bluuebunny/crossref_metadata_2025 huggingface dataset:
S,S‐Chiral Linker Induced U Shape with a Syn‐facial Sensitizer and Photocleavable Ethene Group
Authors: Ghosh Goutam , Belh Sarah J. , Chiemezie Callistus , Walalawela Niluksha , Ghogare Ashwini A. , Vignoni Mariana , Thomas Andrés H. , McFarland Sherri A. , Greer Edyta M. , Greer Alexander
Published: August 2018

There is a major need for light‐activated materials for the release of sensitizers and drugs. Considering the success of chiral columns for the separation of enantiomer drugs, we synthesized an S,S‐chiral linker system covalently attached to silica with a sensitizer ethene near the silica surface. First, the silica surface was modified to be aromatic rich, by replacing 70% of the surface groups with (3‐phenoxypropyl)silane. We then synthesized a 3‐component conjugate [chlorin sensitizer, S,S‐chiral cyclohexane and ethene building blocks] in 5 steps with a 13% yield, and covalently bound the conjugate to the (3‐phenoxypropyl)silane‐coated silica surface. We hypothesized that the chiral linker would increase exposure of the ethene site for enhanced 1O2‐based sensitizer release. However, the chiral linker caused the sensitizer conjugate to adopt a U shape due to favored 1,2‐diaxial substituent orientation; resulting in a reduced efficiency of surface loading. Further accentuating the U shape was π–π stacking between the (3‐phenoxypropyl)silane and sensitizer. Semiempirical calculations and singlet oxygen luminescence data provided deeper insight into the sensitizer's orientation and release. This study has lead to insight on modifications of surfaces for drug photorelease and can help lead to the development of miniaturized photodynamic devices.
Event‐related potentials to threat of predictable and unpredictable shock
Authors: MacNamara Annmarie , Barley Blake
Published: August 2018

Cognitive affective neuroscience tasks that are straightforward to administer, measure key constructs of interest, and can be used in different lab settings and with multiple psychophysiological methods can lead to a more complete understanding of experimental effects. The no‐threat, predictable threat, unpredictable threat (NPU‐threat) task assesses constructs of interest to both clinical and basic affective science literatures, is relatively brief to administer, and has been used across labs with a number of different measurements (e.g., startle eyeblink, fMRI, corrugator response, subjective ratings). ERPs provide another means of assessing neurobiological reactivity during the NPU‐threat task, but to date such measures have been underutilized. That is, no study has yet evaluated cue‐elicited ERPs in the NPU‐threat task. Here, cue‐elicited ERPs were assessed in 78 participants who completed a version of the NPU‐threat task previously shown to reliably moderate startle eyeblink amplitudes. Results showed larger P2 amplitudes for unpredictable versus predictable trials, increased P3s and late positive potentials for threatening versus no‐threat trials, as well as larger stimulus preceding negativities for threatening versus no‐threat trials (driven primarily by predictable threat cues). In line with prior work, we observed enhanced startle eyeblink for threatening versus no‐threat trials and for unpredictable compared to predictable threat interstimulus intervals. In addition, the probe‐elicited P3 was suppressed for predictable and unpredictable compared to no‐threat trials. Therefore, cue‐elicited ERPs, which can be recorded alongside other measures in the NPU‐threat task (e.g., startle), may provide useful indices of temporally distinct stages of predictable and unpredictable threat processing.
Too hard to forget? ERPs to remember, forget, and uninformative cues in the encoding phase of item‐method directed forgetting
Authors: Schindler Sebastian , Kissler Johanna
Published: August 2018

In item‐method directed forgetting, worse memory performance occurs for to‐be‐forgotten (TBF) than for to‐be‐remembered (TBR) items. However, recently TBF items have been found to be recognized more accurately than uninformative (UI) items not associated with any specific task. Here, we compare ERPs elicited by cues signaling the remember or the forget instruction with those elicited by uninformative cues. Participants were presented with a series of complex pictures, each followed by a symbolic TBR, TBF, or UI cue. On a yes–no recognition test, accuracy was higher for TBR than for both TBF and UI items. However, TBF items were recognized more accurately than UI items. ERPs elicited by the TBR cue were larger than ERPs elicited by both TBF and UI cues at the frontal P2, the late frontal negativity, and the late parietal positivity complex. This is consistent with more attention capture, selective rehearsal, and long‐term memory encoding of TBR. In contrast, both TBF and UI cues induced a larger frontal N2 than TBR cues. Critically, TBF elicited a larger late right‐frontal positivity than both UI and TBR cues and a larger late parietal positivity than UI cues. Moreover, the late right‐frontal positivity was correlated with better recognition performance. It may therefore reflect processing orientation rather than inhibition per se. Results suggest that, when compared to UI cues, both TBR and TBF cues are processed actively. Distinct processing is seen at right frontal and centroparietal positive ERPs that may mediate better subsequent recognition of TBF than of UI items.
The problem of enchantment
Authors: Cuthbertson Ian Alexander
Published: August 2018

Scholars have used the term “enchantment” to describe a variety of disparate intellectual trends, affective registers, and social developments. Yet despite its prevalence as an academic concept, appraisals of enchantment itself rather than disenchantment or re‐enchantment are, despite a few exceptions, practically nonexistent. This article considers recent scholarly work on disenchantment and re‐enchantment in order to trace the contours of enchantment itself. It concludes with an appraisal of enchantment as an academic category.
Monetary authority's transparency and income inequality
Authors: de Mendonça Helder Ferreira , Esteves Diogo Martins
Published: August 2018

This paper analyzes how transparency from the monetary authority can affect the income inequality. The contribution is twofold. In the first part, we develop a theoretical model that considers heterogenous agent shopping‐time economy with a lack of transaction technology between rich and poor to observe the effect of central bank transparency on income inequality. The second part provides empirical evidence through panel data methodology that draws on 37 developing countries for the period 1992 to 2012. Our findings indicate that, in general, the monetary authority's transparency is an important tool to reduce income inequality between rich and poor when there are some advantages for the first group.
Cash Transfers and Food Security in Sub‐Saharan Africa
Authors: Burchi Francesco , d’Agostino Giorgio , Pieroni Luca , Scarlato Margherita
Published: August 2018

This paper compares the impact of social protection strategies based on cash transfers in a selection of lower‐middle‐income and low‐income sub‐Saharan African countries. We use the synthetic control method to evaluate changes in the trajectories of the prevalence of undernourishment indicators during the 1990s and 2000s for several relevant countries (Ethiopia, Kenya, Malawi and Rwanda). The results suggest that cash transfers exert a significant effect on access to food, though there are differences in magnitude. Robustness analysis with placebo experiments confirms the soundness of our results, and their implications for policy‐makers are discussed.
Behaviors of shooter and goalkeeper interact to determine the outcome of soccer penalties
Authors: Hunter Andrew H. , Angilletta Michael J. , Wilson Robbie S.
Published: August 2018

During a soccer penalty, the shooter's strategy and the goalkeeper's strategy interact to determine the outcome. However, most models of penalty success overlook its interactive nature. Here, we quantified aspects of shooter and goalkeeper strategies that interact to influence the outcome of soccer penalties—namely, how the speed of the shot affects the goalkeeper's leave time or shot‐blocking success, and the effectiveness of deceptive strategies. We competed 7 goalkeepers and 17 shooters in a series of penalty shoot‐out competitions with a total of 1278 shots taken. Each player was free to use any strategy within the rules of a penalty shot, and game‐like pressure was created via monetary incentive for goal‐scoring (or blocking). We found that faster shots lead to earlier leave times and were less likely blocked by goalkeepers, and—unlike most previous studies—that deceptive shooting strategies did not decrease the likelihood goalkeepers moved in the correct direction. To help identify optimal strategies for shooters and goalkeepers, we generated distributions and mathematical functions sport scientists can use to develop more comprehensive models of penalty success.
Broadening and Deepening the Presence of Environmental Sociology
Authors: Jorgenson Andrew K.
Published: August 2018

In this essay, I describe a few ways in which I've ventured outside of my comfort zone and become more engaged with multidisciplinary communities, policy groups and governmental agencies, the media, and civil society. Through such efforts, I've tried to help broaden and deepen the presence of environmental sociology.
Characterization of bound water in skin hydrators prepared with and without a 3D3P interpenetrating polymer network
Authors: Majewski George P. , Rodan Katie , Fields Kathy , Falla Timothy J.
Published: August 2018

Background

Hyaluronic acid (HA) has been considered the gold standard ingredient for improving skin hydration and combating age‐related effects, however it is an inefficient polymer with inconsistent results partially due to its poor skin penetration, surface deposition, and rapid degradation. Herein we report the synthesis and in vitro characterization of a newly developed, topical super‐humectant with the goal of attracting and binding water molecules more efficiently than traditional, cosmetic‐grade forms of HA.

Methods

A modified interpenetrating polymer network (IPN) was developed using three polymers into a three‐dimensional formation (3D3P) for entrapping HA and water. This 3D3P‐IPN functions as a super‐humectant, attracting and binding water molecules more efficiently than the traditional cosmetic‐grade forms of HA. We compare 3D3P‐IPN serum samples to a traditional commercial benchmark product of similar ingredients using microscopic analysis, rheology, Karl Fischer (KF) titration, differential scanning calorimetry (DSC), thermal gravimetric analysis (TGA), and dynamic vapor sorption (DVS) techniques.

Results

The 3D3P‐IPN samples appeared to bind water tighter than the benchmark sample as evidenced by maximum endpoints of endotherms occurring at significantly higher temperatures. The DVS results further confirm this speculation as the 3D3P‐IPN samples lost approximately 10% less water up to 35% RH than the benchmark. The 3D3P‐IPN samples also absorbed more water as the humidity level increased,demonstrating superior humectant properties. KF titration indicated that all three samples had similar water concentrations; however, TGA results demonstrated that the benchmark (a viscous, humectant‐rich hydrating masque) did not have much bound water.

Conclusion

Through the synthesis of a 3D3P‐IPN using simplified methods, we were able to increase the water‐binding and HA‐delivery capabilities of a thin serum. This 3D3P‐IPN serum has potential to deliver more hydration to the skin's surface compared to traditional HA formulations.
Crop rotation in no‐till soils modifies the soil fatty acids signature
Authors: Ferrari A. E. , Ravnskov S. , Wall L. G.
Published: August 2018

Analysis of whole‐soil fatty acids (WSFA) was used to characterize no‐till productive agricultural soils associated with different crop rotation managements on the Argentinean pampas, over two sampling seasons. Crop rotation (CR) treatment was compared with soybean monocropping (MC). Soils from nearby natural environments (NE) were used as reference treatments. The objective of this study was to characterize the soil lipid signature and seek putative markers of agricultural management. NE sites had greater concentration of total WSFA than agricultural sites, but no differences between CR and MC were identified. NE sites were characterized by straight chain and mono‐unsaturated fatty acids, such as 16:1ω5c, an established biomarker for arbuscular mycorrhiza. Comparing lipid profiles using multivariate methods allowed a comprehensive comparison among treatments. The CR and NE soil samples were more alike than those of MC, with several fatty acids in common. CR soils were associated with mixed, branched and hydroxylated fatty acids. MC profiles appeared to be enriched by 16:010Me and 18:1ω7c fatty acids, which could be potential treatment markers. Thus, use of the WSFA approach to study soil lipid signature appeared to be a sensitive method to characterize soil health and soil use and management. However, some of the fatty acids do not come from living cells but from soil organic matter, which sets a limitation on interpretation in terms of the microbial community but expands the biological origin of the soil lipid signature to any biological matter, alive or death, which is a constitutive part of the soil under study.
Molecular phylogeny and historical biogeography of generaEristicophisandPseudocerastes(Ophidia, Viperidae)
Authors: Fathinia Behzad , Rastegar‐Pouyani Nasrullah , Rastegar‐Pouyani Eskandar
Published: August 2018

The genusPseudocerastescomprises three species of false‐horned vipers:P. fieldi,P. persicusandP. urarachnoides.Pseudocerastes fieldiandP. persicuswere once regarded as two subspecies of the same species. Recent morphological, molecular and toxicological studies elevated these two subspecies to species rank. Upon discovery of a third species, phylogeny and systematic relationships within this genus based on morphology were complicated. A total of 113 specimens of these three species across the Middle‐East were used to perform phylogenetic and biogeographic study. Using both mitochondrial (16S and Cytb) and Nuclear (C‐mos) markers and Bayesian and Maximum Likelihood approaches a robust phylogeny of the group was generated. The phylogenetic findings show thatEristicophisis the closest living relative toPseudocerastes.Pseudocerastes fieldiholds a basal position within the genusPseudocerastes, sister to a taxon comprisingP. persicusandP. urarachnoides. Each of these three species is divided into two main clades with further subdivisions. Divergence time estimation indicates that splitting between generaEristicophisandPseudocerastesoccurred in early Miocene with further main splitting within genusPseudocerastesthat occurred in middle to late Miocene. Additional splittings within each of these species took place during early Pliocene to late Pleistocene. Speciation and cladogensis within this genus coincide with different historical events varying from tectonics to paleoclimatic events which may have resulted in vicariance and dispersal of different populations. The clade comprised of sister generaEristicophisandPseudocerasteshas an Arabian Peninsula – Iranian Plateau origin with an eastward distribution from western Arabia to the Iranian Plateau.
Falls prevention strategies for adult inpatients in a university hospital of São Paulo, Brazil: a best practice implementation project
Authors: Maia Flávia de Oliveira Motta , Cruz Diná de Almeida Lopes Monteiro da , Shimoda Gilceria Tochika , Sichieri Karina , Iida Luciana Inaba Senier
Published: August 2018

Objectives:

The main objective of this project was to reduce the incidence and harm from falls that occur among patients admitted in the acute Internal Medicine Unit and Intensive Care Unit in a public teaching hospital in São Paulo, Brazil.

Introduction:

Falls are a challenge for health professionals and healthcare services as they may result in high-impact outcomes for patients, such as functional decline, increase in length of hospital stay, increase in the cost of healthcare services, and death. In an attempt to promote safe care the World Health Organization (WHO) launched the World Alliance for Patient Safety in 2004 that encourages the adoption of best practice to reduce adverse events in healthcare services.

Methods:

The project used the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI-PACES) and Getting Research into Practice (GRiP) audit tool for promoting change in health practice. A baseline audit was conducted measuring eight best practice criterias, followed by the implementation of target strategies and a follow-up audit.

Results:

The results of the baseline audit identified large gaps between current practice and overall compliance with best practice. The GRiP module helped identify strategies related to education programs for patients, families and nursing teams, and a falls risk assessment with an accurate tool to address the gaps in compliance. The follow-up audit cycle was satisfactory as all best practice audit criteria showed an improvement as an aggregated result.

Conclusions:

The project used the audit and feedback strategy to translate evidence into practice. Some of the measured criteria improved to moderate-high compliance with best practice. The results showed that implementation of evidence-based practice leads to an improvement in falls prevention. Future audits are required to sustain improvements.
The economic cost of robotic rehabilitation for adult stroke patients: a systematic review protocol
Authors: Lo Kenneth , Stephenson Matthew , Lockwood Craig
Published: August 2018

Review question/objective:

The objective of this review is to identify the best available evidence on the economic cost of robotic rehabilitation for adult stroke patients to improve their motor movement abilities. More specifically, the objective is to identify the evidence on the economic cost of robotic training compared to conventional physiotherapy for adult stroke patients, from the perspective of hospitals.
Morphological ontogeny of Diapterobates altaicus (Acari: Oribatida: Ceratozetidae), with comments on Diapterobates Grandjean
Authors: Seniczak Stanisław , Seniczak Anna , Kaczmarek Sławomir , Marquardt Tomasz
Published: August 2018

The morphological ontogeny of Diapterobates altaicus Bayartogtokh, 2010 is described and illustrated. The juveniles of this species are unpigmented, except for a dark sclerite around a gland opening on the hysterosoma. In the larva, most gastronotal setae are of medium size, except for longer c3, dp, lm, lp and h1, whereas in the tritonymph, all gastronotal setae are long, especially c3, dp, lp, h-series and p1. In all juvenile stages, a humeral organ is present. The adult of D. altaicus has setae bv" and v'' on femur I clearly shorter than seta d.
New species and records of phytoptids (Eriophyoidea, Phytoptidae) from cinquefoils (Rosaceae, Potentilla) from Serbia and southern Russia
Authors: Chetverikov Philipp , Radmila Petanović Radmila , Cvrković Tatjana , Marinković Slavica , Sukhareva Sogdiana , Vidović Biljana , Zukoff Sarah
Published: August 2018

Two new vagrant species of the genus Phytoptus Dujardin (Eriophyoidea, Phytoptidae, Phytoptinae) from Serbia are described: Phytoptus argenteus n. sp. from Potentilla argentea and P. serbicus n. sp. from Potentilla tommasiniana. Remarks on morphology of Phytoptus alchemillae Jočić et al. 2011 collected from Alchemilla plicata in Serbia and supplementary description of infrequently encountered species Phytoptus potentillae Chen et al. 2005 from Potentilla bifurca (Poaceae) based on mummies recovered from dry plant material from southern Russia are given. Sequences of mtCOI barcode region (658 bp) of three Phytoptus species (P. alchemillae, P. argenteus n. sp., and P. serbicus n. sp.) are provided. A brief comparison of pairwise genetic distances between congeneric eriophyoid mites across taxa of Eriophyoidea (including genus Phytoptus) indicates that COI sequences of congeneric eriophyoid mites do not precisely reflect phylogenetic relations of their hosts. This fact may be explained by (a) different rate of the COI evolution in different mite clades associated with phylogenetically related and unrelated hosts or by (b) similar timing of the associations between mites and plants (while having the same rate of COI evolution).
Microwave imaging of etching-induced surface impedance modulation of graphene monolayer
Authors: Ji Zhonghang , Myers Joshua , Brockdorf Kathleen , Engel Nick , Mou Shin , Huang Hong , Zhuang Yan
Published: August 2018

Impact of processing-induced structural defects on the electrical properties of a graphene monolayer has been investigated using scanning microwave microscopy (SMM). Graphene sheets grown on copper foil by chemical vapor deposition were transferred to a silicon wafer covered with a 300 nm thick thermal SiO2 layer and then patterned into a grating structure using the standard lithography technique. Raman spectroscopy and SMM were employed to monitor the defect generation and the induced surface impedance change on graphene. Correlation of the SMM image contrast shows that the etching-induced defects cause a decrease of the electrical conductivity and permittivity of the graphene monolayer. In addition, the SMM image contrast shows a frequency dependency: at higher frequencies, the permittivity of the graphene monolayer plays an important role, resulting in the SMM phase imaging contrast reversed from the low frequency measurements. Numerical simulations were performed, which are in very good agreement with the experimental results.
Numerical observation of secondary Mach stem in weak acoustic shock reflection
Authors: Tripathi Bharat B. , Baskar Sambandam , Coulouvrat François , Marchiano Régis
Published: August 2018

Recently Ram, Geva, and Sadot [J. Fluid Mech. 768, 219–235 (2015)] showed, experimentally, the formation of a secondary Mach stem generated from the reflection of the primary Mach stem in the aerodynamic regime. Such a phenomenon has never been observed, either experimentally or numerically, in the framework of weak acoustic shocks. In this work, the formation of a secondary Mach stem is observed from the reflection of acoustic shock waves on a convex-concave boundary giving rise to a complex five-shock pattern. This study is fully numerical and is based on the numerical solution of a nonlinear acoustic system of equations using a recently developed discontinuous Galerkin solver.
Contributions of
yap1
Mutation and Subsequent
atrF
Upregulation to Voriconazole Resistance in Aspergillus flavus
Authors: Ukai Yuuta , Kuroiwa Miho , Kurihara Naoko , Naruse Hiroki , Homma Tomoyuki , Maki Hideki , Naito Akira
Published: August 2018

Aspergillus flavus
is the second most significant pathogenic cause of invasive aspergillosis; however, its emergence risks and mechanisms of voriconazole (VRC) resistance have not yet been elucidated in detail. Here, we demonstrate that repeated exposure of
A. flavus
to subinhibitory concentrations of VRC
in vitro
causes the emergence of a VRC-resistant mutant with a novel resistance mechanism.
Carbapenem Resistance Caused by High-Level Expression of OXA-663 β-Lactamase in an OmpK36-Deficient Klebsiella pneumoniae Clinical Isolate
Authors: Ma Peijun , Laibinis Hannah H. , Ernst Christoph M. , Hung Deborah T.
Published: August 2018

Carbapenem resistance is mainly mediated by carbapenemases or extended-spectrum β-lactamases (ESBL) plus a loss of porins. However, we have identified a
Klebsiella pneumoniae
clinical isolate that contains neither carbapenemases nor ESBLs.
Enterococcal Concentrations in a Coastal Ecosystem Are a Function of Fecal Source Input, Environmental Conditions, and Environmental Sources
Authors: Rothenheber Derek , Jones Stephen
Published: August 2018

Enterococci have long been the federal standard in determining water quality at estuarine and marine environments. Although enterococci are highly abundant in the intestines of many animals, they are not exclusive to that environment and can persist and grow outside fecal tracts. This presents a management problem for areas that are largely impaired by nonpoint source contamination, as fecal sources might not be the root cause of contamination. This study employed different microbial source tracking methods for delineating the influences from fecal source input, environmental sources, and environmental conditions to determine which combination of variables are influencing enterococcal concentrations in recreational waters at a historically impaired coastal town. The results showed that fecal source input, environmental sources, and conditions all play roles in influencing enterococcal concentrations. This highlights the need to include an encompassing microbial source tracking approach to assess the effects of all important variables on enterococcal concentrations.
Sirtuin 2 Isoform 1 Enhances Hepatitis B Virus RNA Transcription and DNA Synthesis through the AKT/GSK-3β/β-Catenin Signaling Pathway
Authors: Piracha Zahra Zahid , Kwon Hyeonjoong , Saeed Umar , Kim Jumi , Jung Jaesung , Chwae Yong-Joon , Park Sun , Shin Ho-Joon , Kim Kyongmin
Published: August 2018

Even though Sirt2, a NAD
+
-dependent protein deacetylase, is overexpressed in many HCCs, and overexpressed Sirt2 promotes hepatic fibrosis and associates positively with vascular invasion by primary HCCs through AKT/GSK-3β/β-catenin signaling, the relationship between Sirt2, HBV, HBx, and/or HBV-associated hepatocarcinogenesis is unclear. Here, we show that HBV DNA replication, not HBV expression, correlates positively with Sirt2 upregulation and AKT activation. We demonstrate that overexpression of Sirt2 further increases HBV replication, increases AKT activation, downregulates GSK-3β, and increases β-catenin levels. Conversely, inhibiting Sirt2 decreases HBV replication, reduces AKT activation, and decreases β-catenin levels. Although HBx activates AKT to upregulate β-catenin, Sirt2-mediated effects were not dependent on HBx. The results also indicate that a Sirt2 inhibitor may control HBV infection and prevent the development of hepatic fibrosis and HCC.
The Endonucleolytic RNA Cleavage Function of nsp1 of Middle East Respiratory Syndrome Coronavirus Promotes the Production of Infectious Virus Particles in Specific Human Cell Lines
Authors: Nakagawa Keisuke , Narayanan Krishna , Wada Masami , Popov Vsevolod L. , Cajimat Maria , Baric Ralph S. , Makino Shinji
Published: August 2018

MERS-CoV represents a high public health threat. Because CoV nsp1 is a major viral virulence factor, uncovering the biological functions of MERS-CoV nsp1 could contribute to our understanding of MERS-CoV pathogenicity and spur development of medical countermeasures. Expressed MERS-CoV nsp1 suppresses host gene expression, but its biological functions for virus replication and effects on host gene expression in infected cells are largely unexplored. We found that nsp1 suppressed host gene expression in infected cells. Our data further demonstrated that nsp1, which was not detected in virus particles, promoted virus assembly or budding in a 293-derived cell line, leading to efficient virus replication. These data suggest that nsp1 plays an important role in MERS-CoV replication and possibly affects virus-induced diseases by promoting virus particle production in infected hosts. Our data, which uncovered an unexpected novel biological function of nsp1 in virus replication, contribute to further understanding of the MERS-CoV replication strategies.
Complete Genome Sequence of a Moderately Thermophilic Facultative Chemolithoautotrophic Hydrogen-Oxidizing Bacterium, Hydrogenophilus thermoluteolus TH-1
Authors: Arai Hiroyuki , Shomura Yasuhito , Higuchi Yoshiki , Ishii Masaharu
Published: August 2018

Hydrogenophilus
spp., which are moderately thermophilic aerobic betaproteobacteria, are widely distributed in geothermal environments. They fix carbon dioxide via the Calvin-Benson-Bassham cycle and exhibit rapid autotrophic growth using hydrogen as an energy source.
Draft Genome Sequences of Lactobacillus salivarius A3iob and Lactobacillus johnsonii CRL1647, Novel Potential Probiotic Strains for Honeybees (Apis mellifera L.)
Authors: Audisio Marcela Carina , Albarracín Leonardo , Torres Maria Julia , Saavedra Lucila , Hebert Elvira Maria , Villena Julio
Published: August 2018

This report describes the draft genome sequences of
Lactobacillus salivarius
A3iob and
Lactobacillus johnsonii
CRL1647, probiotic strains isolated from the gut of honeybee
Apis mellifera
workers. The reads were generated by a whole-genome sequencing (WGS) strategy on an Illumina MiSeq sequencer and were assembled into contigs with total sizes of 2,054,490 and 2,137,413 bp for the A3iob and CRL1647 strains, respectively.
Saving sight in China and beyond: the Lifeline Express model
Authors: Wong Ian Yat Hin , Ni Michael Yuxuan , Wong Irene Oi Ling , Fong Nellie , Leung Gabriel M
Published: August 2018

Cataract and diabetic retinopathy are leading causes of blindness globally. Lifeline Express (LEX) has pioneered the provision of cataract surgery in rural China from custom-built trains and eye centres nationwide. Over the past two decades, LEX has provided free cataract surgery for over 180 000 patients in China. In China, half of the adult population has prediabetes and 113 million adults have diabetes. Recognising the rising threat of diabetic retinopathy, LEX has expanded to providing free diabetic retinopathy screening nationwide by establishing 29 Diabetic Retinopathy Screening Centres across China. Source of referrals included host hospitals, the community and out-reach mobile vans equipped with fundus cameras. Fundi photos taken in the mobile vans were electronically transferred to primary graders. LEX also leveraged the widespread smartphone use to provide electronic medical reports via WeChat, the most popular instant messenger app in China. From April 2014 to December 2016, 34 506 patients with diabetes underwent screening, of which 27.2% (9,396) were identified to have diabetic retinopathy. China’s latest national health strategy (‘Healthy China 2030 Plan’) has championed the ‘prevention first’ principle and early screening of chronic diseases. LEX has accordingly evolved to extend its services to save sight in China—from cataract surgery to diabetic retinopathy screening and most recently outreaching beyond its national borders in a pilot South–South collaboration. With health at the top of the China’s developmental agenda and the country’s growing role in global health—LEX’s large-scale telemedicine-enabled programme could represent a potentially scalable model for nationwide diabetic retinopathy screening elsewhere.
Cancer cachexia: rationale for the MENAC (Multimodal—Exercise, Nutrition and Anti-inflammatory medication for Cachexia) trial
Authors: Solheim Tora S , Laird Barry J A , Balstad Trude R , Bye Asta , Stene Guro , Baracos Vickie , Strasser Florian , Griffiths Gareth , Maddocks Matthew , Fallon Marie , Kaasa Stein , Fearon Kenneth
Published: August 2018

Cancer cachexia is a multifactorial syndrome characterised by an ongoing loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support alone. Cachexia has a high prevalence in cancer and a major impact on patient physical function, morbidity and mortality. Despite the consequences of cachexia, there is no licensed treatment for cachexia and no accepted standard of care. It has been argued that the multifactorial genesis of cachexia lends itself to therapeutic targeting through a multimodal treatment. Following a successful phase II trial, a phase III randomised controlled trial of a multimodal cachexia intervention is under way. Termed the MENAC trial (Multimodal—Exercise, Nutrition and Anti-inflammatory medication for Cachexia), this intervention is based on evidence to date and consists of non-steroidal anti-inflammatory drugs and eicosapentaenoic acid to reduce inflammation, a physical exercise programme using resistance and aerobic training to increase anabolism, as well as dietary counselling and oral nutritional supplements to promote energy and protein balance. Herein we describe the development of this trial.

Trial registration number

NCT02330926.
1 Evaluation of a nurse directed beds model of care in a stand-alone hospice inpatient unit (IPU)
Authors: Brigden Charlotte , Thorns Andrew , Hills Wendy , Timms Amanda
Published: August 2018

Introduction

Patient complexity needs to be understood to match resources to need in palliative care (Pasket al.2018). A future increase in need for these services means alternative models of care should be considered (Etkindet al.2017). Pilgrims Hospice is unique in having three IPUs run by a single organisation covering a distinct geographical area. This set up enabled the implementation of a stand-alone nurse directed unit taking less medically complex patients alongside traditionally staffed IPUs.

Aims

The project aimed to answer the following:

Can we identify medical complexity prior to admission?

Do nurse directed beds in a stand–alone unit improve use of resources produce similar outcome and satisfaction.

Methods

Data were collected from routine activity figures surveys of staff and service users’ thematic analysis of operational meetings and a focus group of staff at a strategic level. Tools were utilised to measure complexity and level of need (Gannon 2017).

Results

The findings supported using resources more efficiently and for the nursing team to be empowered and developed.

Concerns related to:

Travel time when patients not admitted to the closest unit.

Inefficient use of beds

A perceived need for a full multidisciplinary team including medicine

Delay in death certificate completion

The medical complexity tool appeared unreliable as a triage tool

Conclusions

The concept received support from participants. However we were unable to effectively answer the questions posed for a mixture of system data collection and methodological reasons. For nurse directed beds to be successful a different approach is required.

References

. Pask S, Pinto C, Bristowe K, van Vliet L, Nicholson C, Evans C, George R, Bailey K, Davies J, Guo P, Daveson B, Higginson IJ, Murtagh FEM. A framework for complexity in palliative care: A qualitative study with patients family carers and professionals. Palliative Medicine2018;32(6):1078–1090.

. Etkind SN, Bone AE, Gomes B, Lovell N, Evans CJ, Higginson IJ. How many people will need palliative care in 2040? Past trends future projections and implications for services. BMC Medicine2017;15:102. Available at https://doi.org/10.1186/s12916-017-0860-2

. Gannon C. P-82 what level of medical input do hospice inpatients need and does this correspond to their need for specialist nursing input? A service evaluation in a UK hospice.BMJ Supportive and Palliative Care2017;7(Suppl 1). Available at https://www.pah.org.uk/wp-content/uploads/2018/04/pah_jm_A0_medical_input_poster.pdf (Accessed: 25 May 2018)
13 Exploring patient safety incidents arising from advance care planning for end of life patients: a mixed methods analysis of incident reports
Authors: Dinnen Toby , Williams Huw , Noble Simon , Edwards Adrian , Kenkre Joyce , Hibbert Peter , Donaldson Liam , Carson-Stevens Andrew
Published: August 2018

Introduction

Advance Care Planning (ACP) is an important component of patient centred end-of-life care (Houbenet al.2014; Brinkman-Stoppelenburget al.2014). However there is little evidence available on the safety of the process and its impact on quality of care.

Aim

To characterise the nature of patient safety incidents arising around the ACP process for patients approaching end-of-life.

Method

The National Reporting and Learning System (NRLS) collates patient safety incident reports across England and Wales. We performed a keyword search and manual review to identify relevant reports between 2005 and 2015. A mixed methods process combining structured data coding and exploratory descriptive analysis was undertaken to describe incidents underlying causes and outcomes. A thematic analysis identified areas on which to focus improvement initiatives.

Results

We identified 67 incident reports in which patients experienced inadequate care due to issues with implementation of ACP. The most common source of error was (mis)communication of ACP (n=27) where documentation was lost or verbal handover was inaccurate. Over one third of reports (n=24) described an ACP not being followed. In the remaining reports (n=16) an ACP was not completed despite being appropriate. The most common contributory factor was inadequate staff knowledge (n=18). Common outcomes were cardiopulmonary resuscitation attempts contrary to a patient’s wishes (n=18). Other outcomes included inappropriate treatment or transfer/admission.

Conclusion

Our national level analysis identifies key priorities which should be explored in local contexts: specifically improving public and staff understanding and engagement with ACP and developing systems for recording and accessing ACP documentation across healthcare services.

References

. Brinkman-Stoppelenburg A, Rietjens JA, Van Der Heide A. The effects of advance care planning on end-of-life care: A systematic review. Palliative Medicine2014;28:1000–25.

. Houben CH, Spruit MA, Groenen MT, Wouters EF, Janssen DJ. Efficacy of advance care planning: A systematic review and meta-analysis. Journal of the American Medical Directors Association2014;15:477–89.
17 Key information summary (KIS) generation for people who died in scotland in 2017: a mixed methods study
Authors: Finucane Anne M , Davydaitis Deborah , Carduff Emma , Horseman Zoe , Baughan Paul , Meade Richard , Warren Tim , Tapsfield Julia , Spiller Juliet , Campbell Sandra , Murray Scott A
Published: August 2018

Introduction

The percentage of people with a key information summary (KIS) or an anticipatory care plan (ACP) at the time of death can act as an indicator of access to palliative care. Key information summaries (KIS) introduced throughout Scotland in 2013, are shared electronic patient records which contain essential information relevant to a patient’s care including palliative care. There is now a need to examine current levels of KIS generation and ACP documentation in the last months of life to assess progress and review barriers and facilitators to sharing patient information across settings and to inform out-of-hours care.

Aims

To estimate the extent and timing of KIS and ACP generation for people who die with an advanced progressive condition and to compare with our previous study (Tapsfield et al. 2016).

To explore GP experiences of commencing and updating a KIS; and their perspectives on what works well and what can be improved in supporting this process.

Methods

A mixed methods study consisting of a retrospective review of the electronic records of all patients who died in 16 Scottish general practices in 2017 and semi-structured interviews with 16 GPs.

Results

Quantitative and qualitative data collection is in progress.

Conclusion

Findings will describe current levels of KIS and ACP documentation for people who die in Scotland. We will synthesize GP experiences of KIS use and describe the essential components of an ACP that need to be documented to enable good palliative care across settings including emergency and out-of-hours care.

Reference

. Tapsfield J, Hall C, Lunan C, McCutheon H, McLoughlin P, Rhee J, Rus A, Spiller J, Finucane AM, Murray SA. Many people in Scotland now benefit from anticipatory care before they die: An after death analysis and interviews with general practitioners.BMJ Supportive and Palliative Care2016. doi:10.1136/bmjspcare-2015-001014
18 Brief engagement and acceptance coaching in community and hospice settings (the beaches study): protocol for developing and pilot testing an evidence-based intervention to enhance wellbeing at transition into palliative care
Authors: Hulbert-Williams Nick , Gillanders David , Finucane Anne , Millington Susan , Norwood Sabrina , Spiller Juliet , Strachan Jenny , Swash Brooke
Published: August 2018

Introduction

The transition into palliative care can cause uncertainty fear and distress. Quality of life can be detrimentally affected and advance planning for end-of-life is often avoided. Acceptance and Commitment Therapy (ACT) is a promising intervention for supporting palliative patients; the focus on values may be especially relevant to restoring meaningful living. We present a protocol for development and piloting of a brief ACT-based intervention for delivery at the palliative care transition point.

Aims and methods

A multiple-baseline single-case non-controlled design is used. This enables exploration of effectiveness and processes causing outcome improvement. Integrated qualitative interviews provide acceptability data. The five-session intervention is delivered by psychologists to 14 participants in two hospices. Participants with an incurable cancer diagnosis but life expectancy of four months or more are eligible. Weekly self-report questionnaires assess study outcomes (quality of life distress) and changes in therapeutic processes. A smartphone app facilitates daily assessment of brief measures to enable sensitive measurement of process change.

Results

Quantitative data will be analysed using visual plots and statistical change indices across study phases: this enables calculation of indicative effect sizes for future trial planning. Recruitment attrition and engagement will be analysed descriptively as feasibility indicators. Framework analysis is used to for qualitative data.

Conclusions

Single-case designs are not commonly used in psychosocial oncology however they offer a scientific data-driven approach to intervention development. By the end of this study we aim to manualise our intervention for non-psychologist delivery to plan a randomised trial with maximised implementation potential.

References

. Hayes SC, Strosahl KD, Wilson KG.Acceptance and commitment therapy: The process and practice of mindful change2011. Guilford Press.

. Murray, et al. Patterns of social psychological and spiritual decline toward the end of life in lung cancer and heart failure. Journal of Pain and Symptom Management2007;34(4):393–402.

. Ost L. The efficacy of acceptance and commitment therapy: An updated systematic review and meta-analysis. Behaviour Research and Therapy2014;61:105–12.
19 ‘The model for dementia palliative care project’: implementing knowledge transfer and exchange as a core activity
Authors: Fox Siobhán , Drennan Jonathan , Guerin Suzanne , Kernohan George , McKeon Marie , Murphy Aileen , Rabbitte Mary , Robins Amy , Timmons Suzanne
Published: August 2018

Background

Dementia is a terminal illness but often isn’t recognised as such. The Model for Dementia Palliative Care Project will develop a service delivery model for dementia palliative care for use in the Irish Healthcare System. Research methods include reviewing the research evidence and conducting site evaluations of existing services in the Republic of Ireland and other countries. The project timeline is October 2017–October 2020.

Aim

This project will impact people with dementia their families the public researchers and the healthcare system. A key project aim is to ensure effective dissemination to each of these audiences; to meet this aim we included knowledge transfer and exchange (KTE) as a dedicated project work package.

Methods

We used the evidence-based model for the transfer and exchange of research knowledge (‘EMTReK’) to design a KTE plan. The EMTReK model was produced to support researchers developing strategic dissemination strategies in the context of palliative care.

Results and discussion

The core KTE activity involves identifying key messages on an ongoing basis. De-stigmatising and raising awareness about palliative care and dementia palliative care is important. Thus public awareness is central to our KTE plan. Results are being disseminated through multiple media both traditional and non-traditional including print and broadcast media social media a purpose built website and public engagement events. KTE is a two-way process and messages received are shaping our language and research activities. By establishing KTE as a core research activity we will maximise the impact of our findings to all key audiences.
24 Understanding and management of terminal illness within tanzanian traditional medicine
Authors: Higton Naomi , Lewis Emma Grace , Walker Richard , Lee Richard
Published: August 2018

Background

Palliative care (PC) need in Africa is projected to rise by 300% over the next 20 years.1Late presentation and poor community awareness of services are recognised challenges to effective healthcare delivery.2 3Traditional and faith healers (TFH) hold cultural importance and provide a significant proportion of primary healthcare in Africa.4 5This project sought to explore their understanding and management of terminal illness with the aim of improving PC delivery through collaborations between TFH and allopathic services.

Methodology

Data were collected through semi-structured qualitative interviews with traditional healers (n=11) and faith healers (n=8) working within the Kilimanjaro region of Tanzania. Participants were recruited through convenience and purposive sampling. Interviews were audio-recorded and translated transcripts analysed by thematic analysis.

Findings

All TFH had experience of terminally ill and dying patients. Participants had a holistic approach to healthcare with themes of biological psychological social and spiritual factors identified throughout conceptualisation and management of both terminal illness and death. This also informed opinions towards collaboration seeing healthcare professionals and TFH holding different roles within these areas.

Conclusions

The overlap with allopathic explanatory models of health (i.e. the BioPsychoSocial model) provides positive grounds for future collaborations. TFH could complement allopathic PC services through culturally acceptable spiritual care perceived to be lacking in hospitals. Joint dialogue and education between practitioners is necessary to begin collaboration. A significant challenge to this is mistrust between traditional healers and faith healers. The findings merit further research into patient’s preferences and experiences of TFHs in terminal illness.

References

. Grant L, Downing J, Namukwaya E. Palliative care in Africa since 2005: Good progress but much further to go. BMJ Supportive & Palliative Care2011;1(2).

. Harding R, et al. Current HIV/AIDS end-of-life care in sub-Saharan Africa: A survey of models services challenges and priorities. BMC Public Health2003;3(33).

. Lewis EG, Oates LL, Rogathi J, Duinmaijer A, Shayo A, Megiroo S, Bakari B, Dewhurst F, Walker RW, Dewhurst M, Urasa S. ‘We never speak about death.’ Healthcare professionals’ views on palliative care for inpatients in Tanzania: A qualitative study. Palliat Support CareAugust 2017;22:1–14.

. World Health Organisation.WHO: Traditional medicine strategy: 2014–20232013. Geneva: World Health Organisation Geneva.

. Stanifer JW, et al. The determinants of traditional medicine use in Northern Tanzania: A mixed-methods study. PLoS One2015;10(4):e0122638.