bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic nutritional index is superior as a predictor of prognosis among various inflammation‐based prognostic scores in patients with hepatocellular carcinoma after curative resection
Authors: Imai Daisuke , Maeda Takashi , Shimokawa Mototsugu , Wang Huanlin , Yoshiya Shohei , Takeishi Kazuki , Itoh Shinji , Harada Noboru , Ikegami Toru , Yoshizumi Tomoharu , Mori Masaki
Published: November 2019

Aim

There is increasing evidence that inflammation‐based prognostic scores are stage‐independent predictors of poor outcome in patients with hepatocellular carcinoma (HCC). However, these findings were observed in a small‐sized study comparing the prognostic value of these scores for patients after curative resection for HCC.

Methods

We retrospectively analyzed 717 consecutive patients with HCC who underwent curative liver resection at Hiroshima Red Cross Hospital & Atomic Bomb Survivors Hospital. Clinicopathological variables including preoperative inflammation‐based prognostic scores, such as neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, Controlling Nutritional Status score, prognostic nutritional index (PNI), and Glasgow Prognostic Score were analyzed. The prognostic value of these scores was compared by the time‐dependent receiver operating characteristic curve analyses.

Results

The integrate area under the curve of PNI, Controlling Nutritional Status score, neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and Glasgow Prognostic Score were 0.6751, 0.6435, 0.5845, 0.5276, and 0.5351 for overall survival (OS), respectively, and 0.5955, 0.5694, 0.4692, 0.4873, and 0.5272 for disease‐free survival, respectively. Multivariate analyses for prognosis factor in HCC patients showed that PNI was an independent predictor of both OS (HR 0.91, P < 0.001) and disease‐free survival (HR 0.94, P < 0.001). When the patients were divided into high and low PNI groups, the patients in the low PNI group had significant poorer OS (P < 0.001) and disease‐free survival (P < 0.001), even after background factors were matched between these two groups.

Conclusions

PNI is superior to Controlling Nutritional Status score, neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, or Glasgow Prognostic Score as a predictor of OS and recurrence‐free survival in patients with HCC who underwent curative hepatic resection.
Constructing democratic participation in welfare transitions: An analysis of narrative interactions
Authors: Knibbe Mare , Horstman Klasien
Published: November 2019

Objective

This article provides insights into the democratic character of local enactments of welfare reforms by analysing narrative interactions about changes in care. We analyse processes of storytelling that are part of the interactions between citizens giving, receiving and organizing care and the policymakers governing welfare reforms. We also study how narrative interactions shape understandings about changing care practices and what types of narrative interactions support democracy in care.

Background

Stories about recent welfare reforms include messages about citizens’ care, citizen participation, citizens’ powers and revitalization of democracy. However, researchers have cast doubt on their emancipatory and democratic character.

Research setting and methodology

We conducted research of four initiatives and municipal policy settings in the city of Maastricht that organized social care in lifeworlds connected to arts, crafts, farming and entrepreneurship during welfare reforms. Using narrative ethnography, we analyse narrative interactions between the master narrative of welfare reforms about ‘lifeworld care’ and ‘citizen powers’, and small stories told by participants in new care practices.

Results

We identified two types of narrative interaction: idealizing and pragmatizing. Idealizing narrative interactions were strategic for care initiatives in finding support and for policymakers in proving that a so‐called ‘participation society’ works. Pragmatizing narrative interactions gave expression to insights into the everyday practices of social care experiments and included a greater variety of stories.

Conclusions

We conclude that pragmatizing narrative interactions adjust the master narrative about welfare reforms and replace ideals of independency with ideals of active participation in webs of dependency and care.
Predicting outcome in acute interstitial nephritis: a case–series examining the importance of histological parameters
Authors: Rankin Alastair J , Cannon Emma , Gillis Keith , Crosby Jana , Mark Patrick B , Geddes Colin C , Fox Jonathan G , Mackinnon Bruce , McQuarrie Emily P , Kipgen David
Published: November 2019

Aims

The clinical significance of common histological parameters in acute interstitial nephritis (AIN) is uncertain. We aimed to evaluate the utility of histology in predicting clinical outcomes in patients with AIN.

Methods and results

Adult renal biopsies yielding a diagnosis of AIN between 2000 and 2015 were re‐examined. Patients were divided into groups based on: (i) the percentage of non‐fibrotic cortex containing inflammation (NFI score) (NFI‐1 = 0–24%; NFI‐2 = 25–74%; NFI‐3 = 75–100%) and (ii) the percentage of cortex containing tubular atrophy (TA score) (TA1 = 0–9%; TA2 = 10–24%; TA3 = 25–100%). The primary outcome was a composite of ≥50% reduction in serum creatinine (sCr) or an estimated glomerular filtration rate (eGFR) > 60 ml/min/1.73 m2 1 year post‐biopsy. From a total of 2817 native renal biopsies, there were 120 patients with AIN and adequate data for analysis. Of these, 66 (56%) achieved the primary outcome. On univariable logistic regression, NFI‐3 was associated with a 16 times increased likelihood of achieving the primary outcome compared to NFI‐1 [odds ratio (OR) = 16, 95% confidence interval (CI) = 5.2–50)]. In contrast, TA3 was associated with a 90% reduced likelihood of achieving the primary outcome compared to TA1 (OR = 0.10, 95% CI = 0.0–0.3). Maximal clinical utility was achieved by combining TA and NFI into a single prognostic ‘TANFI’ score, which had an independent predictive effect on the primary outcome in a multivariable regression model consisting of age, sex, baseline sCr and identified drug cause.

Conclusions

In patients with biopsy‐proven AIN, a lower percentage of cortical tubular atrophy and, paradoxically, a higher percentage of inflammation in non‐fibrosed cortex were associated with an increased likelihood of a positive clinical outcome.
Evaluation of fluoride and sodium hypochlorite solutions during the electrochemical dissolution of conventional NiTi instruments and Gold thermomechanically treated NiTi instruments
Authors: Cassol L. G. , Kowalczuck A. , Carneiro E. , Westphalen V. P. D. , Laurindo C. A. H. , da Silva Neto U. X.
Published: November 2019

Aim

To compare the dissolution time of two solutions, a fluoride solution and a sodium hypochlorite solution, both saturated with sodium chloride, during the electrochemical dissolution of instruments consisting of conventional nickel‐titanium alloy and Gold thermomechanically treated nickel‐titanium alloy.

Methodology

Two solutions, an NaF solution consisting of 12 g L−1 NaF with 180 g L−1 NaCl and an NaOCl solution consisting of 2.5% NaOCl with 180 g L−1 NaCl, were evaluated in a polarization test of a sample of 48 ProTaper Universal F1 (PTU F1) and WaveOne Gold Small (WOGS) instruments. The electric potentials were 0.5 V and 5 V for the NaF and NaOCl solutions, respectively. The electrochemical cell consisted of three electrodes for the polarization test of the PTU F1 and WOGS instruments, which had 6 mm of the tip immersed in the test solutions. The electric current was recorded for 540 s. If complete dissolution of the immersed tip occurred in less than the expected time, the experiment was considered complete. The time variations (in seconds) of the instruments in the solutions were measured. Data were subjected to statistical analysis using the Mann–Whitney, Kruskal–Wallis and Dunn tests. The corrosion patterns of the instruments were evaluated by scanning electron microscopy (SEM).

Results

The NaF and NaOCl solutions were associated with significantly different (P = 0.000) dissolution times of the instrument, with mean values of 12.96 s and 83.63 s, respectively. There was no significant difference (P = 0.649) in dissolution time between the PTU F1 and WOGS instruments.

Conclusions

NaF and NaOCl solutions were able to electrochemically dissolve PTU F1 and WOGS instruments. However, the NaF solution achieved dissolution in significantly less time.
Association between dental anxiety and intraoperative pain during root canal treatment: a cross‐sectional study
Authors: Murillo‐Benítez M. , Martín‐González J. , Jiménez‐Sánchez M. C. , Cabanillas‐Balsera D. , Velasco‐Ortega E. , Segura‐Egea J. J.
Published: November 2019

Aim

To investigate whether dental anxiety influences the intraoperative pain felt by patients during root canal treatment.

Methodology

In a cross‐sectional design, 180 patients (90 men and 90 women) were included. Pre‐operative anxiety levels were assessed using the short‐form Dental Anxiety Inventory (S‐DAI). Pain during root canal treatment was evaluated using a 10‐cm visual analogue scale (VAS) that ranked the level of pain between ‘Absence of pain’ and ‘Unbearable pain’. The minimal sample size was determined using the software of the National Center for Advancing Translational Sciences (NIH, UK). Multivariate logistic regression analysis was used to identify relationships between variables.

Results

Mean pain level during root canal treatment was 2.2 ± 2.1. The mean anxiety S‐DAI score was 27.2 ± 12.5. Fifty percent of men had mild anxiety levels, while in 70% of women anxiety was moderate or high (P = 0.017). Anxiety correlated positively with intraoperative pain (R = 0.406). Multivariate logistic regression analysis revealed that anxiety was significantly associated with intraoperative pain felt by patients (OR = 4.0; 95% C.I. = 1.7–9.3; P = 0.001).

Conclusions

Anxious patients were more than twice as likely to feel moderate or intense intraoperative pain during root canal treatment. To know the patient´s degree of anxiety could help the dentist to decide whether to use anxiolytic premedication and/or supplemental local anaesthesia to assure better control of pain during root canal treatment.
Developing the Australian Midwifery Workplace Culture instrument
Authors: Catling Christine , Rossiter Chris , McIntyre Erica
Published: November 2019

Aim

To develop and psychometrically test the Australian Midwifery Workplace Culture instrument.

Background

Workplace culture is critical within midwifery settings. Culture determines not only the well‐being and continued retention of maternity staff and managers but it also affects the quality and ultimate safety of the care they provide to women, infants and families. Several studies have identified cultural problems within maternity services. Relatively few instruments take account of the unique aspects of these workplaces and the relationship between midwives and women.

Design

Three‐stage instrument development involved item generation (based on the Culture of Care Barometer), expert content validation and a pilot test.

Methods

During 2016, 38 midwifery experts reviewed the initial items, and 322 midwives then pilot‐tested the draft instrument. We used exploratory factor analysis to identify key domains and to refine the instrument.

Results

The refined instrument contained 22 items in three distinct domains: relationship with managers, empowerment and collegiality.

Conclusion

The instrument can contribute to understanding important dimensions of the culture in maternity workplaces and thus to examining problematic attitudes and practices. The instrument requires further development and testing with larger and more diverse samples of midwives and validation in specific midwifery settings and models of care.
Low‐temperature molten salt synthesis of high‐entropy carbide nanopowders
Authors: Ning Shanshan , Wen Tongqi , Ye Beilin , Chu Yanhui
Published: November 2019

Synthesis of the powders is critical for achieving the extensive applications of high‐entropy carbides (HECs). Previously reported studies focus mainly on the high‐temperature (>2000 K) synthesis of HEC micro/submicropowder, while the low‐temperature synthesis of HEC nanopowders is rarely studied. Herein we reported the low‐temperature synthesis of HEC nanopowders, namely (Ta0.25Nb0.25Ti0.25V0.25)C (HEC‐1), via molten salt synthesis for the first time. The synthesis possibility of HEC‐1 nanopowders was first theoretically demonstrated by analyzing lattice size difference and chemical reaction thermodynamics based on the first‐principle calculations, and then the angular HEC‐1 nanopowders were successfully synthesized via molten salt synthesis at 1573 K. The as‐synthesized nanopowders possessed the single‐crystal rock‐salt structure of metal carbides and high compositional uniformity from nanoscale to microscale. In addition, their formation mechanism was well interpreted by a classical molten salt‐assisted growth.
Time and Space: Access and the Lifecycle of the Art Student
Authors: Mc Ternan Finola
Published: November 2019

Reflecting on how ‘transition’ can be interpreted in the context of an art and design college, this article will discuss how the access programme at the National College of Art and Design (NCAD), Dublin supports the art students’ lifecycle in, through and out of college. The article will present an overview of NCAD’s access programme and will track its development as it has evolved and how, through a series of targeted initiatives and key partnerships it has identified, retained and supported students beyond graduation. The NCAD has a distinctive widening participation programme that is embedded in the School of Education but is part of the organic culture of the art college. This support enables the mainstreaming of NCAD’s access policy through its engagement with schools and community, seeking to raise aspirations and awareness of art and design as a life option for young people.
“We believe, we feel, we act”: Testing the BIAS Map predictions during adolescence
Authors: Constantin Andreea A. , Cuadrado Isabel
Published: November 2019

The present study examined the relation between adolescents’ beliefs, emotions, and intentional behaviors toward two immigrant groups from the Spanish context: Moroccans and Ecuadorians. For this purpose, we tested the SCM/BIAS Map predictions considering the three‐dimensional perspective of stereotype content, which distinguishes between morality, sociability, and competence. Spanish adolescents (N = 231, Mage = 15.39, SD = 1.09) evaluated either Moroccans (n = 114, 55.3% girls) or Ecuadorians (n = 117, 59% girls) on the SCM/BIAS Map variables. Our results confirmed, for both groups, the validity of the three‐dimensional model of stereotype content and showed that adolescents differentiate between the two subdimensions of warmth and treat them as independent in intergroup evaluations. Furthermore, the mediating role of emotions in the stereotype content‐behavior link was also confirmed but only for the univalent emotions in both groups. Finally, only morality acted as a consistent predictor of adolescents active behavioral intentions. The higher perceived morality of the immigrants increased adolescents’ admiration toward them, which in turn led adolescents to manifest more active facilitation intentions. Likewise, the perceived morality of the immigrants negatively affected adolescents’ contempt toward them, which in turn decreased adolescent's active harm intentions toward Ecuadorians and Moroccans. These findings indicate that the perceived morality of the outgroup is the key aspect in order to simultaneously promote helping behavior and decrease harmful one toward immigrant groups during adolescence.
Tropical forest type influences community assembly processes in arbuscular mycorrhizal fungi
Authors: Maciel Rabelo Pereira Camilla , López‐García Álvaro , da Silva Danielle Karla Alves , Costa Maia Leonor , Guldberg Frøslev Tobias , Kjøller Rasmus , Rosendahl Søren
Published: November 2019

Aim

Plant community assembly in tropical rain forest has been shown to be largely governed by stochastic processes, but as arbuscular mycorrhizal (AM) fungi display limited host preference, they may not follow the same stochastic assembly pattern. Here, we determined the relative importance of environmental and spatial drivers responsible for the community assembly process of AM fungi in two types of tropical rain forest: semideciduous rain forest and dense ombrophilous forests.

Location

Atlantic rain forest in north‐eastern Brazil, South America.

Taxon

Arbuscular mycorrhizal fungi (Glomeromycotina).

Methods

We collected root samples from eight protected areas of Atlantic forest along a 700 km transect in north‐eastern Brazil. We measured the relative importance of deterministic and stochastic processes by redundancy analysis (RDA) and variation partitioning in comparison with null expectations using ad hoc generated neutral communities. Furthermore, we accessed species associations from co‐occurrence data, at different scales using a Bayesian approach of Hierarchical Modelling of Species Communities.

Results

Overall, the extent to which stochastic and deterministic processes affected community assembly depended on the forest type and the spatial scale. Specifically, we found that abiotic and biotic predictors of AM fungal community assemblages are related to environmental homogeneity in tropical rain forests.

Main conclusions

The results of the study show that dynamics in community assembly was clearly different between the two forest types, and that the difference most likely is due to differences in responses to environmental variables.
The effect of posture, exercise, and atrial pacing on atrioventricular conduction in systolic heart failure
Authors: Niu Hongxia , Yu Yinghong , Sturdivant John L. , An Qi , Gold Michael R.
Published: November 2019

Background

Optimization of atrioventricular (AV) intervals for cardiac resynchronization therapy (CRT) programming is typically performed in supine patients at rest, which may not reflect AV timing in other conditions.

Objective

To evaluate the effects of posture, exercise, and atrial pacing on intrinsic AV intervals in patients with CRT devices.

Methods

Rate‐dependent A‐V delay by exercise was a multicenter, prospective trial of patients in sinus rhythm following CRT implantation. Intracardiac electrograms were recorded to analyze atrial to right ventricular (ARV), atrial to left ventricular (ALV), and RV to LV (VV) time intervals. Heart rate was increased with incremental atrial pacing in different postures, followed by an exercise treadmill test.

Results

This study included 36 patients. At rest, AV intervals changed minimally with posture. With atrial pacing, AV interval immediately increased compared with sinus rhythm, with ARV slopes being 8.1 ± 7.7, 8.8 ± 13.4, and 6.8 ± 6.5 milliseconds per beat per minute (ms/bpm) and ALV slopes being 8.2 ± 7.7, 9.1 ± 12.8, and 7.0 ± 6.5 ms/bpm for supine, standing and sitting positions, respectively. As the paced heart rate increased, ARV and ALV intervals increased more gradually with similar trends. Interventricular conduction times changed less than 0.2 ms/bpm with atrial pacing. During exercise, the direction of change of intrinsic ARV intervals, as heart rate increased, was variable between patients with relatively small overall group changes (0.1 ± 1.4 and 0.2 ± 1.2 ms/bpm for ARV and ALV, respectively).

Conclusion

Posture and exercise have a smaller effect on AV timing compared with atrial pacing. However, individualized optimization and dynamic rate related changes may be needed to maintain optimal fusion with left ventricular (LV) stimulation.
Asian management of hypertension: Current status, home blood pressure, and specific concerns in Malaysia
Authors: Chia Yook‐Chin , Kario Kazuomi
Published: November 2019

Cardiovascular disease (CVD) accounts for a third of all deaths in Malaysia. The background CV risk of Malaysia is much higher than that of developed countries in the west and in Asia. This high CV mortality is contributed by the high prevalence of CV risk factors especially hypertension which is very prevalent, coupled with low awareness and low control rates. This highlights the importance of home blood pressure measurements (HBPM). HBPM is an important adjunct in the management of hypertension, particularly to identify those unaware as well as white‐coat hypertension which is high in treated hypertensive patients in Malaysia. Ownership of HBPM devices in Malaysia is high, and this is an opportunity as well as timely to encourage more use of HBPM. The Malaysian national guidelines do not require HBPM for the diagnosis of hypertension but do recommend HBPM for specific situations. The most commonly prescribed anti‐hypertensives are calcium channel blockers, followed by renin‐angiotensin system blockers. Despite the wide availability of anti‐hypertensive agents, BP control rates remain low. It is important that strategies are in place to ensure that individuals are aware of the need to have their BP monitored regularly and this can be facilitated by the use of HBPM. Hence, there is a plan to develop a local HBPM consensus document. Strategies to reduce salt intake would also be beneficial. In summary, identification of those unaware and better control of BP with the help of HBPM would help reduce the burden of CV mortality and morbidity in Malaysia.
Impact of fractional excretion of sodium on a single morning void urine collection as an estimate of 24‐hour urine sodium
Authors: Nowson Caryl A. , Lim Karen , Campbell Norm R. C. , O'Connell Stella L. , He Feng J. , Daly Robin M.
Published: November 2019

The standard for assessing dietary sodium intake is to measure 24‐hour urine sodium. On average, 93% of daily sodium intake is excreted over 24‐hours. Expense and difficulties in obtaining complete 24‐hour collections have led to the measurement of sodium concentration in spot and single‐void urine samples, using predictive equations to estimate 24‐hour urine sodium. Although multiple predictive equations have been developed, in addition to having an average bias, all the equations overestimate 24‐hour sodium at lower levels of 24‐hour sodium and underestimate 24‐hour urine sodium at higher levels of 24‐hour sodium. One of the least biased estimating equations is the INTERSALT equation, which incorporates a spot urine creatinine concentration. The authors hypothesized that differential fractional excretion of sodium (FeNa)(derived from a morning void collection) relative to creatinine would impact on the accuracy of the INTERSALT equation in estimating 24‐hour urine sodium. In a prospective study of 139 adults aged 65 years and over, three sequential morning void and 24‐hour urine samples were examined. There was a significant correlation between increasing FENa and the difference between estimated and measured 24‐hours urine sodium (r = 0.358, P < .01). In the lowest quartile of FENa, the INTERSALT equation overestimated 24‐hour urine sodium, but underestimated 24‐hour urine sodium with greater magnitude in each of the subsequent quartiles of FENa. Differential excretion of sodium relative to creatinine, potentially impacted by renal blood flow and hydration, among other factors, affected the accuracy of the INTERSALT equation. Additional research may refine the INTERSALT and other predictive equations to increase their accuracy.
Severe diabetes complications among patients with diabetes with regular follow‐up: Does care setting matter?
Authors: Tsai Tzu‐Ho , Huang Nicole , Lin I‐Feng , Chou Yiing‐Jenq
Published: November 2019

Objective

To investigate diabetes outcomes by long‐term trajectories of patients' care settings among diabetes patients with regular follow‐up.

Research design and methods

This longitudinal population‐based cohort study used data from the National Health Insurance Research Database in Taiwan. The trajectories of diabetes care‐seeking behaviours among newly diagnosed diabetes patients with regular follow‐up were identified using a group‐based trajectory model from 2000 to 2004. Severe diabetes complications were assessed for the period 2005–2010. Cox‐proportional hazard method with a cumulative incidence function was applied.

Results

Among the diabetes patients with regular follow‐up during the first 5 years since diagnosis, 44.5% and 40.6% were persistently cared for in generalized care settings and specialized settings, respectively. Only 14.9% of them had shifted between different levels of care setting during the first 5 years. No significant difference in adverse outcomes was observed between patients who were persistently treated in generalized and specialized care settings. Significantly worse outcomes were observed among patients who shifted from generalized care settings to specialized settings (adjusted hazard ratio [aHR]=3.2, 95% confidence interval [CI]: 1.5, 6.8). In contrast, among the elderly, regular users of generalized care providers had a higher hazard of adverse outcomes than those of specialized care providers (aHR = 3.3, 95% CI: 1.0, 10.7).

Conclusions

Diabetes patients who were persistently treated in generalized care settings had health outcomes comparable to those who were persistently treated in specialized care settings. However, for elderly and less stable patients, regular diabetes care in specialized care settings was preferable.
Coagulation abnormalities, bleeding, thrombosis, and management of patients with acute liver failure in Australia and New Zealand
Authors: Warrillow Stephen , Fisher Caleb , Tibballs Heath , Bailey Michael , McArthur Colin , Lawson‐Smith Pia , Prasad Bheemasenachar , Anstey Matthew , Venkatesh Bala , Dashwood Gemma , Walsham James , Holt Andrew , Wiersema Ubbo , Gattas David , Zoeller Matthew , Garcia Alvarez Mercedes , Bellomo Rinaldo
Published: November 2019

Background and Aim

To study the management of coagulation and hematological derangements among severe acute liver failure (ALF) patients in Australia and New Zealand liver transplant intensive care units (ICUs).

Methods

Analysis of key baseline characteristics, etiology, coagulation and hematological tests, use of blood products, thrombotic complications, and clinical outcomes during the first ICU week.

Results

We studied 62 ALF patients. The first day median peak international normalized ratio was 5.5 (inter‐quartile range [IQR] 3.8–8.7), median longest activated partial thromboplastin time was 62 s (IQR 44–87), and median lowest fibrinogen was 1.1 (IQR 0.8–1.6) g/L. Fibrinogen was only measured in 85% of patients, which was less than other tests (P < 0.0001). Median initial lowest platelet count was 83 (IQR 41–122) × 109/L. Overall, 58% of patients received fresh frozen plasma, 40% cryoprecipitate, 35% platelets, and 15% prothrombin complex concentrate. Patients with bleeding complications (19%) had more severe overall hypofibrinogenemia and thrombocytopenia. Thrombotic complications were less common (10% of patients), were not associated with consistent patterns of abnormal hemostasis, and were not immediately preceded by clotting factor administration and half occurred only after liver transplantation surgery.

Conclusion

In ALF patients admitted to dedicated Australia and New Zealand ICUs, fibrinogen was measured less frequently than other coagulation parameters but, together with platelets, appeared more relevant to bleeding risk. Blood products and procoagulant factors were administered to most patients at variable levels of hemostatic derangement, and bleeding complications were more common than thrombotic complications. This epidemiologic information and practice variability provide baseline data for the design and powering of interventional studies.
A predictive model on the hospital nurses' psychological well‐being
Authors: Kim Jung Min , Han Jeong‐Won
Published: November 2019

Purpose

The purpose of this study is to test a structural model that analyzes and comprehensively identifies the factors that affect the psychological well‐being of hospital nurses, and to reveal the direct and indirect relationships among the factors.

Method

The subjects of this study were 217 nurses working in four advanced general hospitals in Metropolitan City B and Province G with at least one experience of job rotation. Data were analyzed using SPSS 21.0. The characteristics of subjects and the reliability of the research tools were analyzed through descriptive statistics, a t‐test, an analysis of variance, and correlation analyses on the research variables. A confirmatory factor analysis was performed using AMOS 21.0 to verify the fitness of the hypothetical model and hypothesis.

Results

The test of fitness of the hypothetical model yielded χ2 = 152.14, df = 72, χ2/df = 2.11, goodness of fit index = .97, adjusted goodness of fit index = .91, normed fit index = .95, comparative fit index = .98, root mean square = .02, and root mean square error of approximation = .01, which showed that the model had a good fit and explained 63.0% of the variance in psychological well‐being. The hypothesis of the study was verified: Nurses' job rotation stress has indirect effect on psychological well‐being through self‐efficacy, social support, optimism, and coping strategies.

Conclusion

A practical method that can promote self‐efficacy, social support, optimism, and stress‐coping strategies must be established to improve the psychological well‐being of hospital nurses based on this research.
A proposed technique for one‐step preputial reconstruction in the dog
Authors: Milgram J. , Yas‐Natan E. , Benzioni‐Bar H. , Shipov A.
Published: November 2019

Objective

To describe a reverse axial pattern flap based on the superficial branch of the dorsal penile artery and describe its use in preputial reconstruction.

Materials and Methods

Ten penises were harvested from canine cadavers; five were used to describe the dermatome supplied by the superficial branch of the dorsal artery of the penis and five to show perfusion of the skin flap. The superficial branch of the dorsal artery of the penis was identified fluoroscopically by injecting contrast material into the dorsal artery of the penis. This artery was then catheterised and injected with methylene blue to identify the perfused area. A skin flap was created by making a full thickness skin incision at the level of the fornix, along the circumference of the penis. The flap was developed by pulling the cut end toward the tip of the penis while undermining the skin. The flap was considered long enough when the cut end of the flap reached the level of the urethral opening. We also describe a case of preputial resection and reconstruction using this flap.

Results

Injection of methylene blue demonstrated the arterial supply to the skin flap. This flap was successful in treating the clinical case following resection of a mast cell tumour on the prepuce, although a small area of full thickness flap necrosis, which healed by second intention, developed postoperatively.

Clinical Importance

This technique may be useful for single step preputial reconstruction.
Increased alertness behavior in Australian fur seals (Arctocephalus pusillus doriferus) at a high vessel traffic haul‐out site
Authors: Speakman Cassie N. , Johnstone Christopher P. , Robb Kate
Published: November 2019

Vessel impacts on marine mammals are of growing concern, and marine mammals in urbanized marine environments are at particular risk of exposure. Port Phillip Bay (Victoria, Australia) is one such environment, in which Australian fur seals (AUFS; Arctocephalus pusillus doriferus) haul‐out to rest, yet little is known about the impacts of vessels on resting seals. We used remote camera traps to investigate the influence of vessel traffic on AUFS behavior at a nonbreeding haul‐out site. Environmental, temporal, and vessel‐related variables were all associated with changes in AUFS alertness at this site. All vessel types elicited increased alertness above base‐line levels (25%), with recreational and commercial motorized vessels associated with a 5.7%–10.8% increase in alertness. Unidentified vessels, the government vessel, and kayaks were associated with significantly increased alertness of 21.7%, 46.4%, and 60.7%, respectively, though accounted for only 6.2% of vessel observations. Vessels breaching current approach regulations (<5 m) showed a 32% increase in alertness, significantly higher than nonbreach approaches. Partial and complete flushing of the platform was rare, occurring in 1.0% of images analyzed. These results suggest that vessels do elicit a response from AUFS at this haul‐out site, and that further monitoring of vessel activity and compliance is required.
Capping proteins regulate fungal development, DON‐toxisome formation and virulence in Fusarium graminearum
Authors: Tang Guangfei , Chen Ahai , Dawood Dawood H. , Liang Jingting , Chen Yun , Ma Zhonghua
Published: November 2019

Deoxynivalenol (DON) is an important trichothecene mycotoxin produced by the cereal pathogen Fusarium graminearum. DON is synthesized in organized endoplasmic reticulum structures called toxisomes. However, the mechanism for toxisome formation and the components of toxisomes are not yet fully understood. In a previous study, we found that myosin I (FgMyo1)‐actin cytoskeleton participated in toxisome formation. In the current study, we identified two new components of toxisomes, the actin capping proteins (CAPs) FgCapA and FgCapB. These two CAPs form a heterodimer in F. graminearum, and physically interact with FgMyo1 and Tri1. The deletion mutants ΔFgcapA and ΔFgcapB and the double deletion mutant ΔΔFgcapA/B dramatically reduced hyphal growth, asexual and sexual reproduction and endocytosis. More importantly, the deletion mutants markedly disrupted toxisome formation and DON production, and attenuated virulence in planta. Collectively, these results suggest that the actin CAPs are associated with toxisome formation and contribute to the virulence and development of F. graminearum.
Occurrence of land‐plant‐specific glycerol‐3‐phosphate acyltransferases is essential for cuticle formation and gametophore development in Physcomitrella patens
Authors: Lee Saet Buyl , Yang Sun Ui , Pandey Garima , Kim Myung‐Shin , Hyoung Sujin , Choi Doil , Shin Jeong Sheop , Suh Mi Chung
Published: November 2019

During the evolution of land plants from aquatic to terrestrial environments, their aerial surfaces were surrounded by cuticle composed of cutin and cuticular waxes to protect them from environmental stresses. Glycerol‐3‐phosphate acyltransferase (GPAT) harboring bifunctional sn‐2 acyltransferase/phosphatase activity produces 2‐monoacylglycerol, a precursor for cutin synthesis.

Here, we report that bifunctional sn‐2 GPATs play roles in cuticle biosynthesis and gametophore development of Physcomitrella patens.

Land plant‐type cuticle was observed in gametophores but not in protonema. The expression of endoplasmic reticulum‐localized PpGPATs was significantly upregulated in gametophores compared with protonema. Floral organ fusion and permeable cuticle phenotypes of Arabidopsis gpat6‐2 petals were rescued to the wild type (WT) by the expression of PpGPAT2 or PpGPAT4. Disruption of PpGPAT2 and PpGPAT4 caused a significant reduction of total cutin loads, and a prominent decrease in the levels of palmitic and 10,16‐dihydroxydecanoic acids, which are major cutin monomers in gametophores. Δppgpat2 mutants displayed growth retardation, delayed gametophore development, increased cuticular permeability, and reduced tolerance to drought, osmotic and salt stresses compared to the WT.

Genome‐wide analysis of genes encoding acyltransferase or phosphatase domains suggested that the occurrence of sn‐2 GPATs with both domains may be a key event in cuticle biogenesis of land plants.
Electrocardiographic predictors of pacemaker battery depletion: Diagnostic sensitivity, specificity, and clinical risk
Authors: Carlson Daniel , Marine Joseph E. , Love Charles J. , Chrispin Jonathan , Barth Andreas S. , Rickard John “Jack” , Spragg David D. , Berger Ronald , Calkins Hugh , Tomaselli Gordon F. , Sinha Sunil K.
Published: November 2019

Background

Pacemaker battery depletion triggers alert for replacement notification and results in automatic reprogramming, which has been shown to be associated with relevant cardiorespiratory symptoms and adverse clinical events.

Objective

Determine if electrocardiogram (ECG) pacing features may be predictive of pacemaker battery depletion and clinical risk.

Methods

This is an ECG substudy of a cohort analysis of 298 subjects referred for pacemaker generator replacement from 2006 to 2017. Electronic medical record review was performed; clinical, ECG, and pacemaker characteristics were abstracted. We applied two ECG prediction rules for pacemaker battery depletion that are relevant to all major pacemaker manufacturers except Boston Scientific and MicroPort: (1) atrial pacing not at a multiple of 10 and (2) nonsynchronous ventricular pacing not at a multiple of 10, to determine diagnostic sensitivity, specificity, and risk in applicable ECG subjects.

Results

We excluded 32 subjects not at replacement notification or duplicate surgeries. Overall, 176 of 266 subjects (66.2%) demonstrated atrial pacing or nonsynchronous ventricular pacing on preoperative ECG. When utilizing both rules, 139 of 176 preoperative ECGs and 12 of 163 postoperative ECGs met criteria for battery depletion yielding reasonable sensitivity (79.0%), high specificity (92.6%), and a positive likelihood ratio of 11.6:1. These rules were associated with significant increase in cardiorespiratory symptoms (P < .001) and adverse clinical events (P < .025).

Conclusions

The “Rules of Ten” provided reasonable sensitivity and specificity for detecting replacement notification in pacemaker subjects with an applicable ECG. This ECG tool may help clinicians identify most patients with pacemaker battery depletion at significant clinical risk.
Control of water‐use efficiency by florigen
Authors: Robledo Jessenia M. , Medeiros David , Vicente Mateus H. , Azevedo Aristéa A. , Thompson Andrew J. , Peres Lázaro E.P. , Ribeiro Dimas M. , Araújo Wagner L. , Zsögön Agustin
Published: November 2019

A major issue in modern agriculture is water loss through stomata during photosynthetic carbon assimilation. In water‐limited ecosystems, annual plants have strategies to synchronize their growth and reproduction to the availability of water. Some species or ecotypes of flowers are early to ensure that their life cycles are completed before the onset of late season terminal drought (“drought escape”). This accelerated flowering correlates with low water‐use efficiency (WUE). The molecular players and physiological mechanisms involved in this coordination are not fully understood. We analyzed WUE using gravimetry, gas exchange, and carbon isotope discrimination in florigen deficient (sft mutant), wild‐type (Micro‐Tom), and florigen over‐expressing (SFT‐ox) tomato lines. Increased florigen expression led to accelerated flowering time and reduced WUE. The low WUE of SFT‐ox was driven by higher stomatal conductance and thinner leaf blades. This florigen‐driven effect on WUE appears be independent of abscisic acid (ABA). Our results open a new avenue to increase WUE in crops in an ABA‐independent manner. Manipulation of florigen levels could allow us to produce crops with a life cycle synchronized to water availability.
Baby's first bath: Changes in skin barrier function after bathing full‐term newborns with water vs liquid baby cleanser
Authors: Lund Carolyn , Kuller Joanne , Durand David J.
Published: November 2019

Background

The impact of the newborn's first bath, whether given with water alone or water with skin cleansing products, on skin barrier function is unknown.

Methods

We evaluated skin barrier function, measured by skin surface pH (primary outcome), transepidermal water loss (TEWL), and hydration of the stratum corneum (SCH) in 100 newborns before and after their first bath, randomizing this cohort to bathing with water alone or with water and a liquid baby cleanser. Two consecutive measurements of each parameter were obtained at two anatomic locations, the volar forearm, and below the sternum. Randomization was by mode of delivery, with 50 vaginal and 50 cesarean section (C/S) delivered newborns.

Results

Skin pH decreased significantly following the first bath at both anatomic sites regardless of whether the bath was performed with water or with cleanser, and there was no significant effect on the change in pH in these two groups. Baseline TEWL and SCH measurements were significantly lower in the sternum area compared to the volar forearm. TEWL decreased significantly after the first bath except when the bath was given with water alone on the sternum site. SCH also decreased significantly after the first bath except in the forearm when the bath was given with water alone.

Conclusions

We conclude that skin surface pH, TEWL, and SCH all decrease significantly following the first bath, an indication of the development of skin barrier function in the newly born infant. In addition, bathing with water alone or water and a liquid baby cleanser does not impact the developing skin barrier.
Impact of an incentive‐based prenatal smoking cessation program for low‐income women in Colorado
Authors: Polinski Kristen J. , Wolfe Rachel , Peterson Anne , Juhl Ashley , Perraillon Marcelo Coca , Levinson Arnold H. , Crume Tessa L.
Published: November 2019

Objective

To assess birth outcomes and cost‐savings of an incentive‐based prenatal smoking cessation program targeting low‐income women in Colorado.

Design

Prospective observational cohort with nonequivalent population control groups.

Sample

Program participants (n = 2,231) linked to the birth certificate to ascertain birth outcomes compared to two reference populations from Pregnancy Risk Assessment Monitoring System (PRAMS) and Colorado live births based on the birth certificate.

Measurements

Tobacco cessation metrics in the third trimester of pregnancy, neonatal low birth weight (<2,500 g), preterm birth (birth at <37 weeks gestation), neonatal intensive care unit (NICU) admission and maternal gestational hypertension. Cost‐savings and return on investment (ROI) were projected using average Medicaid reimbursement.

Results

Infants of mothers enrolled in the program had a lower risk of low birthweight (RR = 0.86; 95% CI = 0.75, 0.97), preterm birth (PTB) (RR = 0.76; 95% CI = 0.65, 0.88) and neonatal intensive care unit (NICU) admission (RR = 0.76; 95% CI = 0.66, 0.88) compared to the birth certificate population, corresponding to a ROI of $7.73 and an individual cost savings of $6,040. Compared to PRAMS, infants of enrolled mothers had a lower risk of PTB (RR = 0.72; 95% CI = 0.53, 0.99) and NICU admission (RR = 0.45; 95% CI = 0.32, 0.62), corresponding to an ROI of $2.79 and an individual cost savings of $2,182.

Conclusions

We found a reduction of adverse birth outcomes, and cost savings.
Strained, Photoejecting Ru(II) Complexes that are Cytotoxic Under Hypoxic Conditions
Authors: Roque John , Havrylyuk Dmytro , Barrett Patrick C. , Sainuddin Tariq , McCain Julia , Colón Katsuya , Sparks William T. , Bradner Evan , Monro Susan , Heidary David , Cameron Colin G. , Glazer Edith C. , McFarland Sherri A.
Published: November 2019

A series of strained Ru(II) complexes were studied for potential anticancer activity in hypoxic tissues. The complexes were constructed with methylated ligands that were photolabile and an imidizo[4,5‐f][1,10]phenanthroline ligand that contained an appended aromatic group to potentially allow for contributions of ligand‐centered excited states. A systematic variation of the size and energy of the aromatic group was performed using systems containing 1–4 fused rings, and the photochemical and photobiological behaviors of all complexes were assessed. The structure and nature of the aromatic group had a subtle impact on photochemistry, altering environmental sensitivity, and had a significant impact on cellular cytotoxicity and photobiology. Up to 5‐fold differences in cytotoxicity were observed in the absence of light activation; this rose to 50‐fold differences upon exposure to 453 nm light. Most significantly, one complex retained activity under conditions with 1% O2, which is used to induce hypoxic changes. This system exhibited a photocytotoxicity index (PI) of 15, which is in marked contrast to most other Ru(II) complexes, including those designed for O2‐independent mechanisms of action.
Arabidopsis nucleoporin CPR5 controls trichome cell death through the core cell cycle regulator CKI
Authors: Peng S. , Sun K. , Guo Y. , Liu Y. , Wang S.
Published: November 2019

The Arabidopsis trichome is a polyploid epidermal cell resulting from multiple rounds of endocycles. The CYCLIN‐DEPENDENT KINASE INHIBITOR (CKI) family proteins are core cell cycle regulators that promote the endocycle. CONSTITUTIVE EXPRESSION OF PR GENES 5 (CPR5) is a plant‐specific nucleoporin. It has been found that two Arabidopsis CKI, SIAMESE (SIM) and SIAMESE‐RELATED 1 (SMR1), function downstream of CPR5 to activate plant effector‐triggered cell death. The sim smr1 double mutants form multicellular and clustered trichomes, while the cpr5 mutants produce dead and branchless trichomes. This study explored roles of the CPR5‐CKI signalling pathway in trichome cell cycle transition.

To examine the underlying mechanism of how cell cycle transition is regulated in plant trichomes, Trypan blue staining, flow cytometry, scanning electron microscopy (SEM) and nuclear DNA measurement were conducted.

The native promoter‐driven CKI and GUS fusion reporter showed that both SIM and SMR1 proteins were preferentially expressed in trichomes. The cpr5‐induced dead and branchless trichomes were fully suppressed by the sim smr1 double mutant, suggesting that SIM and SMR1 function downstream of CPR5 in trichome development. Flow cytometry analysis showed that as compared to the number of 2C (C = DNA content in a haploid nucleus) cells, the number of 4C cells significantly increased, whereas that of polyploidy cells (8C and 16C) dramatically decreased in the cpr5 mutant. The elevated 4C/2C ratio in the cpr5 mutant is consistent with de‐repression of pro‐endocycle regulators SIM and SMR1. The polyploidy cells (8C and 16C) may be selectively targeted to cell death, which is therefore attributed to the branchless trichomes in the cpr5 mutant. Nuclear DNA content analysis demonstrated that the nuclear DNA content of trichomes in the cpr5 sim mutant was significantly higher than in the sim mutant, indicating that CPR5 is a negative endocycle regulator in trichomes.

This study reveals that the CPR5‐CKI signalling pathway controls trichome cell cycle transition and excessive endocycles are required for cell death in plant trichomes.