bluuebunny/crossref_metadata_2025 huggingface dataset:
Tai Chi exercise for sleep problems in older adults
Authors: Si Yuhao , Wang Cenyi , Zheng Jinghui , Guo Yang , Xu Guihua , Ma Yong
Published: November 2019

Background:

Sleep plays a crucial role in the general health of the human body. However, sleep problems become increasingly severe with age, and its incidence is on the rise. Notably, Tai Chi exercise may be an efficacious means to ameliorate sleep problems among older adults. This is especially since Tai Chi has been widely used to manage sleep problems in China for many years, but there is limited evidence regarding its effectiveness. We will conduct this study aiming to investigate the efficacy of Tai Chi as a complementary and alternative therapy for sleep problems in older adults.

Methods:

We will systematically search Scopus, Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang database from their inceptions to August 2019. Only randomized controlled trials of Tai Chi for sleep problems among older adults will be considered for inclusion and the Pittsburgh sleep quality index will be the primary outcome measurement. Moreover, study selection, data extraction, and the evaluation of the methodological quality of trials will each be independently completed by at least 2 researchers. We will employ the software Stata version 12.0 to implement the statistical analysis.

Results:

The current systematic review and meta-analysis will provide synthesized results of the effectiveness and safety of Tai Chi exercise for sleep problems among older adults.

Conclusion:

This systematic review and meta-analysis will provide high-quality evidence on the effectiveness and safety of Tai Chi exercise for sleep problems in older adults.

Registration:

PEROSPERO CRD42019129782.
Status of injuries as a public health burden among children and adolescents in China
Authors: Wang Ziyu , Chen Hui , Yu Taolin , Liu Siyun , Hu Ming
Published: November 2019

Introduction:

Injuries among children and adolescents remain a major public health problem in China. In the present study, we undertook a systematic review and meta-analysis of the published literature of epidemiological studies investigating injuries among children and adolescents in China and aimed to describe the status of injury among children and adolescents (aged 0–19 years) in China nationwide. A random-effects meta-analysis model was used to calculate the pooled prevalence of injury with 95% confidence intervals (CIs) across studies. The potential heterogeneity moderators were identified by subgroup and sensitivity analysis. A total of 775,615 children and adolescents were included in this study. Overall, the pooled injury prevalence among children and adolescents aged 0 to 19 years was 23.0% (95% CI 20.0%−27.0%) in studies using 1996 version of injury definition, and 13.0% (95% CI 10.0%−17.0%) in studies using 2004 version of injury definition. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results.

Conclusion:

Our study shows a moderately high injury prevalence among children and adolescents aged 0 to 19 years in China, more prevention policies and programs should be urgently developed to decrease the occurrence of child and adolescent injury.
Knowledge and attitudes toward end-of-life care among community health care providers and its influencing factors in China
Authors: Shi Hongrui , Shan Baifeng , Zheng Jianzhong , Peng Wei , Zhang Ying , Zhou Xue , Miao Xiaohui , Hu Xiuying
Published: November 2019

A majority of nurses struggled with a negative emotion of anger, doubt, fear, or anxious, uncomfortable in the face of death and dying. However, little was known about community health care providers’ in China. Therefore, we conducted a study to investigate their knowledge and attitudes toward end-of-life care and analyze its influencing factors. To provide reference for developing effective strategies to promote end-of-life care in China.

A total of 132 community health care providers of 10 community health care centers in Changzhi city were investigated by a Questionnaire of Knowledge and Attitudes toward Caring for the Dying from May, 2017 to December, 2017, and data was analyzed by SPSS 22.0 software.

Of the 132 community health care providers who were under investigation, 70 knew about hospice care, but they rated their overall content on end-of-life care as inadequacy, especially in communication skills and knowledge of pain management. The average score of attitudes was 3.47 (SD = 0.44), the lowest score was in the subscale of nurse−patient communication, which was 2.91 (SD = 0.65). Health care providers who had worked for more than 11 years, who had experiences of the death of relatives or friends, and who had previous experiences of caring for terminal patients had more positive attitudes toward caring for the dying (P < .05 for all). There was a significant relationship between community health care providers’ attitudes toward death and their attitudes toward end-of-life care (r = −0.282, P < .01). The significant predictors of attitudes toward end-of-life care were attitudes toward death (β = −0.342), experiences of the death of relatives (β=−0.207), experiences of caring for the dying (β = 0.185), and working experience (β = 0.171).

Community health care providers had positive attitudes toward end-of-life care, but they lacked systematic and professional knowledge and skills of caring for the terminal patients. Education is the top priority. It is imperative to set up palliative care courses and life-death education courses, establish an indigenous end-of-life care model, and improve policies, systems, and laws to promote end-of-life care.
The effect of exercise on cervical radiculopathy
Authors: Liang Long , Feng Minshan , Cui Xin , Zhou Shuaiqi , Yin Xunlu , Wang Xingyu , Yang Mao , Liu Cunhuan , Xie Rong , Zhu Liguo , Yu Jie , Wei Xu
Published: November 2019

Background:

Cervical radiculopathy (CR), which is most often stems from degenerative disease in the cervical spine, has increasingly become a common and frequently occurring disease in clinic due to the popularity of electronic products, such as computes and cell phones. Some studies have shown that exercise or exercise combined with other treatments can effectively decrease pain and improve functional status. The objective was to analyze the effects of exercise for treating patients with CR.

Methods:

Seven databases were searched from inception to December 2018. Randomized controlled trials involving exercise alone or exercise combined with conventional treatment were enrolled. Data were pooled after trials quality assessment for meta-analysis. Outcomes were pain (visual analog scale [VAS]), quality of life (12-short form health survey, 36-short form health survey), and physical function accessed by neck disability index (NDI).

Results:

Ten studies involving 871 participants with CR were included. Meta-analysis revealed that compared with control group, there was a reduction in VAS (standardized mean difference = −0.89; 95% confidence interval [CI]: −1.34 to −0.44; Z = 3.89; P < .001). There was also an improvement of NDI (mean difference = −3.60; 95% CI: −6.27 to −0.94; Z = 2.65; P = .008)]. Additionally, although the results of subgroup analyses were changed due to the paucity of the quantity and quality of the included studies. The pooled results were verified to be stable by sensitivity analyses. Besides, the grading of recommendations assessment, development, and evaluation level of evidence is low for each outcome.

Conclusion:

Exercise alone or exercise plus other treatment may be helpful to patients with CR. However, exercise option should be carefully considered for each patient with CR in accordance with their different situations. Large-scale studies using proper methodology are recommended.
The relationship between magnesium and osteoarthritis of knee
Authors: Wu Zhiming , Yang Juguang , Liu Jiangtao , Lian Kai
Published: November 2019

The impact of magnesium on risk of knee osteoarthritis (KOE) is still under investigation. This meta-analysis evaluated the relationship between magnesium and risk of KOE.

A comprehensive search was performed to identify retrospective cohort study or cross-sectional study of the association between magnesium and KOE from the Cochrane library, PubMed, and Embase. The search time limit was from the establishment of the database to December 2018. Two evaluators selected the literature, extracted the data, and evaluated the quality of the literature according to the inclusion and exclusion criteria, independently. Meta-analysis was performed using RevMan 5.3 software and publication bias was assessed using Begg and Egger test and funnel plot.

Finally, 6 studies were included with a total of 15,715 participants. Although higher daily intake of magnesium was associated with a significantly reduced risk of fracture in patients with KOE (OR = 0.66, 95%CI: 0.56, 0.78; P < .00001), it was not significant for lowering the risk of KOE (OR = 0.80; 95% CI: 0.61, 1.04; P = .1). Meta-analysis also showed that population with higher serum magnesium levels had significantly lower risk of KOE (odds ratio (OR) = 0.84; 95% confidence interval (CI): 0.72, 0.98; P = .03). Further subgroup analysis showed that the relationship between serum magnesium level and KOE risk was significantly affected by serum magnesium level (P = .006 for quartiles 4 vs 1).

Higher level of magnesium intake was not associated with lower risk of KOE. However, higher daily intake of magnesium may be inversely associated with risk of fracture in KOE patients.
Significant response to anti-PD-1 based immunotherapy plus lenvatinib for recurrent intrahepatic cholangiocarcinoma with bone metastasis
Authors: Chen Wei-xun , Li Gan-xun , Hu Zheng-nan , Zhu Peng , Zhang Bi-xiang , Ding Ze-yang
Published: November 2019

Introduction:

The prognosis for recurrent intrahepatic cholangiocarcinoma with bone metastasis remains dismal and its treatment poses a challenge for oncologists. To date, only 2 cases were reported in which pembrolizumab, an agent against programmed cell death protein-1 (PD-1), combined with chemotherapy led to a complete response.
[1]
The safety and efficacy of nivolumab-based immunotherapy combined with lenvatinibin intrahepatic cholangiocarcinoma is unknown.

Patient concerns:

A 40-year-old female was identified as having a lesion of 7.0 cm in diameter in the right lobe of the liver. In addition, calculi in the main and left hepatic bile ducts as well as the gallbladder were found.

Diagnosis:

Based on the results of imaging studies and tumor biomarker level, the patient was initially diagnosed as having intrahepatic cholangiocellular carcinoma and cholelithiasis, after which surgery was performed. The pathological examination confirmed that the tumor was cholangiocarcinoma. Adjuvant chemotherapy was administered after surgery. However, the patient developed recurrent lesions at the 5th month after surgery, and the cholangiocarcinoma expanded to the right thoracic vertebral pedicle (T7–8) at the 6th month.

Interventions:

The patient underwent percutaneous microwave ablation after recurrence in the liver was identified. After that, the patient received nivolumab plus lenvatinib.

Outcomes:

The lesions in the liver decreased in size and disappeared after treatment with nivolumab plus lenvatinib. Additionally, the metastases in the right thoracic vertebral pedicle were stable after 9 months of therapy.

Lessons:

Immunotherapy has revolutionized the treatment of non-small-cell lung cancer, melanoma, and advanced renal cell carcinoma. In this case, the patient achieved an excellent radiological and symptomatic response after receiving nivolumab plus lenvatinib combination therapy. Patients suffering from cholangiocarcinoma with dMMR status and a high tumor mutation burden (TMB) may have a consistent eutherapeutic effect with anti-PD-1-directed treatment.
Incidence, comorbidities, and treatment patterns of nontuberculous mycobacterial infection in South Korea
Authors: Kim Hye Ok , Lee Kyungjong , Choi Hee Kyoung , Ha Sangmi , Lee Sang Moo , Seo Gi Hyeon
Published: November 2019

Nontuberculous mycobacteria (NTM) are important pathogens in humans, and hospital-based studies have shown an increased incidence of NTM infection. However, little is known about the treatment pattern of NTM infection with respect to the number of cases per population in South Korea. This study evaluated the trends in the incidence of NTM infection, respiratory comorbidities, and treatment patterns in South Korea.

National claims data from the Health Insurance Review and Assessment service database for the years 2009 to 2015 were reviewed, and codes related to NTM infection, respiratory comorbidities occurring from one year before NTM infection and associated treatments were identified.

In total, 52,551 patients were included in the study and the average annual incidence per 100,000 person-years was 12.8. The annual incidence was found to have increased from 6.6 to 26.6 per 100,000 persons. Accompanied comorbidities were tuberculosis (33.7%), followed by bronchial asthma (33.2%), chronic obstructive pulmonary disease (25.6%), and lung cancer (5.8%). A total of 76.6% of patients did not receive any combination treatment within one year after the diagnosis of NTM infection. Macrolide-based treatment was administered to 18.8% of patients.

A dramatic increase in the incidence of NTM infection was noted in the population of South Korea. Approximately three-fourth of the patients with NTM infection were clinically observed without treatment for at least 1 year after the identification of NTM infection and most patients who treated NTM infection received macrolide-based combination therapy.
Feasibility and safety of total percutaneous closure of femoral arterial access sites after veno-arterial extracorporeal membrane oxygenation
Authors: Xu Xin , Liu Zhenjie , Han Pan , He Minzhi , Xu Yongshan , Yin Li , Xu Zhijun , Liang Qiqiang , Huang Man
Published: November 2019

To evaluate the safety and efficacy of total percutaneous closure of the femoral artery access site after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) with the Perclose ProGlide device.

This retrospective observational study during an almost 2-year period included 21 patients who underwent VA-ECMO in whom the femoral artery puncture site was closed percutaneously with Perclose ProGlide devices. Technical success was defined as successful arterial closure of the common femoral artery, without the need for additional surgical or endovascular procedures. Access site complications were recorded at 24 hours and 30 days after arterial closure, such as major bleeding requiring transfusion or surgical intervention, minor bleeding, groin infection, pseudoaneurysm, and lymphocele.

Technical success was achieved in 20 patients (95.2%). One patient required surgical repair for an access site pseudoaneurysm. Eighteen femoral arteries were closed with 2 devices each, while 3 patients required the use of a third device for femoral artery access site closure to achieve adequate hemostasis. No arterial thrombosis, arterial dissection, arterial stenosis, groin infection, or arteriovenous fistula occurred during the periprocedural period (within 24 hours of arterial closure) or during 30-day follow-up.

Percutaneous closure with the Perclose ProGlide device is a feasible procedure for closing femoral arterial access sites after VA-ECMO, with a low incidence of access site complications.
Clinical and radiological results comparison of allograft and polyetheretherketone cage for one to two-level anterior cervical discectomy and fusion
Authors: Yang Sen , Yu Yang , Liu Xun , Zhang Zehua , Hou TianYong , Xu Jianzhong , Wu Wenjie , Luo Fei
Published: November 2019

Background:

Recently, many kinds of cages for cervical fusion have been developed to avoid the related complications caused by tricortical iliac crest graft. The existing literature has reported the excellent clinical efficacy and superior fusion rate. However, various types of cages have their own disadvantages. Which bone graft material is the best choice for cage with the fewest complications? At present, there is still no conclusion.

Methods:

By reviewing patients with 1 to 2-level cervical degenerative disease in our hospital with a novel cage made of allograft or polyetheretherketone (PEEK), we evaluated the efficacy and reliability of the new cage in anterior cervical discectomy and fusion (ACDF). From 2015 to 2016, a prospective review of 58 and 49 consecutive cases with spondylotic radiculopathy or myelopathy undergoing ACDF using allograft (group A) and PEEK (group B) cage were performed. The follow-up ranged from 12 to 40 months. Intraoperative index, clinical outcome and complications were recorded. Radiographs evaluated segmental and overall cervical lordosis, the height of the intervertebral space, interbody height ratio (IHR), cage positioning, and fusion state.

Results:

A total of 134 cages were implanted. Compared to preoperatively, the visual analog scale (VAS) and neck disability index (NDI) were reduced postoperatively without any change during the subsequent follow-up in both groups. There was no migration or extrusion of the cages at the latest follow-up. There were 2 and 4 patients suffering dysphagia respectively. In both groups, the intervertebral height, IHR, segmental and overall cervical lordosis were significantly greater than pre-operation (P < .05) and were maintained at the last follow-up, but were not statistically significant (P > .05). The allograft group achieved a fusion rate of 100% (58/58) according to CT scans at 3 months post-operation, while PEEK group was 91.8% (45/49), which reached 95.9% (47/49) at 6 months and 100% at 12 months. In addition, the fusion state was maintained in all patients at the last follow-up.

Conclusion:

Our data showed that the new allograft cage is superior to the PEEK cage in providing a high fusion rate and fewer complications after 1-level and 2-level ACDF procedures. It may represent an excellent alternative to other cages.
Parental Psychological Factors and Quality of Life of Children With Inflammatory Bowel Disease
Authors: Bramuzzo Matteo , De Carlo Chiara , Arrigo Serena , Pavanello Paolo Maria , Canaletti Claudia , Giudici Fabiola , Agrusti Anna , Martelossi Stefano , Di Leo Grazia , Barbi Egidio
Published: November 2019

Objectives:

Parents have a central role in the management of children with inflammatory bowel disease (IBD). Alterations in parental psychological well‐being may affect the patient's health‐related quality of life (HRQoL). This study aimed to evaluate the correlation between maternal and paternal distress, anxiety, depression and pain catastrophizing and the HRQoL of patients with IBD.

Methods:

Children with IBD ages 8 to 18 years and their parents were prospectively recruited. Children answered questionnaires on HRQoL while parents completed an assessment of distress, anxiety, depression, and pain catastrophizing. Univariate and multivariate regression models analysis were used to evaluate correlations between parental measures and patient's HRQoL and between the factors related to children health and parental psychological suffering.

Results:

One hundred patients (45 Crohn disease, 55 ulcerative colitis), 90 mothers and 62 fathers were enrolled. Parents had high levels of distress while anxiety, depression, and pain catastrophizing levels were relatively low. Parental distress had the most substantial correlation with children's HRQoL and was associated with patients’ disease activity and recent flares. On multivariate regression analysis, parental factors explained less than 20% of the variance in the children's HRQoL scores. Mothers suffered from psychological alterations more frequently than fathers, but the parental inter‐rater agreement was strong in regards to distress and anxiety.

Conclusions:

Parental distress is high and correlates with the HRQoL of children with IBD. Interventions aimed at evaluating and managing parental distress should be considered during the management of children with IBD.
Growth in Infants and Children With Intestinal Failure‐associated Liver Disease Treated With Intravenous Fish Oil
Authors: Raphael Bram P. , Mitchell Paul D. , Gura Kathleen M. , Potemkin Alexis K. , Squires Robert H. , Puder Mark , Duggan Christopher P.
Published: November 2019

Background:

Infants with intestinal failure (IF) and IF‐associated liver disease (IFALD) are at risk for poor somatic growth because of increased metabolic demands, inadequate intake, intestinal malabsorption, chronic liver disease and other comorbidities. There are limited data on the nutritional adequacy of intravenous fish oil lipid emulsion (FOLE) compared with standard soybean oil lipid emulsion (SOLE) in the setting of intestinal failure.

Aims:

To describe growth patterns in a large cohort of infants with IFALD treated with FOLE.

Methods:

We compared growth data from infants enrolled in a single‐center, prospective FOLE study to published norms, as well as to a multicenter, historical cohort of infants with IF treated with SOLE.

Results:

One hundred thirty‐eight infants with IFALD were treated with FOLE and 108 with SOLE. Compared with normative growth curves from WHO and published preterm data, infants in both groups from 6 to 11 months postmenstrual age exhibited declines in mean weight‐ and length‐for‐age z scores. At 24 months postmenstrual age compared with WHO growth data, infants treated with FOLE had a mean (95% confidence interval [CI]) weight‐for‐age z‐score of 0.13 (−0.18 to 0.45) and length‐for‐age z‐score of 0.07 (−0.33 to 0.47). In comparison, at 24 months postmenstrual age, infants treated with SOLE had a mean weight for age z‐score of −0.93 (−1.20 to −0.67) and mean length for age z‐score of −2.33 (−2.75 to −1.91). Independent predictors of higher weight, length and head circumference z‐scores included older postmenstrual age at baseline, fewer central line‐associated blood stream infections, resolution of cholestasis, type of intravenous fat emulsion (FOLE vs SOLE) and female sex.

Conclusions:

Infants with IFALD treated with FOLE showed comparable somatic growth to those treated with SOLE in early infancy, and improved somatic growth up to 24 months of age, supporting its wider use in this patient population.
Multidisciplinary Quality Improvement Intervention to Achieve Sustained Improvement in Hand Hygiene Reliability in a Pediatric Intensive Care Unit
Authors: Albert Ben D. , Petti Chonel , Caraglia Adrianna , Geller Margaret , Horak Robin , Barrett Megan , Hastings Ryan , O’Brien Mary , Ormsby Jennifer , Sandora Thomas J. , Kleinman Monica E. , Priebe Gregory P. , Mehta Nilesh M.
Published: November 2019

Introduction:

Suboptimal hand hygiene (HH) remains a significant modifiable cause of healthcare-associated infections in the intensive care unit. We report a single-center, quality improvement project aimed at improving adherence to optimal HH among physicians, nurse practitioners, and nursing staff, and to sustain any improvement over time.

Methods:

A key driver diagram was developed to identify 5 primary drivers of change: leadership support, education initiatives, patient-family engagement, increased audit frequency, and individual feedback to promote accountability. We examined HH compliance over 3 years in 3 phases (pre-intervention, intervention, and post-intervention). The intervention period involved a multimodal approach designed to influence unit culture as well as individual HH practice. HH screens were installed outside the patient rooms to provide just-in-time reminders and display of regularly updated HH adherence data for provider groups.

Results:

We recorded 6,563 HH opportunities, providers included nurses (66%), attendings (12%), fellow/resident (16%), and nurse practitioners (NP) (6%). All clinical groups demonstrated HH compliance >90% during the post-intervention period. The improvements in practice were sustained for a year after the intervention.

Conclusion:

Our report highlights modifiable factors that impact HH and may inform quality improvement interventions aimed at improving HH compliance at other centers.
CA1 Hippocampal Pyramidal Cells in Rats, Resuscitated From 8 Minutes of Ventricular Fibrillation Cardiac Arrest, Recover After 20 Weeks of Survival: A Retrospective Pilot Study
Authors: Weihs Wolfgang , Warenits Alexandra-Maria , Ettl Florian , Magnet Ingrid Anna Maria , Herkner Harald , Kramer Anne Margarethe , Teubenbacher Ursula , Lobmeyr Elisabeth , Schriefl Christoph , Clodi Christian , Bauder Barbara , Tiboldi Akos , Holzer Michael , Janata Andreas , Högler Sandra
Published: November 2019

Purpose:

The cornu ammonis 1 (CA1) region of the hippocampus is specifically vulnerable to global ischemia. We hypothesized that histopathological outcome in a ventricular fibrillation cardiac arrest (VFCA) rat model depends on the time point of the examination.

Methods:

Male Sprague-Dawley rats were put into VFCA for 8 min, received chest compressions for 2 min, and were defibrillated to achieve return of spontaneous circulation. Animals surviving for 80 min, 14 days and 140 days were compared with controls. Viable neurons were counted in a 500 μm sector of the CA1 region and layer thickness measured. Microglia cells and astrocytes were counted in a 250×300 μm2 aspect.

Results:

Control and 80 min surviving animals had similar numbers of pyramidal neurons in the CA1 region. In 14 days and 140 days survivors neuron numbers and layer thickness were severely diminished compared with controls (P < 0.001). Two-thirds of the 140 days survivors showed significantly more viable neurons than the last third. Microglia was increased in 14 days survivors compared with controls and 140 days survivors, while astrocytes increased in 14 days and 140 days survivors compared with controls (P < 0.001). 140 days survivors had significantly higher astrocyte counts compared with 14 days survivors.

Conclusions:

The amount and type of brain lesions present after global ischemia depend on the survival time. A consistent reduction in pyramidal cells in the CA1 region was present in all animals 14 days after VFCA, but in two-thirds of animals a repopulation of pyramidal cells seems to have taken place after 140 days.
Enterobacter wuhouensis sp. nov. and Enterobacter quasihormaechei sp. nov. recovered from human sputum
Authors: Wang Chengcheng , Wu Wenjing , Wei Li , Feng Yu , Kang Mei , Xie Yi , Zong Zhiyong
Published: November 2019

Two novel strains of members of the genus

Enterobacter

, WCHEs120002T and WCHEs120003T, were recovered from the sputum of two patients at a hospital in PR China in 2017. The strains were Gram-stain-negative, facultatively anaerobic, motile and non-spore-forming. The two strains were subjected to whole-genome sequencing. Phylogenetic analysis based on core genes of type strains of species of the family

Enterobacteriaceae

revealed that the two strains belonged to the genus

Enterobacte

r but were distinct from any previously known species of the genus. Both average nucleotide identity and in silico DNA–DNA hybridization values between strains WCHEs120002T and WCHEs120003T and type strains of all known species of the genus

Enterobacter

were lower than the recommended thresholds of 95 and 70  %, respectively, for species delineation. The major fatty acids of the two strains were C16 : 0, C17 : 0 cyclo and C18:1ω7c, which are similar to those of other species of the genus

Enterobacter

. Genomic DNA G+C contents of strains WCHEs120002T and WCHEs120003T were 56.09 and 55.91 mol%, respectively. WCHEs120002T ferments melibiose and sucrose but is negative for d-sorbitol and methyl-α-d-mannopyranoside reactions, which distinguish it from all other species of the genus

Enterobacter

. WCHEs120003T can be differentiated from other species of the genus

Enterobacter

by its ability to ferment potassium gluconate and its negative reactions for d-sorbitol and l-fucose. Genotypic and phenotypic characteristics indicate that strains WCHEs120002T and WCHEs120003T represent two novel species of the genus

Enterobacter

, for which the names Enterobacter wuhouensis sp. nov. and Enterobacter quasihormaechei sp. nov. are proposed, respectively. The type strain of E. wuhouensis sp. nov. is WCHEs120002T (=GDMCC1.1569T=NCTC 14273T) and the type strain of E. quasihormaechei sp. nov. is WCHEs120003T (=GDMCC1.1568T=NCTC 14274T).
Performance of the Safer Nursing Care Tool to measure nurse staffing requirements in acute hospitals: a multi-centre observational study
Authors: Griffiths Peter , Saville Christina , Ball Jane E , Culliford David , Pattison Natalie , Monks Thomas
Published: November 2019

Objectives

To determine the precision of nurse staffing establishments estimated using the SNCT patient classification system, and to assess whether the recommended staff levels correspond with professional judgements of adequate staffing.

Setting / population

81 medical/surgical units in 4 acute care hospitals.

Methods

Nurses assessed patients using the SNCT and reported on the adequacy of staffing at least daily for one year. Bootstrap samples of varying sizes were used to estimate the precision of the tool’s recommendations for the number of nurses to employ on each unit. Multi-level regression models were used to assess the association between shortfalls from the measured staffing requirement and nurses’ assessments of adequate staffing.

Results

The recommended minimum sample of 20 days allowed the required number to employ to be estimated with a mean precision of 4.1%. For most units, much larger samples were required to estimate establishments within +/- 1 whole time staff member. Every registered nurse hour per patient day shortfall in staffing was associated with an 11% decrease in the odds of nurses reporting that there were enough staff to provide quality care and a 14% increase in the odds of reporting that necessary nursing care was left undone. No threshold indicating an optimal staffing level was observed. Surgical specialty, patient turnover and more single bedded rooms were associated with lower odds of staffing adequacy.

Conclusions

The SNCT can provide reliable estimates of the number of nurses to employ on a unit, but larger samples than the recommended minimum are usually required. The SNCT provides a measure of nursing workload that correlates with professional judgements, but the recommended staffing levels may not be optimal. Some sources of systematic variations in staffing requirements for some units are not accounted for. SNCT measurements are a potentially useful adjunct to professional judgement, but cannot replace it.
Serum proteomics expands on high-affinity antibodies in immunized rabbits than deep B-cell repertoire sequencing alone
Authors: Bonissone Stefano R. , Lima Thiago , Harris Katherine , Davison Laura , Avanzino Brian , Trinklein Nathan , Castellana Natalie , Patel Anand
Published: November 2019

Abstract

Rabbits are a model for immunology studies, and monoclonal antibodies developed from rabbits have been sought after to empower immunoassays in a variety of applications. High-throughput characterization of circulating serum antibodies in response to specific antigens is highly impactful for both humoral immunology studies and antibody development. A combination of high throughput sequencing of antibody transcripts from B cells and proteomic analysis of serum antibodies, an approach referred to as immunoproteogenomics, is applied to profile the immune response of rabbits toβ-galactosidase (Beta-gal) in both recombinant antigen and peptide antigen immunization formats. The use of intact protein antigen resulted in observing 56.3% more heavy chains CDR3s in serum than immunization with peptide antigens. Additionally, sampling peripheral blood mononuclear cells (PBMCs) for B-cell repertoire sequencing at different time points throughout the immunization was found to capture 47.8%-72.8% of total proteomically observed heavy chain CDR3s, and would serve well in replacing sequencing the B cell rich, but more difficult to access spleen or bone marrow compartments. Despite B-cell repertoire sequencing to depths of 2M to 10M reads, we found proteomic evidence supporting at least 10% of serum antibodies are still missed. Further improvements to proteomic analysis techniques would enable more precise characterization of antibodies circulating in serum and determine antibody protein sequences missed by repertoire sequencing.
Progress in HAXPES performance combining full-field k-imaging with time-of-flight recording
Authors: Medjanik K. , Babenkov S. V. , Chernov S. , Vasilyev D. , Schönhense B. , Schlueter C. , Gloskovskii A. , Matveyev Yu. , Drube W. , Elmers H. J. , Schönhense G.
Published: November 2019

An alternative approach to hard-X-ray photoelectron spectroscopy (HAXPES) has been established. The instrumental key feature is an increase of the dimensionality of the recording scheme from 2D to 3D. A high-energy momentum microscope detects electrons with initial kinetic energies up to 8 keV with a k-resolution of 0.025 Å−1, equivalent to an angular resolution of 0.034°. A special objective lens with k-space acceptance up to 25 Å−1 allows for simultaneous full-field imaging of many Brillouin zones. Combined with time-of-flight (ToF) parallel energy recording this yields maximum parallelization. Thanks to the high brilliance (1013 hν s−1 in a spot of <20 µm diameter) of beamline P22 at PETRA III (Hamburg, Germany), the microscope set a benchmark in HAXPES recording speed, i.e. several million counts per second for core-level signals and one million for d-bands of transition metals. The concept of tomographic k-space mapping established using soft X-rays works equally well in the hard X-ray range. Sharp valence band k-patterns of Re, collected at an excitation energy of 6 keV, correspond to direct transitions to the 28th repeated Brillouin zone. Measured total energy resolutions (photon bandwidth plus ToF-resolution) are 62 meV and 180 meV FWHM at 5.977 keV for monochromator crystals Si(333) and Si(311) and 450 meV at 4.0 keV for Si(111). Hard X-ray photoelectron diffraction (hXPD) patterns with rich fine structure are recorded within minutes. The short photoelectron wavelength (10% of the interatomic distance) `amplifies' phase differences, making full-field hXPD a sensitive structural tool.
Coherence properties of the high-energy fourth-generation X-ray synchrotron sources
Authors: Khubbutdinov R. , Menushenkov A. P. , Vartanyants I. A.
Published: November 2019

An analysis of the coherence properties of the fourth-generation high-energy storage rings with emittance values of 10 pm rad is performed. It is presently expected that a storage ring with these low emittance values will reach diffraction limit at hard X-rays. Simulations of coherence properties were performed with the XRT software and an analytical approach for different photon energies from 500 eV to 50 keV. It was demonstrated that a minimum photon emittance (diffraction limit) reached at such storage rings is λ/2π. Using mode decomposition it is shown that, for the parameters of the storage ring considered in this work, the diffraction limit will be reached for soft X-ray energies of 500 eV. About ten modes will contribute to the radiation field at 12 keV photon energy and even more modes give a contribution at higher photon energies. Energy spread effects of the electron beam in a low-emittance storage ring were analysed in detail. Simulations were performed at different relative energy spread values from zero to 2 × 10−3. A decrease of the degree of coherence with an increase of the relative energy spread value was observed. This analysis shows that, to reach the diffraction limit for high photon energies, electron beam emittance should go down to 1 pm rad and below.
Structural, theoretic and spectroscopic analysis of 2-methyl-5-nitroaniline salts with various inorganic acids
Authors: Medviediev Volodymyr , Daszkiewicz Marek
Published: November 2019

Crystal structures of six new salts of 2-methyl-5-nitroaniline with inorganic acids [(H2Me5NA)Br, (H2Me5NA)I, (H2Me5NA)NO3, (H2Me5NA)Cl, (H2Me5NA)HSO4 and (H2Me5NA)I3·0.5H2O] are determined by single-crystal X-ray diffraction. The most important hydrogen-bonding patterns are formed by the ammonio group and respective anions composing 1D or 2D networks. The patterns are analysed using the graph-set approach and mathematical interrelations between graph-set descriptors are shown for comparative purposes. Analysis of IR spectra enables the strength of hydrogen bonds in the crystals to be assessed. The frequency of N—H and O—H stretching vibrations and NH3 group libration indicates that the strongest hydrogen bonds are present in (H2Me5NA)HSO4, whereas the weakest ones occur in (H2Me5NA)I3·0.5H2O. Hirshfeld surface analysis reveals that apart from obvious N—H...anion hydrogen bonds, the molecules are also connected to each other by exclusive C—H...ONO2 interactions. The opposite occurs in the crystal structure of 2-methyl-4-nitroaniline salts, where a variety of ONO2...π(N)NO2 non-hydrogen bonding interactions are observed.
Organically pillared layer framework of [Eu(NH2–BDC)(ox)(H3O)]
Authors: Thammakan Supaphorn , Panyarat Kitt , Rujiwatra Apinpus
Published: November 2019

The non-porous three-dimensional structure of poly[(μ5-2-aminobenzene-1,4-dicarboxylato)(μ6-oxalato)(oxomium)europium(III)], [Eu(C8H5NO4)(C2O4)(H3O)]
n
or [EuIII(NH2–BDC)(ox)(H3O)]
n
(NH2–BDC2− = 2-aminoterephthalate and ox2− = oxalate) is constructed from two-dimensional layers of EuIII–carboxylate–oxalate, which are connected by NH2–BDC2− pillars. The basic structural unit of the layer is an edge-sharing dimer of TPRS-{EuIIIO9}, which is assembled through the ox2− moiety. The intralayer void is partially occupied by TPR-{EuIIIO6} motifs. Weak C—H...O and strong, classical intramolecular N—H...O and intermolecular O—H...O hydrogen-bonding interactions, as well as weak π–π stacking interactions, affix the organic pillars within the framework. The two-dimensional layer can be simplified to a uninodal 4-connected sql/Shubnikov tetragonal plane net with point symbol {44.62}.
How artistic directors motivate the consistency of artists’ performance
Authors: Ricotta Anthony G. , Fan Susan K. , Dwyer Rocky J.
Published: November 2019

Purpose

The purpose of this paper is to explore what motivation strategies live-entertainment artistic directors (ADs) use to increase consistency in their employees’ performances.

Design/methodology/approach

The purpose of this qualitative case study was to explore the research question: what motivation strategies do live-entertainment ADs use to improve consistency in employee performance? Semistructured face-to-face interviews with artistic and senior ADs of a large international live-entertainment company’s US division participated in the study. In addition to the interviews, a further analysis of archival records of artists’ evaluations, and written company documents regarding performance evaluation to understand the ADs’ strategies were completed. Finally, self-reported interview data compared to AD evaluations of artists from randomly selected prior years verified the ADs practices.

Findings

The finding indicated ADs use multiple techniques geared at improving employee well-being and technical competence, thereby creating an environment conducive to the employees self-determining their consistent behavior in performance.

Practical implications

These findings may offer managers across multiple industries a variety of strategies and techniques to use to improve consistency for their workers.

Originality/value

This study is the one of few that studies manager influence on the motivation of those employees whose job is to entertain others regardless of the employee’s emotional state. From these findings, ADs may determine how to implement workplace safety improvements, expanding employee well-being, which in turn can improve performance consistency.
Internationalization of industrial small-medium enterprises in an emerging country
Authors: Ibarra-Morales Luis Enrique , Blanco-Jimenez Monica , Hurtado-Bringas Beatriz Alejandra
Published: November 2019

Purpose

The purpose of this paper is to boost the internationalization of companies by implementing key factors that will help them to increase their exports in a context of an emerging country such as Mexico, where very few small- and medium-sized enterprises (SMEs) achieve internationalization.

Design/methodology/approach

According to different theories on the internationalization of companies, five independent variables were designed to measure their effect on the export performance using a multiple regression model on a sample of 95 Mexican industrial SMEs. In this context, the objective of this study is to investigate the impact of the product price, product quality, installed capacity, innovation capacity and financial capacity on the export performance of SMEs; and to identify the factors that are more signiﬁcant.

Findings

The results indicate that innovation has a positive relationship, while the price of the product has a negative relationship with the internationalization of small- and medium-sized enterprises, showing that there is a possibility of overemphasizing the role of both variables in export performance of SMEs, at least in the Mexican context. The rest of the variables were not statistically significant to the generated model, perhaps because they are implicitly considered at the time of exporting and entering international markets.

Originality/value

These results will help companies to focus their efforts on obtaining resources to maintain and expand exports and find new opportunities in foreign markets to grow. They also show that companies can implement different types of internationalization strategies with the study’s variables to achieve better performance.
School board directors’ information needs and financial reporting’s role
Authors: Chen Hanmei , Smith Steven Howard
Published: November 2019

Purpose

The purpose of this paper is to examine whether Washington State school district financial reporting and budget reporting meet the information needs of school board directors charged with governance.

Design/methodology/approach

Washington State school board directors were surveyed and asked to rank information items’ usefulness in carrying out their governance role. School district annual reports, budgets and websites were examined to determine whether the identified information was reported and easily transparent to those charged with governance and the public.

Findings

Directors rank information on strategic oversight, budget planning and student outcomes as more useful, consistent with the strategic role of new public management. Follow-on analysis of district annual financial reports, budgets and websites reveal that the availability of the information ranked useful by directors is limited. The findings suggest an information gap exists between directors’ information needs and school district reporting. Annual reports and budgets, when provided, often provide typical financial statements and variance data, respectively, rather than reporting on mission-aligned performance measures. The main consequence of the information gap may be compromised decision-making effectiveness.

Originality/value

By directly asking those charged with governance what information they identify as useful and then examining whether the information is reported in the annual report, budget or website, the study links user information needs to information transparency.
Reforming the government budgeting system in Malta
Authors: Ellul Lauren , Hodges Ron
Published: November 2019

Purpose

The purpose of this paper is to analyse the pre-adoption phase of budgetary reform. Perspectives on the introduction and use of performance information in budgeting are obtained through interviews with current and former senior politicians and civil servants in Malta. Institutional theories are used to analyse the pressures that are perceived as promoting or inhibiting reforms.

Design/methodology/approach

The research followed a qualitative approach, using data gathered from documentary sources and empirical evidence collected from semi-structured interviews. Documentary sources were used to provide knowledge, obtaining an understanding of budgeting processes in the Maltese central government. Two categories of interviewee are identified in the analysis: political interviewees, consisting of 7 politicians; and administrative interviewees consisting of 13 senior civil servants.

Findings

The authors find that the current line-item budgeting system is deeply embedded into government practices. Malta’s membership of the European Union and its adoption of the Euro support coercive pressures for reductions in fiscal deficits. Normative pressures appear to be significant and may have a longer-term impact in promoting budgeting reform.

Originality/value

This paper contributes to existing performance-based budgeting literature by studying the pre-adoption phase which has rarely been the focus of previous studies. The study delves into the interaction between institutional and economic forces, an aspect which has been inadequately studied. The access to current and former Prime Ministers and other Ministers of State in this study is unusual. As such, the researchers have been able to obtain the perceptions of political decision makers in a way that might be more difficult to do in larger countries.
Abnormal trading around common factor pricing models
Authors: Wang Jiexin , Han Xue , Huang Emily J. , Yost-Bremm Christopher
Published: November 2019

Purpose

The purpose of this paper is to investigate the impact of factor-based trading strategies on pricing and volume.

Design/methodology/approach

The authors employ a regression discontinuity approach to identify abnormalities in volume or pricing around expected portfolio changes. In addition, the authors characterize more granular effects on pricing and volume as a result of portfolio re-classification through Fama and Macbeth (1973) regressions.

Findings

The authors find that firms which are predicted to transfer among the factor portfolios of Fama and French (1993) exhibit strong and statistically significant short-term variation in stock price and volume. Short-term returns around the cutoff values comprising SMB and HML tend to be temporarily high if the firm is predicted to move into a long component of a factor-mimicking portfolio, and temporarily low if moving into a short component. Similar results are apparent when examining movement in and out of the 25 size and book-to-market sorted test asset portfolios.

Practical implications

The use of portfolio strategies formulated on the basis of sorting procedures, while once upon a time a niche market in the portfolio management industry, is now ubiquitous. The results of this study raise interesting methodological questions about the pricing implications arising from these common methodologies.

Originality/value

This study makes a number of contributions. First, it contributes to the idea that the publication or dissemination of trading strategies or – more generally – common portfolio sorting methods, leads to effects on pricing and volume through commonly motivated trading pressure. In other words, recipe-like discoveries of advantageous trading strategies lead to a synthetic creation of demand. Second, by noting that a lot of factor-focused trading activity begins around July and August of each year, the study relates to existing literature which documents seasonal variation in stock returns and volume. The findings raise questions about what guides institutional investors’ portfolio allocation decisions and whether these are optimal in aggregate.