bluuebunny/crossref_metadata_2025 huggingface dataset:
A critical appraisal of randomized controlled trials on intravenous phenytoin in convulsive status epilepticus
Authors: Brigo F. , Bragazzi N. L. , Lattanzi S. , Nardone R. , Trinka E.
Published: December 2017

Since the 1970s, intravenous (IV) phenytoin (PHT) has traditionally been used as second‐stage treatment for convulsive status epilepticus (SE) after failure of benzodiazepines. The aim of this review was to critically assess the evidence supporting the use of IV PHT as treatment of convulsive SE in patients of any age. In particular, we critically appraised the results of randomized controlled trials (RCTs) evaluating IV PHT as treatment of convulsive SE. A systematic search of the literature was carried out to identify RCTs evaluating IV PHT as treatment of convulsive SE in patients of any age. Eight RCTs (544 patients allocated to IV PHT) were included. The included studies differed in almost every single characteristic considered. Six RCTs (472 patients) used IV PHT without demonstrating refractoriness of SE to benzodiazepines. Only two RCTs (72 patients) used IV PHT as second‐line treatment for benzodiazepine‐resistant convulsive SE. Overall, most evidence from RCTs supports the use of IV PHT immediately after IV diazepam, even if seizures have not recurred. The recommendation derived from RCTs supporting the use of IV PHT as second‐line treatment in benzodiazepine‐resistant convulsive SE is weak. This is emblematic of the lack of robust evidence from large RCTs to inform clinical practice on how to treat SE after failure of first‐line drugs. IV PHT given immediately after first‐line benzodiazepines could prolong their short antiepileptic effect and prevent seizure recurrence.
Challenges to DNA replication in hypoxic conditions
Authors: Ng Natalie , Purshouse Karin , Foskolou Iosifina P. , Olcina Monica M. , Hammond Ester M.
Published: December 2017

The term hypoxia refers to any condition where insufficient oxygen is available and therefore encompasses a range of actual oxygen concentrations. The regions of tumours adjacent to necrotic areas are at almost anoxic levels and are known to be extremely therapy resistant (radiobiological hypoxia). The biological response to radiobiological hypoxia includes the rapid accumulation of replication stress and subsequent DNA damage response, including both ATR‐ and ATM‐mediated signalling, despite the absence of detectable DNA damage. The causes and consequences of hypoxia‐induced replication stress will be discussed.
PKA‐binding domain of AKAP8 is essential for direct interaction with DPY30 protein
Authors: Bieluszewska Anna , Weglewska Martyna , Bieluszewski Tomasz , Lesniewicz Krzysztof , Poreba Elzbieta
Published: December 2017

The main function of the A kinase‐anchoring proteins (AKAPs) is to target the cyclic AMP‐dependent protein kinase A (PKA) to its cellular substrates through the interaction with its regulatory subunits. Besides anchoring of PKA, AKAP8 participates in regulating the histone H3 lysine 4 (H3K4) histone methyltransferase (HMT) complexes. It is also involved in DNA replication, apoptosis, transcriptional silencing of rRNA genes, alternative splicing, and chromatin condensation during mitosis. In this study, we focused on the interaction between AKAP8 and the core subunit of all known H3K4 HMT complexes—DPY30 protein. Here, we demonstrate that the PKA‐binding domain of AKAP8 and the C‐terminal domain of DPY30, also called Dpy‐30 motif, are crucial for the interaction between these proteins. We show that a single amino acid substitution in DPY30 L69D affects its dimerization and completely abolishes its interaction with AKAP8 and another DPY30‐binding partner brefeldin A‐inhibited guanine nucleotide‐exchange protein 1 (BIG1), which is also AKAP domain‐containing protein. We further demonstrate that AKAP8 interacts with DPY30 and the RII alpha regulatory subunit of PKA both in the interphase and in mitotic cells, and we show evidences that AKAP8L, a homologue of AKAP8, interacts with core subunits of the H3K4 HMT complexes, which suggests its role as a potential regulator of these complexes. The results presented here reinforce the analogy between AKAP8–RII alpha and AKAP8–DPY30 interactions, postulated before, and improve our understanding of the complexity of the cellular functions of the AKAP8 protein.
Nest monitoring does not affect nesting success of Whinchats Saxicola rubetra
Authors: Border Jennifer A. , Atkinson Lydia R. , Henderson Ian G. , Hartley Ian R.
Published: December 2017

It is important to assess the effect that research activities may have on animals in the wild, especially when key parameters, such as breeding success, could potentially be influenced by observer activity. For birds, some studies have suggested that nest monitoring can increase the chances of nest failure due to predation, whereas others suggest that human nest visits may actually deter mammalian predators. Nest monitoring visits can also influence breeding success more indirectly by altering parental provisioning behaviour. Here, the influence of monitoring activities on nest success was examined in a ground‐nesting grassland bird, the Whinchat Saxicola rubetra. During the egg phase, a sample of nests were not visited between the initial finding event and the estimated hatching date; instead, the nest status was assessed at a distance. Daily survival rates (DSR) for these nests were compared with that of nests visited every 2 days. During the nestling phase, the effects of observer nest visits on parental provisioning behaviour were determined. Nest visits were found not to affect egg DSR significantly, and parental provisioning was disrupted for a maximum of 20 min (0.52% of the nestling period) following an observer visit. Given the variation in response to nest visits across species, we suggest that consideration should be given to observer impact in all studies where predation risk is high. Here, we illustrate a method for researchers to assess the impact of their nest visits to ensure they are not biasing estimates of breeding success.
The impact of dental caries and its treatment by conventional or biological approaches on the oral health‐related quality of life of children and carers
Authors: BaniHani Alaa , Deery Chris , Toumba Jack , Munyombwe Theresa , Duggal Monty
Published: December 2017

Background

The effect of untreated dental caries and the approaches taken to its treatment have not been extensively elucidated in children.

Aim

To investigate the impact of untreated dental caries on children aged 4–9 years and whether its treatment with either a conventional or a biological approach influenced the oral health‐related quality of life (OHRQoL) of the children and their carers.

Design

Children (n = 110) and their carers attending two specialist centres for treatment of carious primary teeth completed the Early Childhood Oral Health Impact Scale and the Self‐reported Scale of Oral Health Outcomes for 5‐year‐old Children at baseline prior to dental treatment and at 3–6 months following completion of dental care. Dental treatment was provided using either a conventional or a biological approach.

Results

Dental caries showed a negative impact on the child and family's OHRQoL (P = 0.001). Children reported difficulty eating (55.5%), sleeping (40%), and avoiding smiling because of how the teeth looked (27.3%). More than half of the parents reported their child had toothache. Parents perceived difficulty eating (40.9%), being irritable (38.2%), and difficulty drinking (30.9%) as being impacts of caries on their child's OHRQoL. In addition, approximately half the parents reported feeling a sense of guilt because of their child's dental disease. Following dental treatment, participants reported significant improvement in their overall health status (P = 0.001). Children's age, gender, or the treatment approach were not statistically significantly associated with changes in OHRQoL of the child or carer. Children and parents who initially reported greater impacts of untreated dental caries demonstrated greater improvements in their overall oral health status (P < 0.0001).

Conclusion

Dental caries was associated with negative impacts on children and parents' quality of life. Treatment of caries improved the quality of life of children and families significantly, irrespective of whether the treatment was provided by a conventional or a biological approach.
The transmission dynamics and diversity of human metapneumovirus in Peru
Authors: Pollett Simon , Trovão Nidia S. , Tan Yi , Eden John‐Sebastian , Halpin Rebecca A. , Bera Jayati , Das Suman R. , Wentworth David , Ocaña Victor , Mendocilla Silvia M. , Álvarez Carlos , Calisto Maria E. , Garcia Josefina , Halsey Eric , Ampuero Julia S. , Nelson Martha I. , Leguia Mariana
Published: December 2017

Background

The transmission dynamics of human metapneumovirus (HMPV) in tropical countries remain unclear. Further understanding of the genetic diversity of the virus could aid in HMPV vaccine design and improve our understanding of respiratory virus transmission dynamics in low‐ and middle‐income countries.

Materials & Methods

We examined the evolution of HMPV in Peru through phylogenetic analysis of 61 full genome HMPV sequences collected in three ecologically diverse regions of Peru (Lima, Piura, and Iquitos) during 2008‐2012, comprising the largest data set of HMPV whole genomes sequenced from any tropical country to date.

Results

We revealed extensive genetic diversity generated by frequent viral introductions, with little evidence of local persistence. While considerable viral traffic between non‐Peruvian countries and Peru was observed, HMPV epidemics in Peruvian locales were more frequently epidemiologically linked with other sites within Peru. We showed that Iquitos experienced greater HMPV traffic than the similar sized city of Piura by both Bayesian and maximum likelihood methods.

Conclusions

There is extensive HMPV genetic diversity even within smaller and relatively less connected cities of Peru and this virus is spatially fluid. Greater diversity of HMPV in Iquitos compared to Piura may relate to higher volumes of human movement, including air traffic to this location.
Enhanced early warning system impact on nursing practice: A phenomenological study
Authors: Burns Kathleen A. , Reber Tracey , Theodore Karen , Welch Brenda , Roy Debra , Siedlecki Sandra L.
Published: December 2017

Aim

To determine how an enhanced early warning system has an impact on nursing practice.

Background

Early warning systems score physiologic measures and alert nurses to subtle changes in patient condition. Critics of early warning systems have expressed concern that nurses would rely on a score rather than assessment skills and critical thinking to determine the need for intervention. Enhancing early warning systems with innovative technology is still in its infancy, so the impact of an enhanced early warning system on nursing behaviours or practice has not yet been studied.

Design

Phenomenological design.

Methods

Scripted, semistructured interviews were conducted in September 2015 with 25 medical/surgical nurses who used the enhanced early warning system. Data were analysed using thematic analysis techniques (coding and bracketing). Emerging themes were examined for relationships and a model describing the enhanced early warning system experience was developed.

Findings

Nurses identified awareness leading to investigation and ease of prioritization as the enhanced early warning system's most important impact on their nursing practice. There was also an impact on organizational culture, with nurses reporting improved communication, increased collaboration, increased accountability and proactive responses to early changes in patient condition.

Conclusions

Rather than hinder critical thinking, as many early warning systems’ critics claim, nurses in this study found that the enhanced early warning system increased their awareness of changes in a patient's condition, resulting in earlier response and reassessment times. It also had an impact on the organization by improving communication and collaboration and supporting a culture of proactive rather than reactive response to early signs of deterioration.
Effectiveness of executive function training on mental set shifting, working memory and inhibition in healthy older adults: A double‐blind randomized controlled trials
Authors: Chiu Huei‐Ling , Chan Pi‐Tuan , Kao Ching‐Chiu , Chu Hsin , Chang Pi‐Chen , Hsiao Shu‐Tai Sheen , Liu Doresses , Chang Wen‐Chi , Chou Kuei‐Ru
Published: December 2017

Aims

The aim of this study was to evaluate the effectiveness of executive function training on mental set shifting, working memory and inhibition for healthy older adults.

Background

Executive functions control and guide individuals' behaviours through a top‐down cognitive model and have been regarded as the exhibition and integration of various high‐level cognitive functions. However, prior studies have rarely focused on the subcomponent indicators of executive function, such as mental set shifting, working memory and inhibition in healthy older adults.

Design

Randomized controlled trial.

Methods

A total of 62 participants were recruited between January 2015 ‐ March 2017, with both groups attending a 30‐min training session three times per week for 8 weeks. Executive function training group received the training content that focused on the mental set shifting, working memory and inhibition. Active control group engaged in passive information activities. The primary outcome was mental set shifting, measured by the Wisconsin card sort test. The secondary outcomes were working memory measured by digit span and inhibition measured by the Stroop color word test.

Results

The executive function training group had statistically significant higher scores of mental set shifting and working memory at immediate follow‐up and that its effect on mental set shifting could be maintained for 3–6 months. However, this training did not have any statistically significant results on inhibition.

Conclusion

The executive function training may be an effective preventive intervention for healthy older adults. Future studies are recommended to include a broader range of participants with different levels of cognitive function.
A randomized controlled trial of a nursing psychotherapeutic intervention for anxiety in adult psychiatric outpatients
Authors: Sampaio Francisco Miguel Correia , Araújo Odete , Sequeira Carlos , Lluch Canut María Teresa , Martins Teresa
Published: December 2017

Aim

To evaluate the short‐term efficacy of a psychotherapeutic intervention in nursing on Portuguese adult psychiatric outpatients with the nursing diagnosis “anxiety.”

Background

Several efficacious forms of treatment for anxiety are available, including different forms of psychotherapy and pharmacotherapy. However, literature tends to favour findings from studies on the efficacy of psychotherapies and therapies provided by nurses to the detriment of those arising from studies on the efficacy of nursing psychotherapeutic interventions (interventions which are classified, for instance, on Nursing Interventions Classification).

Design

Randomized controlled trial.

Methods

The study was performed, between November 2016 ‐ April 2017, at a psychiatry outpatient ward. Participants were randomly allocated to an intervention group (N = 29) or a treatment‐as‐usual control group (N = 31). Patients in the intervention group received psychopharmacotherapy with interventions integrated in the Nursing Interventions Classification for the nursing diagnosis “anxiety.” A treatment‐as‐usual control group received only psychopharmacotherapy (if applicable). Anxiety level and anxiety self‐control were the primary outcomes.

Results

Patients from both groups had reduced anxiety levels, between the pre‐test and the posttest assessment; however, according to analysis of means, patients in the intervention group displayed significantly better results than those of the control group. Furthermore, only patients in the intervention group presented significant improvements in anxiety self‐control.

Conclusion

This study demonstrated the short‐term efficacy of this psychotherapeutic intervention model in nursing in the decrease of anxiety level and improvement of anxiety self‐control in a group of psychiatric outpatients with pathological anxiety.

Trial Registration Number: NCT02930473.
Cell therapy with allogenic canine periodontal ligament‐derived cells in periodontal regeneration of critical size defects
Authors: Nuñez Javier , Sanchez Nerea , Vignoletti Fabio , Sanz‐Martin Ignacio , Caffesse Raul , Santamaria Silvia , Garcia‐Sanz Jose A. , Sanz Mariano
Published: December 2017

Aim

The objective of this in vivo experimental study to evaluate the regenerative potential of a cell therapy combining allogenic periodontal ligament‐derived cells within a xenogeneic bone substitute in a similar experimental model.

Methods

In nine beagle dogs, critical size 6‐mm supra‐alveolar periodontal defects were created around the PIII and PIV. The resulting supra‐alveolar defects were randomly treated with either 1.4 × 106 allogenic canine periodontal ligament‐derived cells seeded on de‐proteinized bovine bone mineral with 10% collagen (DBBM‐C) (test group) or DBBM‐C without cells (control group). Specimens were obtained at 3 months, and histological outcomes were studied.

Results

The histological analysis showed that total furcation closure occurred very seldom in both groups, being the extent of periodontal regeneration located in the apical third of the defect. The calculated amount of periodontal regeneration at the furcation area was comparable in both the test and control groups (1.93 ± 1.14 mm (17%) versus 2.35 ± 1.74 mm (22%), respectively (p = .37). Similarly, there were no significant differences in the amount of new cementum formation 4.49 ± 1.56 mm (41%) versus 4.97 ± 1.05 mm (47%), respectively (p = .45).

Conclusions

This experimental study was unable to demonstrate the added value of allogenic cell therapy in supra‐crestal periodontal regeneration.
Early second trimester maternal serum markers in the prediction of gestational diabetes mellitus
Authors: Zhao Baihui , Han Xiujun , Meng Qing , Luo Qiong
Published: December 2017

Aims/Introduction

To determine whether maternal serum markers in the early second trimester are useful for prediction of gestational diabetes mellitus (GDM).

Materials and methods

A total of 876 singleton pregnancies were recruited in the present study. Blood samples were collected during 16–20 gestational weeks. GDM women were diagnosed by an oral glucose tolerance test during 24–28 gestational weeks. A total of 56 women with GDM and 73 healthy pregnant women were selected. Maternal serum concentrations of placental protein 13 (PP13), pentraxin 3 (PTX3), soluble fms‐like tyrosine kinase‐1 (sFlt‐1), myostatin and follistatin (FST) were detected at 16–20 weeks’ gestation. All of these markers concentrations were expressed as multiples of the medians. The Mann–Whitney U‐test was used for comparison of the multiples of the medians of different concentrations of these five serum markers between the GDM group and the control group. Receiver operating characteristic curve analysis was applied to assess the sensitivity and specificity of significant serum markers from a Mann–Whitney U‐test comparison.

Results

Compared with healthy pregnancies, the serum levels of PP13, PTX3, sFlt‐1, myostatin and FST in the early second trimester were significantly increased in patients who had developed GDM late. In screening for GDM by PP13, PTX3, sFlt‐1, myostatin and FST, the detection rates were 92.3, 94.9, 94.9, 92.5 and 92.3%, respectively at 80% specificity. PTX3 and sFlt‐1 were the most sensitive markers.

Conclusions

Maternal serum markers including PP13, PTX3, sFlt‐1, myostatin and FST increase in the early second trimester of women with GDM. These five markers, especially PTX3 and sFlt‐1, could have the value of prediction for those patients who would develop GDM in the late second trimester.
Insulin deficiency with and without glucagon: A comparative study between total pancreatectomy and type 1 diabetes
Authors: Niwano Fumimaru , Hiromine Yoshihisa , Noso Shinsuke , Babaya Naru , Ito Hiroyuki , Yasutake Sara , Matsumoto Ippei , Takeyama Yoshifumi , Kawabata Yumiko , Ikegami Hiroshi
Published: December 2017

Aims/Introduction

Patients with a total pancreatectomy and type 1 diabetes are similar in regard to absolute insulin deficiency, but different in regard to glucagon, providing a unique opportunity to study the contribution of glucagon to glucose metabolism in an insulin‐dependent state. The aim of the present study was to investigate the contribution of glucagon to glucose homeostasis in complete insulin deficiency in vivo.

Methods

A total of 38 individuals with a complete lack of endogenous insulin (fasting C‐peptide <0.0066 nmol/L) and whose glycemic control was optimized with an insulin pump during hospitalization were retrospectively studied. The basal insulin requirement, time‐to‐time adjustment of the basal insulin infusion rate, prandial insulin requirement and fasting plasma glucagon were compared between patients with a total pancreatectomy (n = 10) and those with type 1 diabetes (n = 28) after achievement of optimal glycemic control.

Results

Total daily insulin (P = 0.03) and basal insulin (P = 0.000006), but not prandial insulin requirements, were significantly lower in total pancreatectomy patients than in type 1 diabetes patients. The basal percentage (basal insulin/total daily insulin) was also significantly lower in total pancreatectomy patients than in type 1 diabetes patients (15.8 ± 7.8 vs 32.9 ± 10.1%, P = 0.00003). An increase in the insulin infusion rate early in the morning was not necessary in most patients with a pancreatectomy. The fasting plasma glucagon concentration was significantly lower in total pancreatectomy patients than in type 1 diabetes patients (P = 0.00007), and was positively correlated with the basal insulin requirement (P = 0.038).

Conclusions

The difference in insulin requirements between total pancreatectomy and type 1 diabetes patients suggests a contribution of glucagon to the basal insulin requirement and dawn phenomenon.
Can Ebola virus evolve to be less virulent in humans?
Authors: Sofonea M. T. , Aldakak L. , Boullosa L. F. V .V. , Alizon S.
Published: December 2017

Understanding Ebola virus (EBOV) virulence evolution not only is timely but also raises specific questions because it causes one of the most virulent human infections and it is capable of transmission after the death of its host. Using a compartmental epidemiological model that captures three transmission routes (by regular contact, via dead bodies and by sexual contact), we infer the evolutionary dynamics of case fatality ratio on the scale of an outbreak and in the long term. Our major finding is that the virus's specific life cycle imposes selection for high levels of virulence and that this pattern is robust to parameter variations in biological ranges. In addition to shedding a new light on the ultimate causes of EBOV's high virulence, these results generate testable predictions and contribute to informing public health policies. In particular, burial management stands out as the most appropriate intervention since it decreases the of the epidemics, while imposing selection for less virulent strains.
Interactions between host sex and age of exposure modify the virulence–transmission trade‐off
Authors: Gipson S. A. Y. , Hall M. D.
Published: December 2017

The patterns of immunity conferred by host sex or age represent two sources of host heterogeneity that can potentially shape the evolutionary trajectory of disease. With each host sex or age encountered, a pathogen's optimal exploitative strategy may change, leading to considerable variation in expression of pathogen transmission and virulence. To date, these host characteristics have been studied in the context of host fitness alone, overlooking the effects of host sex and age on the fundamental virulence–transmission trade‐off faced by pathogens. Here, we explicitly address the interaction of these characteristics and find that host sex and age at exposure to a pathogen affect age‐specific patterns of mortality and the balance between pathogen transmission and virulence. When infecting age‐structured male and female Daphnia magna with different genotypes of Pasteuria ramosa, we found that infection increased mortality rates across all age classes for females, whereas mortality only increased in the earliest age class for males. Female hosts allowed a variety of trade‐offs between transmission and virulence to arise with each age and pathogen genotype. In contrast, this variation was dampened in males, with pathogens exhibiting declines in both virulence and transmission with increasing host age. Our results suggest that differences in exploitation potential of males and females to a pathogen can interact with host age to allow different virulence strategies to coexist, and illustrate the potential for these widespread sources of host heterogeneity to direct the evolution of disease in natural populations.
Factors affecting readiness for discharge and perceived social support after childbirth
Authors: Yanıkkerem Emre , Esmeray Nicole , Karakuş Aslı , Üstgörül Sema , Baydar Özge , Göker Aslı
Published: December 2017

Aims and objectives

To evaluate the factors affecting readiness for discharge and perceived social support after childbirth.

Background

Many women still die during and following pregnancy and childbirth. Both early and late discharges are conflicting issues in the world. Evaluation of the readiness for discharge in terms of patient safety, satisfaction, physical, emotional, psychological and social aspects is important.

Design

Descriptive and cross‐sectional study.

Methods

The study was carried out with 610 women in the early postpartum period at two hospitals in Turkey between October 2014–March 2015 using Readiness for Hospital Discharge Scale–New Mother Form and Multidimensional Scale of perceived social support.

Results

The mean scores for Readiness for Hospital Discharge Scale–New Mother Form and Multidimensional Scale of perceived social support were found as 163.5 (SD: 34.1) and 64.2 (SD: 18.8), respectively. Women who were discharged from Merkezefendi Hospital, women who had one child or one pregnancy and women or baby who experienced complication during or after birth had lower scores on Readiness for Hospital Discharge Scale–New Mother Form. Women who received information about the postpartum period had significantly higher scores on the total Readiness for Hospital Discharge Scale–New Mother Form than women did not (165.5 ± 33.8 vs 151.1 ± 36.1). Personal status, knowledge and total score of the Readiness for Hospital Discharge Scale–New Mother Form were significantly higher in women who were ready for discharge.

Conclusions

Findings provide vital information that can inform nursing clinical practice, especially related to readiness for discharge protocols and developing strategies for women, who had low sociodemographic backgrounds, did not have any information about postpartum period and were not ready for discharge.

Relevance to Clinical Practice

The mother and family face with postpartum difficulties on their own when early discharge takes place. Providing postpartum care services plays an important role for maternal–child health.
Benefit finding for Chinese family caregivers of community‐dwelling stroke survivors: A cross‐sectional study
Authors: Mei Yongxia , Wilson Susan , Lin Beilei , Li Yingshuang , Zhang Zhenxiang
Published: December 2017

Aims and objectives

To identify whether benefit finding is a mediator or moderator in the relationship between caregiver burden and psychological well‐being (anxiety and depression) in Chinese family caregivers of community‐dwelling stroke survivors.

Background

Family caregivers not only bear a heavy burden, a high level of anxiety and depression, but also experience benefit finding (positive effects result from stressful events). However, the relationships among benefit finding, caregiver burden and psychological well‐being in Chinese family caregivers are not well known.

Design

This study was a cross‐sectional correlational design.

Methods

Caregivers (n = 145) of stroke survivors were recruited from two communities in Zhengzhou, China. Data were collected by face‐to‐face interviews with structured questionnaires, examining caregiver burden, benefit finding and psychological well‐being of caregivers. A hierarchical regression analysis explored whether caregiver burden and benefit finding were associated with anxiety and depression of caregivers. The moderator role of benefit finding was examined by testing the significance of the interaction between caregiver burden and benefit finding. A mediational model was used to test benefit finding as a mediator between caregiver burden and psychological well‐being of caregivers using process in spss 21.0.

Results

Caregiver burden and benefit finding were significantly associated with both anxiety and depression of caregivers. Benefit finding did not portray a moderating role, but portrayed the mediator role in the relationship between caregiver burden, anxiety and depression in caregivers.

Conclusion

This study provides the preliminary evidence to nurses that intervention focus on benefit finding may help improve the psychological well‐being of caregivers.

Relevance to clinical practice

This study offers nurses rational for assessing caregiver's negative emotions and benefit finding. By targeting benefit finding, the nurse may guide caregivers in benefit identification and implement interventions to reduce anxiety, depression and caregiver burden.
Transmission of reduction‐oriented crafting among colleagues: A diary study on the moderating role of working conditions
Authors: Demerouti Evangelia , Peeters Maria C. W.
Published: December 2017

Zooming into reduction‐oriented job crafting among employees, next to minimizing demands (i.e., making a job less strenuous), we introduced optimizing demands (i.e., simplifying the job and making work processes more efficient) and suggested that optimizing demands should be positively related to work engagement, whereas minimizing demands negatively related to work engagement. Moreover, we suggested that both forms of reduction‐oriented crafting can be transferred among colleagues, and this will particularly occur in jobs that are high on demands (workload and emotional demands), low on resources (autonomy), and when the colleagues have a high‐quality relationship. We examined these hypotheses among 65 dyads of employees who filled in a general questionnaire and a diary for three working days. Multilevel analyses supported the transmission of both job crafting dimensions among colleagues. Moreover, there is more transmission of minimizing demands among colleagues when workload and emotional demands are high and autonomy is low. Additionally, optimizing demands was transmitted among colleagues when autonomy was low and quality of relationship with colleague was high. Optimizing demands was positively related to work engagement, whereas minimizing demands was unrelated to work engagement. These findings imply that optimizing demands is a favourable behaviour and can be transmitted among colleagues under specific conditions.

Practitioner points

Working smarter is related to higher work engagement

Employees model their colleague's proactive behaviour

Unfavourable working conditions stimulate modelling behaviour of colleagues
Experiences of adults who as children lived with a parent experiencing mental illness in a small‐scale society : A Qualitative study
Authors: Dam K. , Joensen D. G. , Hall E. O. C.
Published: December 2017

Accessible summary

What is known on the subject?

Children of parent with severe mental illness are often carrying a caring burden; they keep the illness in the family, are documented to be stigmatized, bullied and to take special attention to their mentally ill parent's health and well‐being.

Little is however known about these children's experiences when growing up in a small‐scale society.

What this study adds to existing knowledge?

Children's experiences of living with a parent with severe mental illness in the small‐scale society (Faroe Islands) are paradoxical, life is often unreasonable and evidently contradictory but anyway connected.

The results show that “everybody knows everybody” which refers to that, in the small‐scale society, it is difficult to be anonymous. The children were familiar with that people talked and had a prejudiced attitude; this resulted that the participants were constantly reminded of their mental ill parent's difference, and they were feeling less worthy than their pals.

Children of parents with severe mental illness in a small‐scale society need to support from the close family as well as mental healthcare professionals.

What are the implications for practice?

The study adds knowledge about the challenges that children of mental ill parents have to go through.

Dialogue among mental healthcare colleagues not only about caring for the sick parent but also about modes of caring for the children and the family at large would deepen the staff's knowing of the need for family‐centred care within mental health care.

Introduction

An estimated 23% of children worldwide live with a parent experiencing mental illness. These children are exposed to emotional and psychosocial challenges. Little is known about these children when living in small‐scale societies.

Aim

To explore how adults, who as children lived with parents experiencing mental illness in a small‐scale society, recalled their childhood life.

Method

Individual interviews with 11 adults were analysed using content analysis.

Results

Living as a child with a parent experiencing mental illness in a small‐scale society was described as “living in a paradox” which emerged from three categories: “intergenerational help and caring,” “barriers understanding parental illness” and “everybody knows everybody”. The children received little or no support from family members, nor from health and education professionals.

Discussion

In a small‐scale society, stigma surrounding mental illness is notable. Families often attempt to conceal mental illness from outsiders with negative or adverse effects on children.

Implications for practice

Mental healthcare professionals need to consider the needs of children who have parents experiencing mental illness. It is imperative for the well‐being of the patients’ children to support them in understanding what is happening, turn gossiping in a positive direction and address stigma in the communities.
Macroalgal spore dysfunction: ocean acidification delays and weakens adhesion
Authors: Guenther Rebecca , Miklasz Kevin , Carrington Emily , Martone Patrick T.
Published: December 2017

Early life stages of marine organisms are predicted to be vulnerable to ocean acidification. For macroalgae, reproduction and population persistence rely on spores to settle, adhere and continue the algal life cycle, yet the effect of ocean acidification on this critical life stage has been largely overlooked. We explicitly tested the biomechanical impact of reduced pH on early spore adhesion. We developed a shear flume to examine the effect of reduced pH on spore attachment time and strength in two intertidal rhodophyte macroalgae, one calcified (Corallina vancouveriensis) and one noncalcified (Polyostea robusta). Reduced pH delayed spore attachment of both species by 40%–52% and weakened attachment strength in C. vancouveriensis, causing spores to dislodge at lower flow‐induced shear forces, but had no effect on the attachment strength of P. robusta. Results are consistent with our prediction that reduced pH disrupts proper curing and gel formation of spore adhesives (anionic polysaccharides and glycoproteins) via protonation and cation displacement, although experimental verification is needed. Our results demonstrate that ocean acidification negatively, and differentially, impacts spore adhesion in two macroalgae. If results hold in field conditions, reduced ocean pH has the potential to impact macroalgal communities via spore dysfunction, regardless of the physiological tolerance of mature thalli.
Comparative study of sequence aligners for detecting antibiotic resistance in bacterial metagenomes
Authors: McCall C. , Xagoraraki I.
Published: December 2017

We aim to compare the performance of Bowtie2, bwa-mem, blastn and blastx when aligning bacterial metagenomes against the Comprehensive Antibiotic Resistance Database (CARD). Simulated reads were used to evaluate the performance of each aligner under the following four performance criteria: correctly mapped, false positives, multi-reads and partials. The optimal alignment approach was applied to samples from two wastewater treatment plants to detect antibiotic resistance genes using next generation sequencing. blastn mapped with greater accuracy among the four sequence alignment approaches considered followed by Bowtie2. blastx generated the greatest number of false positives and multi-reads when aligned against the CARD. The performance of each alignment tool was also investigated using error-free reads. Although each aligner mapped a greater number of error-free reads as compared to Illumina-error reads, in general, the introduction of sequencing errors had little effect on alignment results when aligning against the CARD. Given each performance criteria, blastn was found to be the most favourable alignment tool and was therefore used to assess resistance genes in sewage samples. Beta-lactam and aminoglycoside were found to be the most abundant classes of antibiotic resistance genes in each sample.

Significance and Impact of the Study

Antibiotic resistance genes (ARGs) are pollutants known to persist in wastewater treatment plants among other environments, thus methods for detecting these genes have become increasingly relevant. Next generation sequencing has brought about a host of sequence alignment tools that provide a comprehensive look into antimicrobial resistance in environmental samples. However, standardizing practices in ARG metagenomic studies is challenging since results produced from alignment tools can vary significantly. Our study provides sequence alignment results of synthetic, and authentic bacterial metagenomes mapped against an ARG database using multiple alignment tools, and the best practice for detecting ARGs in environmental samples.
High Efficacy of ombitasvir/paritaprevir/ritonavir plus dasabuvir in hepatitis C genotypes 4 and 1–infected patients with severe chronic kidney disease
Authors: Sanai Faisal M. , Alghamdi Abdullah S. , Afghani Ahmad A. , Alswat Khalid , AlZanbagi Adnan , Alghamdi Mosfer N. , AlMousa Abdallah , Aseeri Mohammed , Assiri Abdullah M. , Babatin Mohamed A.
Published: December 2017

Background & Aims

Limited data have shown high efficacy of co‐formulated ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) in the treatment of hepatitis C virus (HCV) genotype (GT)‐4, and combined with dasabuvir (DSV) in GT1 patients, with chronic kidney disease (CKD) stages 4‐5 (<30 mL/min/1.73 m2). We assessed real‐world safety and efficacy of OBV/PTV/r ± DSV in GT1‐ and 4‐infected patients.

Methods

In this observational cohort (n = 67), we enrolled stages 4‐5 CKD treatment‐naïve or Peginterferon/RBV‐experienced GT4‐infected patients (n = 32) treated for 12‐24 weeks with OBV/PTV/r ± RBV, and plus DSV in GT1 patients (n = 35, including 3 with GT1/4 co‐infection). RBV was dosed by physician discretion between 200 mg weekly and 200 mg daily. Primary endpoints were SVR12, calculated on intention‐to‐treat (ITT) basis, and occurrence of serious adverse events.

Results

The mean age of the cohort was 45.7 ± 12.7 years, 50.7% were females, 20.9% had cirrhosis, 35.8% were treatment‐experienced and 97% were on haemodialysis. Three patients (F4) received 24‐week treatment, 2 with GT4, and 1 with GT1a; and 19.4% were treated without RBV, including 9 GT1, and 4 GT4. Overall, 65 (97.1%) patients achieved SVR12, including 100% of those with a post‐treatment follow‐up (modified ITT analysis). Of the two patients without SVR12, one died from sepsis‐related complications and the other from a myocardial infarction 2 weeks after completing therapy. Grades 3‐4 anaemia occurred in 8.9%.

Conclusion

A 12‐week regimen of OBV/PTV/r ± DSV with or without RBV is highly effective with a favourable safety profile amongst GT4 and GT1 patients with CKD stages 4‐5. SVR12 rates were high regardless of patient characteristics.
Inpatient hospital burden of hepatitis C‐diagnosed patients with decompensated cirrhosis
Authors: McDonald Scott A. , Innes Hamish A. , Aspinall Esther J. , Hayes Peter C. , Alavi Maryam , Valerio Heather , Goldberg David J. , Hutchinson Sharon J.
Published: December 2017

Background & Aims

To describe the burden on inpatient hospital resources over time from patients diagnosed with hepatitis C virus (HCV) infection and who have reached the decompensated stage of cirrhosis (DC), as existing estimates of hospital stay in these patients are limited.

Methods

A retrospective longitudinal dataset was formed via record‐linkage between the national HCV diagnosis database and inpatient/daycase hospitalisation and death registers in Scotland. The study population consisted of HCV‐diagnosed patients with a first DC admission in 1996‐2013, with follow‐up available until 31 May 2014. We investigated and quantified the mean cumulative length of hospital stay, distributions over discharge diagnosis categories, and trends in admission rates.

Results

Among our study population (n = 1543), we identified 10 179 admissions with any diagnosis post‐first DC admission. Between 1996 and 2013 there was a 16‐fold rise in annual total admissions (from 112 to 1791) and an 11‐fold rise in hospital stay (719‐8045). When restricting minimum possible follow‐up to 2 years, DC patients (n = 1312) had an overall admission rate of 7.3 per person‐year, and spent on average 43 days (26 days during first 6 months) in hospital; for all liver‐related, liver‐related other than HCC/DC, and non‐liver related only admissions, this was 39, 14, and 5 days respectively.

Conclusions

HCV‐infected DC patients impose a considerable inpatient hospital burden, mostly from DC‐ and other liver‐related admissions, but also from admissions associated with non‐liver comorbidities. Estimates will be useful for monitoring the impact of prevention and treatment, and for computing the cost‐effectiveness of new therapies.
Review: Neurodegenerative processes in temporal lobe epilepsy with hippocampal sclerosis: Clinical, pathological and neuroimaging evidence
Authors: Tai X. Y. , Bernhardt B. , Thom M. , Thompson P. , Baxendale S. , Koepp M. , Bernasconi N.
Published: December 2017

Cognitive decline is increasingly described as a co‐morbidity of temporal lobe epilepsy (TLE). Mechanisms underlying cognitive impairment are not fully understood despite examining clinical factors, such as seizure frequency, and cellular mechanisms of excitotoxicity. We review the neuropsychometry evidence for progressive cognitive decline and examine the pathology and neuroimaging evidence supporting a neurodegenerative process in hippocampal sclerosis (HS)‐relatedTLE. Accelerated cognitive decline is described in groups of adultHS‐relatedTLEpatients. Large childhood studies show early onset of seizures result in poor development of verbal memory and a hindrance in achieving cognitive potential. We discussHSclassification according to different patterns of neuronal loss and correlation to post‐temporal lobectomy cognitive outcomes in refractoryTLEpatients. Factors such as lateralization ofHSpathology, neuronal density and subtype have correlated to cognitive outcomes with varying significance between different studies. Furthermore, alterations in neuronal maturity, regenerative capacity and aberrant connectivity appear to affect cognitive performance post‐operatively suggesting a complex multifactorial process. More recent studies have identified tau pathology being present inHS‐relatedTLEand correlated to post‐operative cognitive decline in some patients. A traumatic head injury‐related or novel tauopathy has been hypothesized as an underlying process. We discuss the value of prospective and cross‐sectional imaging in assessing cognition and review volumetric magnetic resonance studies with progressive ipsilateral hippocampal atrophy identified to correlate with seizure frequency. Finally, we consider the use of positron emission tomography biomarkers, such as tau tracers, and connectivity studies that may examinein vivopathways and further explore cognitive decline inTLE.
A massive ganglion cell tumor with unusual localization and favorable outcome
Authors: Afrantou Theodora , Natsis Konstantinos S. , Kyriazis Odyssefs , Ioannidis Panagiotis , Grigoriadis Nikolaos
Published: December 2017

Gangliocytomas are neoplasms of the central nervous system which are deriving from mature neuron cells. In the following case, we present the clinical, neuroimaging, and histopathological findings of a massive ganglion cell tumor involving the left cerebellar hemisphere with extension throughout the whole brainstem, including midbrain, pons, and medulla oblongata.
Light and growth form interact to shape stomatal ratio among British angiosperms
Authors: Muir Christopher D.
Published: December 2017

In most plants, stomata are located only on the abaxial leaf surface (hypostomy), but many plants have stomata on both surfaces (amphistomy). High light and herbaceous growth form have been hypothesized to favor amphistomy, but these hypotheses have not been rigorously tested together using phylogenetic comparative methods.

I leveraged a large dataset including stomatal ratio, Ellenberg light indicator value, growth form and phylogenetic relationships for 372 species of British angiosperms. I used phylogenetic comparative methods to test how light and/or growth form influence stomatal ratio and density.

High light and herbaceous growth form are correlated with amphistomy, as predicted, but they also interact; the effect of light is pronounced in therophytes (annuals) and perennial herbs, but muted in phanerophytes (shrubs and trees). Furthermore, amphistomy and stomatal density evolve together in response to light.

Comparative analyses of British angiosperms reveal two major insights. First, light and growth form interact to shape stomatal ratio; amphistomy is common under high light, but mostly for herbs. Second, coordinated evolution of adaxial stomatal density and light tolerance indicates that amphistomy helps to optimally balance light acquisition with gas exchange. Stomatal ratio may have potential as a functional trait for paleoecology and crop improvement.