outsider perspective. These perspectives differed in terms of perceived power dynamics within the doctor‐patient relationship, patients' perceived ability, and willingness to provide feedback and evaluate their physician's performance. Patients' perspectives thus affected the role patients envisaged for themselves in evaluating physician performance.

Discussion and conclusion

Although not all patients are equally suitable or willing to be involved, patients can play a role in evaluating physician performance and continuing training through formative approaches. To involve patients successfully, it is imperative to distinguish between different patient perspectives and empower patients by ensuring a safe environment for feedback.
A windshields surface characterization damaged by sandblasting
Authors: Benterki Smail , Faci Abdelaziz , Bouaouadja Nourredine
Published: November 2019

The present work is part of a study of windshield glass erosion subjected to the Saharan sand particles projection. The objective is to highlight the effect of the sand grains size Ps on the degradation process of the ordinary glasses surface (damage rate Dr) and to search the visibility limit of vehicles' drivers. Various erosion tests are carried out and have led to different surface states by varying the sand mass Mp and the particles size Ps. The effect of the surface damage on root mean square roughness Rq, damage rate Dr, and optical transmission To are presented. A clear dependence between these three parameters and the particles size has been highlighted. The results show that Rq increases linearly with Ps increasing, whereas the Dr variation in function of Ps obeys a Gaussian function. In addition, a good correlation between the optical transmission loss and the damage rate is found. In terms of the driver's good vision, the damage of the windshield surface depends essentially on the parameter Dr. Therefore, the visibility limit is determined with regard to this parameter which is dependent on the sand particles size.
Characterization of a large cohort of patients with unclassified bleeding disorder; clinical features, management of haemostatic challenges and use of global haemostatic assessment with proposed recommendations for diagnosis and treatment
Authors: MacDonald Stephen , Wright Alfie , Beuche Frederik , Downes Kate , Besser Martin , Symington Emily , Kelly Anne , Thomas Will
Published: November 2019

Introduction

There is an unmet need to characterize the diagnosis and management of patients with an unclassified bleeding disorder (UBD).

Methods

Retrospective review of registered patients with UBD at our centre. Assessment including rotational thromboelastometry (ROTEM) and thrombin generation (TG) were used.

Results

A total of 124 patients were identified; 91% female. Mean age of presentation was 38.3 years. Mean bleeding score was 8.8 (standard deviation [SD] 3.8); 6.6 in men (SD 1.4) and 9.7 in women (SD 3.3), which was significantly different (P < .05). In women, after deduction of scores for menorrhagia and postpartum haemorrhage, the mean score was 6.4 which was not significantly different to the male score (P = .11). Twenty‐three percent of patients have been transfused, 61% women had treatment for menorrhagia and 17% for epistaxis. TxA and desmopressin were effective at preventing bleeding in 69 procedures and 13 deliveries. TG revealed 26% patients with a long lag time and 19% with a decreased endogenous thrombin potential but no diagnostic pattern was seen. ROTEM (NATEM) was unable to characterize patients; 9% had a prolonged clot time or maximum lysis. ThromboGenomics was normal in 45 tested patients.

Conclusions

We provide data which shows the bleeding score is biased towards gynaecological bleeding but which remains elevated even when the bleeding score is deducted. Tranexamic acid and desmopressin are effective as haemostatic prophylaxis but there is an urgent need for clinical trials. In conclusion, we describe the use of the bleeding score in these patients and phenotype, diagnosis (including ThromboGenomic testing) and management with practice recommendations.
Stocking and over-the-counter sale of misoprostol for medical abortion in Ghana’s community pharmacies: comparison of questionnaire and mystery client survey
Authors: Ganle John Kuumuori , Busia Nana Tiwaa , Baatiema Leonard
Published: November 2019

Objectives

In many sub-Saharan African countries with restricted safe abortion services, community pharmacies are important sources of abortifacients. However, data on stocking and over-the-counter sale of abortifacients in community pharmacies are often limited. The main objective of this study was to compare stocking and over-the-counter sale of misoprostol at community pharmacies using questionnaire and mystery client surveys in Ghana.

Methods

A cross-sectional questionnaire-based survey, complemented with a mystery client survey, was conducted at 165 randomly selected community pharmacies in Accra, Ghana. Structured questionnaires were administered to pharmacists/pharmacy workers. A mystery client survey to each of these pharmacies was also undertaken. Descriptive statistical techniques (frequencies and proportions) were used to estimate and compare stocking and over-the-counter sale of misoprostol at community pharmacies from the two data collection methods.

Key findings

Some 50.3% (83) of community pharmacists/pharmacy workers reported stocking misoprostol and selling it over-the-counter for medical abortion in the questionnaire-based survey. However, in the mystery client survey, 122 (74%) pharmacists/pharmacy workers reported stocking misoprostol and actually selling it over-the-counter to the mystery clients. Thus approximately 39 (24%) more pharmacies stocked misoprostol and sold it over-the-counter even though they originally denied stocking the drug in the questionnaire survey. Also, the drug was often sold without a prescription, and many did so without asking for a confirmatory pregnancy test or gestational age.

Conclusions

In contexts where access to safe abortion services is restricted, mystery client surveys, rather than conventional questionnaire-based survey techniques, may better illuminate stocking and over-the-counter sale of abortifacients at community pharmacies.
The relationship between emotional labour and job satisfaction in nursing
Authors: Gulsen Mehmet , Ozmen Dilek
Published: November 2019

Aim

To investigate the relationship between emotional labour strategies and job satisfaction among nurses in Turkey.

Background

Nursing is one of the professions in which emotional labour is heavily used. The relationship between emotional labour strategies and job satisfaction has many different consequences in nursing.

Introduction

Although studies have focused on the relationship between emotional labour and job satisfaction among nurses abroad, no studies on the subject have been found in Turkey.

Methods

A cross‐sectional descriptive design was employed. The study was conducted with 281 nurses working in a university hospital and three public hospitals in Manisa, Turkey. Research data were collected using the Personal Information Form, Emotional Labour Scale and Minnesota Satisfaction Questionnaire. Descriptive statistics and Pearson correlation analysis were used in data evaluation.

Results

Analyses showed that the type of emotional labour strategy most frequently exhibited by nurses was surface acting. In surface acting, behaviours do not reflect employees’ true feelings. Job satisfaction of nurses was higher than the medium level. A negative correlation was found between deep acting and job satisfaction. In deep acting, employees try to feel the emotions appropriate to the behaviour expected of them.

Discussion

Nurses’ emotional labour may cause some undesirable consequences.

Conclusion

Nurses’ emotional labour strategies are related to their job satisfaction levels.

Implications for nursing policy

Managers should be aware of the emotional labour of nurses and its possible negative consequences. Management strategies that target the negative consequences of emotional labour are important not only for the well‐being of nurses but also for the quality of patient care.
G9α‐dependent histone H3K9me3 hypomethylation promotes overexpression of cardiomyogenesis‐related genes in foetal mice
Authors: Peng Bohui , Han Xiao , Peng Chang , Luo Xiaomei , Deng Ling , Huang Lixin
Published: November 2019

Alcohol consumption during pregnancy can cause foetal alcohol syndrome and congenital heart disease. Nonetheless, the underlying mechanism of alcohol‐induced cardiac dysplasia remains unknown. We previously reported that alcohol exposure during pregnancy can cause abnormal expression of cardiomyogenesis‐related genes, and histone H3K9me3 hypomethylation was observed in alcohol‐treated foetal mouse heart. Hence, an imbalance in histone methylation may be involved in alcohol‐induced cardiac dysplasia. In this study, we investigated the involvement of G9α histone methyltransferase in alcohol‐induced cardiac dysplasia in vivo and in vitro using heart tissues of foetal mice and primary cardiomyocytes of neonatal mice. Western blotting revealed that alcohol caused histone H3K9me3 hypomethylation by altering G9α histone methyltransferase expression in cardiomyocytes. Moreover, overexpression of cardiomyogenesis‐related genes (MEF2C, Cx43, ANP and β‐MHC) was observed in alcohol‐exposed foetal mouse heart. Additionally, we demonstrated that G9α histone methyltransferase directly interacted with histone H3K9me3 and altered its methylation. Notably, alcohol did not down‐regulate H3K9me3 methylation after G9α suppression by short hairpin RNA in primary mouse cardiomyocytes, preventing MEF2C, Cx43, ANP and β‐MHC overexpression. These findings suggest that G9α histone methyltransferase‐mediated imbalance in histone H3K9me3 methylation plays a critical role in alcohol‐induced abnormal expression cardiomyogenesis‐related genes during pregnancy. Therefore, G9α histone methyltransferase may be an intervention target for congenital heart disease.
Research Review: Effectiveness of universal eating disorder prevention interventions in improving body image among children: a systematic review and meta‐analysis
Authors: Chua Joelle Yan Xin , Tam Wilson , Shorey Shefaly
Published: November 2019

Background

Increasingly, children are at risk of developing eating disorders. A systematic review and a meta‐analysis were conducted to examine the effectiveness of universal eating disorder prevention interventions in improving body image, internalization of appearance ideals, and self‐esteem among children aged 5–17 years old.

Methods

Nine electronic databases were systematically searched from each database’s point of inception to March 2019. The Cochrane Risk of Bias tool assessed each study’s risk of bias, while the GRADE approach judged the overall evidence for each review outcome. A meta‐analysis was conducted using the random‐effect model to obtain standardized mean differences with 95% confidence intervals under the inverse variance method. Heterogeneity was assessed using I2 statistic and Cochran’s Q chi‐squared test. Publication bias was assessed using funnel plots.

Results

A total of 24 studies (22 trials) were included in this review. Universal interventions were found to be effective in improving children’s body esteem, self‐esteem, and internalization of appearance ideals at postintervention and at follow‐up timepoints. Subgroup analyses found that girls benefited more from these interventions than boys. Multisessional interventions with an optimal duration of approximately one month were found to be more effective.

Conclusions

The findings encourage the incorporation of universal preventive interventions into school curricula to benefit most children. Laypeople such as teachers can deliver these interventions, but content experts should address topics on body dissatisfaction. Due to the low quality of evidence, as accorded by the GRADE approach, current findings should be validated by future research.
Accelerometer‐Measured Hospital Physical Activity and Hospital‐Acquired Disability in Older Adults
Authors: Pavon Juliessa M. , Sloane Richard J. , Pieper Carl F. , Colón‐Emeric Cathleen S. , Cohen Harvey J. , Gallagher David , Hall Katherine S. , Morey Miriam C. , McCarty Midori , Hastings Susan N.
Published: November 2019

BACKGROUND

Hospital‐acquired disability (HAD) is common and often related to low physical activity while in the hospital.

OBJECTIVE

To examine whether wearable hospital activity trackers can be used to predict HAD.

DESIGN

A prospective observational study between January 2016 and March 2017.

SETTING

An academic medical center.

PARTICIPANTS

Community‐dwelling older adults, aged 60 years or older, enrolled within 24 hours of admission to general medicine (n = 46).

MAIN MEASURES

Primary outcome was HAD, defined as having one or more new activity of daily living deficits, decline of four or greater on the Late‐Life Function and Disability Instrument (calculated between baseline and discharge), or discharge to a skilled nursing facility. Hospital activity (mean active time, mean sedentary time, and mean step counts per day) was measured using ankle‐mounted accelerometers. The association of the literature‐based threshold of 900 steps/day with HAD was also evaluated.

RESULTS

Mean age was 73.2 years (SD = 9.5 years), 48% were male, and 76% were white. Median length of stay was 4 days (interquartile range [IQR] = 2.0‐6.0 days); 61% (n = 28) reported being able to walk without assistance of another person or walking aid at baseline. Median daily activity time and step counts were 1.1 h/d (IQR = 0.7‐1.7 h/d) and 1455.7 steps/day (IQR = 908.5‐2643 steps/day), respectively. Those with HAD (41%; n = 19) had lower activity time (0.8 vs 1.4 h/d; P = .04) and fewer step counts (1186 vs 1808 steps/day; P = .04), but no difference in sedentary time, compared to those without HAD. The 900 steps/day threshold had poor sensitivity (40%) and high specificity (85%) for detecting HAD.

CONCLUSIONS

Low hospital physical activity, as measured by wearable accelerometers, is associated with HAD. Clinicians can utilize wearable technology data to refer patients to physical/occupational therapy services or other mobility interventions, like walking programs. J Am Geriatr Soc 68:261–265, 2020
Diagnosis and treatment of Guillain‐Barré syndrome during the Zika virus epidemic in Brazil: A national survey study
Authors: Leonhard Sonja E. , Conde Rodrigo M. , de Assis Aquino Gondim Francisco , Jacobs Bart C.
Published: November 2019

The Zika virus (ZIKV) epidemic in Brazil in 2015‐2016 was followed by an increase in the incidence of patients with Guillain‐Barré syndrome (GBS). With this national survey study, we aimed to gain a better understanding of how neurologists in Brazil are currently diagnosing and treating patients with GBS, and how this increase in incidence has impacted the management of the disease. The questionnaire consisted of 52 questions covering: personal profile of the neurologist, practice of managing GBS during and outside of the ZIKV epidemic, and limitations in managing GBS. All 3264 neurologists that were member of the Brazilian Academy of Neurology at the time of the study were invited to participate. The questionnaire was fully answered by 171 (5%) neurologists. Sixty‐one percent of neurologists noticed an increase in patients with GBS during the ZIKV epidemic, and 30% experienced an increase in problems in managing GBS during this time. The most important limitations in the diagnosis and management of GBS included the availability of nerve conduction studies (NCS), beds in the Intensive Care Unit (ICU) and referral to rehabilitation centers. Most neurologists did not use a protocol for treating patients with GBS and the treatment practice varied. Increasing availability of NCS and beds in the ICU and rehabilitation centers, and the implementation of (inter)national guidelines, are critical in supporting Brazilian neurologist in their management of GBS, and are especially important in preparing for future outbreaks.
Factors affecting the outcome of the suction blisters using two different harvesting techniques in vitiligo patients
Authors: Anbar Tag S. , El‐Fakahany Hasan M. , El‐khayyat Mohammed A. , Abdel‐Rahman Amal T. , Saad Enas K.
Published: November 2019

Background

Suction blister grafting (SBG) technique has been used for long to treat various skin conditions. Different suction methods have been used such as syringes, Chinese cups, and suction device. There are some limitations of its use as time consumption, failure of induction or incomplete blister formation and pain.

Aim

The aim of this work was to evaluate the outcome of using two different suction techniques, namely the syringes and the Chinese cups in induction of suction blisters. The effect of the device diameter and preheating of the donor area on the suction blister induction time (SBIT) was studied. The effect of saline injection in the blister formation and its completion was also evaluated.

Methods

The study was a left‐right comparative study that included 50 patients with stable nonsegmental vitiligo. They were classified into four groups: Group 1 included 15 patients where different diameters of syringes (1.3, 1.7, and 2 cm) were compared against each other, group 2 included 15 patients where different diameters of cups (2, 3.5, and 5 cm) were compared against each other, group 3 included 20 patients subdivided into two groups; 10 patients each, where the effect of preheating the skin on blister induction was tested with use of cups (3a) and syringes (3b). Lastly, group 4 included randomly chosen 40 incomplete or multilocular blisters where the effect of saline injection on blister completion and coalescence of multilobulation was examined. SBIT was calculated in all patients.

Results

The use of the small diameter syringes or cups gave shorter SBIT; however, the difference, which was significant between all sizes of cups, was significant between the 1.3‐ and 2‐cm‐diameter syringes only. Preheating of the donor area shorten SBIT significantly. No complications were reported at the donor site except for transient postinflammatory hyperpigmentation in all patients.

Conclusion

The small diameter syringes or cups and preheating of the donor area shorten the SBIT, while intra‐blister saline injection increased the blister size and turns the multilocular blisters to unilocular ones.
The Role of Dialectical Interrogation in Review Studies: Theorizing from What We See Rather Than What We Have Already Seen
Authors: Hoon Christina , Baluch Alina M.
Published: November 2019

Review‐centric works receive increasing attention for generating insightful contributions to management and organization studies. Despite this, the literature on theory building has taken little note of their place in the theorizing process. This deserves attention, however, given the challenges reviews face in theorizing in the absence of new empirical observations. Accordingly, these works run the risk of merely summarizing ‘what we have already seen’, instead of ‘maximizing what we see’. Drawing on the strategies of theorizing from similarities and theorizing from anomalies, we propose dialectical interrogation as a critical step in theorizing through which review scholars imaginatively engage in a back and forth inquiry between the phenomenal world of a given field and existing theory. By analysing selected review studies from top management journals, we reveal that theorizing outcomes occur through two ways of dialectical interrogation (consolidative and disruptive). We contribute by demonstrating that review scholars can enter into powerful theorizing through the consolidative or disruptive interrogation of the review data with extant theory to detect emergence and novelty alongside puzzles, conflicts and paradoxes. Dialectical interrogation can address the shortcomings of current theorizing in review‐centric works and bears potential for advancing theories of management and organization studies.
Association of masticatory muscle activity with sleep arousal and other concomitant movements during sleep
Authors: Miki Haruna , Minakuchi Hajime , Miyagi Mayu , Hara Emilio Satoshi , Shigemoto Shuji , Suzuki Yoshitaka , Maekawa Kenji , Matsuka Yoshizo , Clark Glenn T. , Kuboki Takuo
Published: November 2019

Objective

This study aims to verify the associations among sleep bruxism (SB), sleep arousal (SA) and concurrent body movements.

Material and Methods

Subjects underwent a standard overnight polysomnography test and audio‐video recordings. Sleep quality was evaluated according to the Rechtschaffen and Kales criteria, while SA was determined as per the American Sleep Disorders Association criteria. Analyses were performed by an external institution after masking of the subjects' information. SB was assessed based on the presence/absence of rhythmic masticatory muscle activity (RMMA) episodes, which were identified by using electromyography of the masseter muscle. The observed simultaneous movements included lower leg movement (LLM), swallowing, face scratching, head movement, body movement, eye blinking, coughing, licking, sighing, body scratching, lip sucking, somniloquy and yawning. The LLM was determined visually, as well as through an increase in the tibialis electromyogram signal. Other movements were visually assessed using audio‐video recordings. The incidences of all the simultaneous movements were compared between RMMA with intercurrent SA (SAwRMMA; RMMA episode derived from a masseter electromyogram showing more than 10% of maximum voluntary contraction) and SA without RMMA (SAw/oRMMA).

Results

Fourteen subjects were included in this study (females/males: 4/10, mean age: 31.5 ± 5.7 years). Among these, LLM, swallowing, body movement, licking, body scratching and lip sucking were frequently observed in SAwRMMA episodes than in SAw/oRMMA episodes, significantly. However, the non‐specific simultaneous movements were higher observed in SAw/oRMMA episodes than that in SAwRMMA.

Conclusion

Our results suggest that SB is concurrently activated with LLM in relation to arousal.