bluuebunny/crossref_metadata_2025 huggingface dataset:
An umbrella systematic review of drain fluid analysis in colorectal surgery for the detection of anastomotic leak: Not yet ready to translate research studies into clinical practice
Authors: Clark David A. , Steffens Daniel , Solomon Michael
Published: July 2021

Aim

Anastomotic leak (AL) is the most important complication of intestinal surgery with an anastomosis. Whilst a number of studies have defined risk factors for AL, frustratingly, low‐risk patients still develop AL. Studies have looked at drain fluid analysis for detection of AL, but these findings have failed to translate into routine clinical practice. This umbrella systematic review aims to provide an overview of the promising candidate biomarkers (BMs) that show potential to translate into clinical practice.

Methods

A systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane, KSR Evidence and the Epistemonikos databases on the 14 April 2021. Only systematic reviews of cohort or controlled studies measuring drain fluid biomarkers in humans were included. The methodological quality of the reviews was assessed using the AMSTAR 2 instrument. Clinical trial registries were searched for trials actively investigating drain fluid BMs. Candidate BMs were classified, and threshold values investigated.

Results

Nine systematic reviews, published between 2007 and 2020, met the inclusion criteria, and contained a total of 36 cohort studies. A total of 38 different BMs were studied. The most promising category of drain fluid BM was the extravasated intra‐luminal substances (EILS) and five registered trials of these BMs were found. Two of nine reviews were of moderate quality.

Conclusions

The majority of BMs show inconsistent threshold values and are in the experimental stage. A number are not readily available for adoption into routine clinical practice. Most do not state a cut‐off value to be considered as diagnostic.
Factors influencing engagement and utilisation of opium tincture‐assisted treatment for opioid use disorder: A qualitative study in Tehran, Iran
Authors: Noroozi Alireza , Conigrave Katherine M. , Mirrahimi Bahareh , Bastani Parsa , Charkhgard Nader , Salehi Mohammad , Narenjiha Hooman , Vaziri Alaleh , Kebriaeezadeh Abbas
Published: July 2021

Introduction

In response to a high burden of opioid use disorder (OUD), Iran established a network of opioid agonist treatment (OAT) centres beginning in 2002. To increase treatment diversity, particularly for patients who use opium as their drug of choice, opium tincture (OT)‐assisted treatment was introduced to the network. This study aimed to explore factors influencing OT‐assisted treatment selection for OUD in Tehran, Iran.

Methods

We conducted 54 in‐depth interviews with patients with OUD (n = 33), family members of patients (n = 9) and drug treatment providers (n = 12). Participants were recruited from 12 drug treatment centres across Tehran, between September and November 2019. All interviews were audio‐recorded, transcribed and coded in OpenCode 4.02 software and analysed using thematic analysis.

Results

Study participants more commonly reported individual‐level factors as facilitators (e.g. to reduce harms associated with illicit opioid use, achieve recovery through a gradual dose reduction regimen combined with Congress 60 recovery program) and structural level factors (e.g. low adoption by OAT system and lack of familiarity of treatment providers) as barriers for utilisation of OT‐assisted treatment regimens. OT was perceived to produce lower levels of physiological dependence than methadone, but the requirement for twice supervised dosing was restrictive. Low familial and community acceptance were also seen as barriers to access.

Discussion and Conclusions

This research identified a range of perceived benefits for OT‐assisted treatment ranging from harm reduction to an intermediate step to achieve recovery. However, several structural‐, individual‐, familial‐ and community‐level barriers impede its availability and acceptability.
Bridgehead effects distort global flows of alien species
Authors: Bertelsmeier Cleo , Ollier Sébastien
Published: July 2021

Aim

A major goal of invasion biology is to understand global species flows between donor and recipient regions. Our current view of such flows assumes that species are moved directly from their native to their introduced range. However, if introduced populations serve as bridgehead populations that generate additional introductions, tracing intercontinental flows between donor and recipient regions misrepresents the introduction history. Our aim was to assess to what extent bridgehead effects distort our view of global species flows.

Location

Global.

Methods

We separately mapped “flows” of 252 alien ant species established on one to six continents, representing a gradient of relatively certain to completely unreliable flows. To assess the importance of bridgehead effects in distorting our view of global species flows, we first quantified the proportion of cosmopolitan species per country. A high proportion of such species would indicate that exclusively mapped flows from the native range to these countries are unreliable. We then tested if the global flows obtained mapping species exotic in one continent to six continents differed and tested if these flows can be linked to global trade flows.

Results

In 83% of countries, more than 50% of alien ants were established on six continents, indicating that flows to these countries are unreliable. Flows of species established on a single continent were linked to global trade flows, while flows including cosmopolitan species were not linked to global trade.

Main conclusion

It is crucial to account for bridgehead effects when assessing the biogeography and intercontinental flows of alien species. This is urgent for improving our understanding of how species are moved around the planet.
Quantitative proteomic analysis of human peripheral nerves from subjects with type 2 diabetes
Authors: Ising Erik , Åhrman Emma , Thomsen Niels O. B. , Eriksson Karl‐Fredrik , Malmström Johan , Dahlin Lars B.
Published: July 2021

Aims

Diabetic peripheral neuropathy (DPN) is a common and severe complication to type 2 diabetes. The pathogenesis of DPN is not fully known, but several pathways and gene polymorphisms contributing to DPN are described. DPN can be studied using nerve biopsies, but studies on the proteome of the nerve itself, and its surrounding tissue as a whole, are lacking. Studies on the posterior interosseous nerve (PIN) have proposed PIN a useful indicator of DPN.

Methods

A quantitative mass spectrometry‐based proteomics analysis was made of peripheral nerves from age‐ and gender‐matched living human male tissue donors; nine type 2 diabetes subjects, with decreased sural nerve action potentials indicating DPN, and six controls without type 2 diabetes, with normal electrophysiology results.

Results

A total of 2617 proteins were identified. Linear regression was used to discover which proteins were differentially expressed between type 2 diabetes and controls. Only soft signals were found. Therefore, clustering of the 500 most variable proteins was made to find clusters of similar proteins in type 2 diabetes subjects and healthy controls.

Conclusions

This feasibility study shows, for the first time, that the use of quantitative mass spectrometry enables quantification of proteins from nerve biopsies from subjects with and without type 2 diabetes, which may aid in finding biomarkers of importance to DPN development.
Diabetes distress and glycaemic control in young adults with type 1 diabetes: Associations by use of insulin pumps and continuous glucose monitors
Authors: Nagel Kathryn E. , Dearth‐Wesley Tracy , Herman Allison N. , Smith Hannah G. , Whitaker Robert C.
Published: July 2021

Aims

We determined whether high diabetes distress (DD) in young adults with type 1 diabetes was associated with higher glycated haemoglobin (HbA1c) levels and whether this association was similar among those who were and were not using diabetes devices (insulin pumps and/or continuous glucose monitors [CGMs]).

Methods

In 2017, an online survey was completed by 423 of 743 (57%) young adults (19–31 years) with type 1 diabetes receiving care at a specialty clinic in New York City. HbA1c level was the primary outcome measure, and high DD (Diabetes Distress Scale score ≥3) was the primary exposure. Associations were adjusted for sociodemographic covariates.

Results

Of the 419 respondents with complete DD data, 59% were female and 69% were non‐Hispanic white. Both devices (pump and CGM) were used by 35%, either device by 42% and neither device by 24%. The mean (SD) HbA1c was 64 (19) mmol/mol (8.0 [1.7] %) and 24% had high DD. The adjusted mean (95% confidence interval) HbA1c was 10 (6, 14) mmol/mol (0.9 [0.5, 1.2] %) greater in those with high DD than in those without it. This HbA1c difference associated with high DD was similar regardless of device use: 9 (3, 15) mmol/mol (0.8 [0.3, 1.4] %) greater among those using both devices; and 9 (−0.9, 18) mmol/mol (0.8 [−0.1, 1.7] %) greater among those using neither device.

Conclusions

High DD in young adults requires more attention because it is associated with higher HbA1c levels, even among those using insulin pumps and CGMs.
Gene drive strategies of pest control in agricultural systems: Challenges and opportunities
Authors: Legros Mathieu , Marshall John M. , Macfadyen Sarina , Hayes Keith R. , Sheppard Andy , Barrett Luke G.
Published: July 2021

Recent advances in gene‐editing technologies have opened new avenues for genetic pest control strategies, in particular around the use of gene drives to suppress or modify pest populations. Significant uncertainty, however, surrounds the applicability of these strategies to novel target species, their efficacy in natural populations and their eventual safety and acceptability as control methods. In this article, we identify issues associated with the potential use of gene drives in agricultural systems, to control pests and diseases that impose a significant cost to agriculture around the world. We first review the need for innovative approaches and provide an overview of the most relevant biological and ecological traits of agricultural pests that could impact the outcome of gene drive approaches. We then describe the specific challenges associated with using gene drives in agricultural systems, as well as the opportunities that these environments may offer, focusing in particular on the advantages of high‐threshold gene drives. Overall, we aim to provide a comprehensive view of the potential opportunities and the remaining uncertainties around the use of gene drives in agricultural systems.
Love in the time of COVID‐19: A brief report on relationship and individual functioning among committed couples in the United States while under shelter‐in‐place orders
Authors: Weber Danielle M. , Wojda Alexandra K. , Carrino Emily A. , Baucom Donald H.
Published: July 2021

The COVID‐19 pandemic in the United States has changed many aspects of people's daily life, including increased time at home in response to shelter‐in‐place orders, heightened stress about health effects of COVID‐19, and shifts in other domains of life (e.g., employment). These lifestyle changes are likely to impact the well‐being of individuals and their romantic relationships. This investigation examined how COVID‐19 influenced couple and individual well‐being in real‐time during the early phase of the pandemic. Data were collected in early May 2020 during shelter‐in‐place orders in the United States. Participants in committed relationships (n = 332) completed an online survey assessing their experiences currently and before the pandemic. Results suggested that while couple functioning overall maintained or even improved, individual well‐being was more negatively impacted by the pandemic. Moreover, some groups who are at higher risk of a poor health outcome from COVID‐19 or experience unique challenges as a result of COVID‐19 reported worse outcomes (e.g., those whose employment changed) while others did not decline in their psychological and couple functioning (e.g., Black individuals and older individuals). These findings suggest that the pandemic has had varied impacts on couples and individuals, as well as across different virus‐related risk factors. Further research is needed to understand the nuanced effects of this pandemic on couples and individuals across time.
Hydrology drives variation in spawning phenologies and diversity of larval assemblages of Australian wet–dry tropical fish
Authors: Tyler Kyle J. , Wedd Dion , Crook David A. , Kennard Mark J. , King Alison J.
Published: July 2021

Setting ecologically based water‐extraction rules requires an understanding of the relationships between hydrology and the completion of aquatic organism life cycles. Successful reproduction of riverine fishes has been linked to hydrological variation across diverse climatic regions. However, the reproductive ecology for many species in wet–dry tropical northern Australia is poorly understood, and consequently there is little knowledge on how temporal (seasonal) and spatial hydrological variation influences fish reproduction in this region.

This study aimed to quantify the hydrology‐related reproductive ecologies of freshwater fish across the wet–dry seasonal cycle and between differing hydrological classes in a northern Australian river (Daly River, Northern Territory) subject to increasing interest in water extraction. Sampling of larval and juvenile fish was undertaken over 1 year at eight sites classified into perennial and intermittent flow types. Fish spawning phenologies were developed and spatial–temporal dynamics in larval fish assemblages were investigated using model‐based multivariate and univariate analyses.

Spawning occurred in all hydrological seasons, with low‐flow dry season periods identified as important for many fish taxa. For a different fish assemblage, spawning mostly occurred during high‐flow wet season periods. Larval assemblages in the wet season were more diverse than in the dry and wet–dry seasons. Perennial sites maintained higher diversity than intermittent sites year‐round; however, larvae were more abundant in intermittent sites for some taxa. Spatial and temporal differences in larval assemblages were largely explained by variation in the occurrence and relative abundance of three aseasonally spawning taxa (Craterocephalus spp., Melanotaenia spp. and Ambassis spp.) and the largely wet‐period spawning of Terapontidae spp.

These results add to growing evidence of variation in spawning phenologies among fish species and the use of multiple hydrological phases for aseasonal reproduction. The diverse range of hydrological conditions used for spawning and rearing, and the differences between hydrological river classes among taxa, suggests that water‐extraction and environmental flow rules should aim to maintain hydrological conditions catchment‐wide during both low and high‐flow periods to reduce the risk of impacting fish reproduction. In particular, the results suggest that if perennially flowing sites began to flow intermittently, such as through over‐extraction of water or due to climate change, less diverse fish assemblages may result.

This study expands our understanding of the relationships between hydrology and the reproductive ecology of freshwater fish in wet–dry tropical climates and may inform future ecologically based approaches to setting water‐extraction rules.
Drought stress mitigation by nitrogen in boreal forests inferred from stable isotopes
Authors: Dulamsuren Choimaa , Hauck Markus
Published: July 2021

Forest growth in most parts of the boreal zone is originally limited by low temperatures and low nitrogen availability. Due to the rapid climate warming at high latitudes, an increasing forest area is switching to drought limitation, especially in continental and southern parts of the boreal forest. Studies addressing this issue were mostly dendrochronological and remote‐sensing analyses focusing on climatic effects, but not answering the question whether drought is effective alone or in combination with nitrogen shortage at limiting the forests’ productivity and vitality. Here we show in a case study from larch forests of Mongolia with a combination of stable isotope analyses, tree‐ring analysis and bioindication of the local variability of livestock densities using epiphytic lichens that, in the studied highly drought‐prone forests at the southern fringe of the boreal forest in Inner Asia, the trees’ vulnerability to drought is modified by nitrogen fertilization from livestock kept in the vicinity and the edge of the forests. The most likely mechanism behind this drought‐nitrogen interaction is the reduction of stomatal conductance, which is known to be induced by low nitrogen levels in plants. Nitrogen fertilization by the livestock could, thus, shorten the times of stomatal closure and thereby increase tree growth, which we measured as radial stem increment. Even though the underlying mechanisms, which were so far examined in angiosperms, should be experimentally tested for conifers, our results indicate that focusing on water alone is not enough to understand the climate change response of drought‐limited boreal forests.
How biochar works, and when it doesn't: A review of mechanisms controlling soil and plant responses to biochar
Authors: Joseph Stephen , Cowie Annette L. , Van Zwieten Lukas , Bolan Nanthi , Budai Alice , Buss Wolfram , Cayuela Maria Luz , Graber Ellen R. , Ippolito James A. , Kuzyakov Yakov , Luo Yu , Ok Yong Sik , Palansooriya Kumuduni N. , Shepherd Jessica , Stephens Scott , Weng Zhe (Han) , Lehmann Johannes
Published: July 2021

We synthesized 20 years of research to explain the interrelated processes that determine soil and plant responses to biochar. The properties of biochar and its effects within agricultural ecosystems largely depend on feedstock and pyrolysis conditions. We describe three stages of reactions of biochar in soil: dissolution (1–3 weeks); reactive surface development (1–6 months); and aging (beyond 6 months). As biochar ages, it is incorporated into soil aggregates, protecting the biochar carbon and promoting the stabilization of rhizodeposits and microbial products. Biochar carbon persists in soil for hundreds to thousands of years. By increasing pH, porosity, and water availability, biochars can create favorable conditions for root development and microbial functions. Biochars can catalyze biotic and abiotic reactions, particularly in the rhizosphere, that increase nutrient supply and uptake by plants, reduce phytotoxins, stimulate plant development, and increase resilience to disease and environmental stressors. Meta‐analyses found that, on average, biochars increase P availability by a factor of 4.6; decrease plant tissue concentration of heavy metals by 17%–39%; build soil organic carbon through negative priming by 3.8% (range −21% to +20%); and reduce non‐CO2 greenhouse gas emissions from soil by 12%–50%. Meta‐analyses show average crop yield increases of 10%–42% with biochar addition, with greatest increases in low‐nutrient P‐sorbing acidic soils (common in the tropics), and in sandy soils in drylands due to increase in nutrient retention and water holding capacity. Studies report a wide range of plant responses to biochars due to the diversity of biochars and contexts in which biochars have been applied. Crop yields increase strongly if site‐specific soil constraints and nutrient and water limitations are mitigated by appropriate biochar formulations. Biochars can be tailored to address site constraints through feedstock selection, by modifying pyrolysis conditions, through pre‐ or post‐production treatments, or co‐application with organic or mineral fertilizers. We demonstrate how, when used wisely, biochar mitigates climate change and supports food security and the circular economy.
The reuse of avian samples: opportunities, pitfalls, and a solution
Authors: Brlík Vojtěch , Pipek Pavel , Brandis Kate , Chernetsov Nikita , Costa Fábio J. V. , Herrera M. L. Gerardo , Kiat Yosef , Lanctot Richard B. , Marra Peter P. , Norris D. Ryan , Nwaogu Chima J. , Quillfeldt Petra , Saalfeld Sarah T. , Stricker Craig A. , Thomson Robert L. , Zhao Tianhao , Procházka Petr
Published: July 2021

Tissue samples are frequently collected to study various aspects of avian biology, but in many cases these samples are not used in their entirety and are stored by the collector. The already collected samples provide a largely overlooked opportunity because they can be used by different researchers in different biological fields. Broad reuse of samples could result in multispecies or large‐scale studies, interdisciplinary collaborations, and the generation of new ideas, thereby increasing the quality and impact of research. Sample reuse could also reduce the number of new samples needed for a study, which is especially pertinent to endangered species where sample collection is necessarily limited. Importantly, reusing samples may be mutually beneficial for both the researchers providing samples and those reusing them. Here, we identify the benefits of sample reuse, describe currently available sources of already collected samples and their limitations, and highlight the wide range of potential applications in a single research field – avian isotopic ecology. To facilitate the reuse of avian samples worldwide and across research fields, we introduce the AviSample Network metadata repository. The main aims of this metadata repository are to collate and provide access to descriptions of available avian tissue samples. We contend that the creation of the AviSample Network metadata repository will provide the opportunity for new collaborations and studies. Moreover, we believe that this will help create research connections between ornithologists across the globe and encourage sample reuse in other fields.
The potential pigmentation‐related genes in spider mites revealed by comparative transcriptomes of the red form of Tetranychus urticae
Authors: Huo S.‐M. , Zhang Y.‐Y. , Song Z.‐R. , Xiong X.‐H. , Hong X.‐Y.
Published: July 2021

Colouration in spider mites is due to the presence of carotenoids with diverse colours, including yellows, oranges and reds. Tetranychus urticae has two main colour forms, red and green. Although a ketolase has been implicated in determining the colour, the underlying genetic basis of body colour divergence between the two forms has remained unclear. Based on a combination of comparative transcriptomes and RNA interference, we found that a gene encoding a cytochrome P450 enzyme of the CYP4 clan (CYP389B1) had remarkably high expression in adult females of the red T. urticae, as well as in hybrids obtained by crossing the red and green forms. Down‐regulation of this gene by RNA interference resulted in decreased accumulation of red pigment. Up‐regulation of the expressions of a scavenger receptor gene (SCARB1) and a mitochondrial glycine transporter (SLC25A38) also strongly contributed to red colour development in adult females. Suppressing the mRNA levels of these genes also resulted in reduced accumulation of red pigment in the three other spider mites with red body colour. Our results provide evidence that the body colour divergence between the two forms is caused by different expressions of pigmentation‐related genes, and point to a possible role of a novel cytochrome P450 gene (CYP389B1) in regulating red‐orange body colour. These findings expand the number of candidate cytochrome P450 genes involved in endogenous pigmentation and will help to understand their roles in determining colour patterns in mites and other species.
miRNA‐34 and miRNA‐210 target hexamerin genes enhancing their differential expression during early brain development of honeybee (Apis mellifera) castes
Authors: Vieira J. , Freitas F. C. P. , Cristino A. S. , Moda L. M. R. , Martins J. R. , Bitondi M. M. G. , Simões Z. L. P. , Barchuk A. R.
Published: July 2021

During the honeybee larval stage, queens develop larger brains than workers, with morphological differentiation appearing at the fourth larval phase (L4), just after a boost in nutritional difference both prospective females experience. The molecular promoters of this caste‐specific brain development are already ongoing in previous larval phases. Transcriptomic analyses revealed a set of differentially expressed genes in the L3 brains of queens and workers, which represents the early molecular response to differential feeding females receive during larval development. Three genes of this set, hex70b, hex70c and hex110, are more highly transcribed in the brain of workers than in queens. The microRNAs miR‐34, miR‐210 and miR‐317 are in higher levels in the queens' brain at the same phase of larval development. Here, we tested the hypothesis that the brain of workers expresses higher levels of hexamerins than that of queens during key phases of larval development and that this differential hexamerin genes expression is further enhanced by the repressing activity of miR‐34, miR‐210 and miR‐317. Our transcriptional analyses showed that hex70b, hex70c and hex110 genes are differentially expressed in the brain of L3 and L4 larval phases of honeybee queens and workers. In silico reconstructed miRNA–mRNA interaction networks were validated using luciferase assays, which showed miR‐34 and miR‐210 negatively regulate hex70b and hex110 genes by directly and redundantly binding their 3′UTR (untranslated region) sequences. Taken together, our results suggest that miR‐34 and miR‐210 act together promoting differential brain development in honeybee castes by downregulating the expression of the putative antineurogenic hexamerin genes hex70b and hex110.
Trauma‐informed qualitative research: Some methodological and practical considerations
Authors: Isobel Sophie
Published: July 2021

Mental health nurses who engage in research are likely to undertake research on sensitive topics, related to experiences of illness, care delivery and treatment. With recognition of the high prevalence of trauma in the lives of people who interact with mental health services, it is likely that many research participants will have experienced trauma in their lives and that while this may not be the focus of the research, sensitivity and awareness are required. Reference to ‘trauma‐informed’ approaches in research design and practice is emerging in fields such as trauma‐focused research and social sciences; however, it has not yet been applied to nurses. Trauma‐informed approaches can build upon existing ethical and methodological frameworks to inform how mental health nurses go about qualitative research and what they need to consider when doing so. This discursive paper explores some of the implications of awareness and sensitivity to trauma for research undertaken by mental health nurses, including practical and methodological considerations. Recommendations include training and structural supports for nurse researchers, collaborative research designs, consideration of the environments where research occurs, awareness of approaches to distress and inclusion of trauma sensitivity within research policies, frameworks and leadership, alongside vigilance to interpersonal approach and the establishment and protection of psychological safety throughout. Continuing to undertake research on topics, and with people, where trauma is present, is essential to ensure ongoing awareness. Many of the existing skills held by mental health nurses can also support research to be undertaken in trauma‐informed ways.
Pricing and entry strategies for competitive firms with optimistic entrant
Authors: Xu Peng , Xiao Tiaojun
Published: July 2021

Entrepreneurs are usually optimistic when entering an existing market. We introduce the entrant's optimism into the game models of entry deterrence to study the entry strategy of the potential entrant and the pricing (deterrence) strategy of the incumbent. Further, we examine the impacts of the entrant's optimism on the optimal decisions for both firms in the post‐entry game (Stackelberg price competition). In the price ex‐post setting, our analysis shows that in the post‐entry game, the entrant's optimism increases both firms’ prices and could benefit both firms. For the entry strategy, the high optimism of the entrant induces an incorrect entry decision; and our results reveal that the low optimism of the entrant benefits her entry. As for the pricing strategy, the incumbent will blockade the low optimistic entrant by keeping the normal price, impede the moderately optimistic entrant by lowering price, or accommodate the high optimistic entrant by setting the post‐entry price. Additionally, we consider the asymmetric information (about the entrant's type) setting, the price ex‐ante setting, and two optimistic firms setting. We find that the asymmetric information could not make the entrant benefit from her optimism, which is inconsistent with the symmetric information case; the entrant may miss the opportunity to enter the market in the price ex‐ante setting; and the incumbent's optimism makes him worse off.
Voices from the COVID‐19 frontline: Nurses’ trauma and coping
Authors: Foli Karen J. , Forster Anna , Cheng Chang , Zhang Lingsong , Chiu Yu‐Chin
Published: July 2021

Aim

To describe the experiences of frontline nurses who are working in critical care areas during the COVID‐19 pandemic with a focus on trauma and the use of substances as a coping mechanism.

Design

A qualitative study based on content analysis.

Methods

Data were collected from mid‐June 2020 to early September 2020 via an online survey. Nurses were recruited through the research webpage of the American Association of Critical Care Nurses as well as an alumni list from a large, public Midwest university. Responses to two open‐ended items were analysed: (1) personal or professional trauma the nurse had experienced; and (2) substance or alcohol use, or other mental health issues the nurse had experienced or witnessed in other nurses.

Results

For the item related to psychological trauma five themes were identified from 70 nurses’ comments: (1) Psychological distress in multiple forms; (2) Tsunami of death; (3) Torn between two masters; (4) Betrayal; and (5) Resiliency/posttraumatic growth through self and others. Sixty‐five nurses responded to the second item related to substance use and other mental health issues. Data supported three themes: (1) Mental health crisis NOW!!: ‘more stressed than ever and stretched thinner than ever’; (2) Nurses are turning to a variety of substances to cope; and (3) Weakened supports for coping and increased maladaptive coping due to ongoing pandemic.

Conclusions

This study brings novel findings to understand the experiences of nurses who care for patients with COVID‐19, including trauma experienced during disasters, the use of substances to cope and the weakening of existing support systems. Findings also reveal nurses in crisis who are in need of mental health services.

Impact

Support for nurses’ well‐being and mental health should include current and ongoing services offered by the organization and include screening for substance use issues.
Frontline nurses’ willingness to work during the COVID‐19 pandemic: A mixed‐methods study
Authors: Ke Qiaohong , Chan Sally Wai‐chi , Kong Yue , Fu Jianguo , Li Wengang , Shen Qu , Zhu Jiemin
Published: July 2021

Aim

Frontline nurses’ willingness to work has significant implications for maintaining workforce stability and quality of care during the COVID‐19 pandemic; however, few studies have investigated their willingness and the corresponding reasons. This study aims to examine frontline nurses’ willingness to work, identify its predictors and explore its corresponding reasons.

Design

A mixed‐methods design was conducted.

Methods

Based on a multilevel behavioural‐diagnostic model, a questionnaire survey was used to collect quantitative and qualitative data concurrently from 13 February to 24 February 2020 to explore frontline nurses’ willingness to work and the corresponding reasons in two hospitals in Wuhan, China. One was a designated hospital which only received COVID‐19 patients, and the other was built up temporarily for COVID‐19 patients.

Results

Of the 2014 participants, most (n = 1950, 96.8%) indicated their willingness to work, and a few (n = 64, 3.2%) expressed their unwillingness. Binary logistic regression analysis identified five predictors of participants’ willingness to work, including monthly family income, average working hours per shift, belief in their colleagues’ preparedness, belief in their hospitals’ preparedness and levels of depression. These indicators explained 27% of the variance (p < .05). Frontline nurses’ willingness to work mainly arose from professional commitment, patriotism and faith, while unwillingness to do so primarily stemmed from safety concerns and family responsibility.

Conclusion

Most frontline nurses were willing to work and showed great professional commitment.

Impact

Professional commitment and patriotism were two important individual‐level factors affecting frontline nurses’ willingness to work during a pandemic. Strategies should be implemented, such as appreciating and acknowledging their contribution, rewarding their valuable work, arranging reasonable working hours, enhancing colleagues’ and hospitals’ preparedness, and providing emotional support. Moreover, adequate personal protective equipment, self‐protection training and social support should be ensured to address frontline nurses’ safety concerns and family responsibility.
A challenging VT ablation with a large cardiac tumor
Authors: Lynes Carlos , Lancaster Megan , Aboud Asad A. , Stevenson William , Schlendorf Kelly , Richardson Travis
Published: July 2021

Introduction

Ventricular tachycardia (VT) normally occurs from an abnormal structural substrate.

Case

We report a case in which VT was caused by a large tumor in the interventricular septum. Surgical intervention was not an option due to the location of the tumor and its proximity to the coronary arteries.

Conclusion

The patient underwent ablation and upgrade to CRT before ultimately receiving a heart transplant.
Development of neuroactive steroids for the treatment of postpartum depression
Authors: Gunduz‐Bruce Handan , Takahashi Koji , Huang Ming‐Yi
Published: July 2021

Postpartum depression (PPD) is a common major depressive episode surrounding childbirth, with estimated rates ranging from 5.5% to 23.5% of all live births across Europe and the USA based on the presence of key symptoms. PPD has been associated with significant impairments in both maternal functioning and mother‐infant attachment, and these impairments can have lasting effects on the emotional and cognitive development of children. Although the precise pathophysiology of PPD is unknown, preclinical findings suggest that large fluctuations in neurosteroid hormone levels can induce physiological plasticity in the expression of functional GABAA receptors during pregnancy and the postpartum period, and that deficits in this plasticity may underpin a biological mechanism that contributes to the manifestation of depressive symptoms. Here, we review the controlled clinical trials to date that have assessed the efficacy of pharmacological treatments for PPD, including oestradiol, selective serotonin reuptake inhibitors, brexanolone (an iv formulation of allopregnanolone) and an investigational neuroactive steroid and GABAA positive allosteric modulator, zuranolone. Coupled with the GABAergic deficits implicated in major depressive disorder, these findings highlight not only the potential role of GABAA receptor plasticity in the pathophysiology of PPD, but also the novel therapeutic approach of using positive allosteric modulators targeting GABAergic transmission to treat women affected by PPD.
On the frontline treating COVID‐19: A pendulum experience—from meaningful to overwhelming—for Danish healthcare professionals
Authors: Rosted Elizabeth , Thomsen Thora Grothe , Krogsgaard Marianne , Busk Henriette , Geisler Anja , Thestrup Hansen Stine , Kjerholt Mette , Mortensen Camilla Becker , Thomsen Trine Hørmann , Beck Malene , Petersen Marian
Published: July 2021

Objectives

In the current study, we aimed to explore the experiences and attitudes among healthcare professionals as they transitioned from their familiar disciplines to respiratory medicine, intensive care or other departments during the first wave of the COVID‐19 pandemic.

Background

In preparation for the increasing number of patients suspected of having or who would be severely ill from COVID‐19, a major reconstruction of the Danish Healthcare System was initiated. The capacity of the healthcare system to respond to the unprecedented situation was dependent on healthcare professionals’ willingness and ability to engage in these new circumstances. For some, this may have resulted in uncertainty, anxiety and fear.

Design

The study was a descriptive study using semi‐structured focus group interviews.

Healthcare professionals (n = 62) from seven departments were included, and 11 focus group interviews were conducted. The focus group interviews took place during June 2020. Analyses was conducted using thematic analysis. The current study was reported using the consolidated criteria for reporting Qualitative research (COREQ).

Results

Healthcare professionals experiences was described by five themes: 1) Voluntary involvement, 2) Changes within the organisation, 3) Risks, 4) Professional identity and 5) Personal investment. Common to all five themes was the feeling of being on a pendulum from a meaningful experience to an experience of mental overload, when situations and decisions no longer seemed to be worthwhile.

Conclusions

Healthcare professionals experienced a pendulum between a meaningful experience and one of mental overload during the COVID‐19 pandemic. The swinging was conditioned by the prevailing context and was unavoidable.

Relevance to clinical practice. To balance the continuous pendulum swing, leaders must consider involvement, and to be supportive and appreciative in their leader style. This is consistent with a person‐centred leadership that facilitates a well‐adjusted work‐life balance and may help prevent mental overload developing into burnout.
Risk factors of medical device‐related pressure injury in intensive care units
Authors: Dang Wen , Liu Yuan , Zhou Qing , Duan Yuyu , Gan Huaxiu , Wang Lin , Zhu Qiongli , Xie Chunyan , Hu Ailing
Published: July 2021

Objectives

Intensive care unit (ICU) patients are at high risk of medical device related pressure injury (MDRPI). This study aims to ascertain the MDRPI prevalence in ICU patients and analyse the risk factors of MDRPI.

Background

The occurrence of MDRPI not only increases hospitalisation time with pain and economic burden, but also causes medical disputes. A better understanding of this condition will increase knowledge and facilitate the ability to recognise and prevent MDRPI for clinical nursing staff. However, there are few multicentre studies of MDRPI prevalence in ICU patients in China.

Design

A cross‐sectional study design was employed.

Methods

Data from 694 patients in 66 adult ICU at 30 hospitals in China were included between October 2018 and March 2019. The stage of each MDRPI was determined according to the definitions of National Pressure Ulcer Advisory Panel. The study methods were followed by the STORBE guidelines.

Results

The overall prevalence rate of MDRPI was 13.1% (91/694), with 98 anatomic locations in total. The most common stages of MDRPI were stage 1 (54.1%, 53/98), stage 2 (15.3%, 15/98) and mucosal membrane pressure injury (15.3%, 15/98). MDRPI mainly occurred in the finger (32.7%, 32/98), followed by nose (18.4%, 18/98). The prevalence rate of MDRPI caused by CPAP or BiPAP masks (25%) was highest. Lower Braden scores and having skin oedema were risk factors for MDRPI in adult ICU patients.

Conclusion

The prevalence of MDRPI in this study was still high. Nurses should take these related factors into consideration when taking care of ICU patients, and appropriate prevention measures should be adopted to decrease the prevalence of MDRPI.

Relevance to clinical practice: The study can help to improve the PI prevention efforts in ICU patients specific to medical device related PI.
Experiences of nurses working with COVID‐19 patients: A qualitative study
Authors: Akkuş Yeliz , Karacan Yasemin , Güney Rabiye , Kurt Berna
Published: July 2021

Background

The global COVID‐19 pandemic has led to massive disruptions in daily life, business, education, lifestyle and economies worldwide. Nurses are a professional group who care directly for COVID‐19 patients and thus face direct exposure to the virus. The nurses who work on the front lines during this period put their own well‐being at risk to care for these patients.

Purpose/Aim

The aim of this study was to identify the experiences and challenges faced by nurses working in pandemic clinics in Turkey during the COVID‐19 pandemic.

Methods

This qualitative study was based on semi‐structured in‐depth interviews conducted through the mobile application Whatsapp with 19 nurses who were actively working in pandemic clinics. Due to the pandemic, the snowball sampling method was used to reach the sample group. Interviews were continued until data saturation was achieved. All interviews were audio recorded and later transcribed. The study data were interpreted according to themes identified using thematic analysis. Throughout the study, the authors followed the COREQ checklist.

Results

The experiences of nurses caring for COVID‐19 patients were summarised into five major themes: psychosocial adaptation, protection, difficulty in care and treatment, access to information and working conditions.

Conclusion

Nurses caring for COVID‐19 patients in Turkey have been affected psychologically, socially and physiologically. They experienced stigmatisation, exhaustion and burnout. One of the biggest challenges for the nurses was difficulty providing physical care and treatment due to the use of personal protective equipment. Nurses want improved compensation in addition to applause from the public. Interventions to help bolster nurses’ psychological and physiological strength are recommended.

Relevance to clinical practice

This study emphasised nurses’ psychologically, socially and physiologically affected. Therefore, improvements in financial and moral support would provide psychological reinforcement for nurses during the epidemic. Informing the public is necessary to reduce the stigmatisation of nurses working in pandemic clinics.
Pedicle screws implantation in polymethylmethacrylate construct to stabilise sixth lumbar vertebral body fracture in dogs: 5 cases (2015‐2018)
Authors: Gougeon E. , Meheust P.
Published: July 2021

Objectives

To assess the feasibility and outcome of pedicle screw implantation on sixth lumbar vertebral body fractures.

Materials and Methods

Dogs with sixth lumbar vertebral body fractures stabilised using L6 and L7 (±L5) pedicular implantation via a dorsal approach preferentially and conventional vertebral body implantation otherwise were reviewed. Coaptation was made with bone cement. Complete neurological examination, pre and postoperative imaging consistent with L6 body fracture (radiographs ± CT scan) and follow up including clinical examination and radiographs 3 to 5 weeks post‐operatively were required as inclusion criteria. When available, owner interview and/or clinical examination and imaging (radiographs ± CT scan) at least 1 year after surgery were reported.

Results

Five dogs met the inclusion criteria. Dorsal pedicle screws implantation was feasible in all L7 vertebrae and in four L6 vertebrae. Adequate implantation was observed in all of the post‐operative radiographs and on all of the three CT scans available. At 3 to 6 weeks after surgery, neurological status and locomotion were normal in four dogs, while one dog suffering from severe sciatic neuropathy did not regain normal locomotion. At least 1 year after surgery, clinical outcome was excellent for four dogs and imaging by radiography and CT scan were available for three dogs and showed complete healing of the fracture and correct positioning of the implants. The dog suffering from sciatic neuropathy had a further trauma and was euthanased 7 weeks after the surgery.

Clinical Significance

In this case series, pedicle screw implantation achieved stabilisation of L6 vertebral body fractures, with full recovery observed in four out of five dogs. Further studies are required to confirm the safety and the effectiveness of this intervention.
Hepatitis C virus care cascade in persons experiencing homelessness in the United States in the era of direct‐acting antiviral agents: A scoping review
Authors: Del Rosario Aubrey , Eldredge Jonathan D. , Doorley Sara , Mishra Shiraz I. , Kesler Denece , Page Kimberly
Published: July 2021

The hepatitis C virus (HCV) care cascade has been well characterized in the general United States population and other subpopulations since curative medications have been available. However, information is limited on care cascade outcomes in persons experiencing homelessness. The main objective of this study was to map the available evidence on HCV care cascade outcomes in people experiencing homelessness in the U.S. in the era of direct‐acting antiviral agents (DAAs). Primary and secondary outcomes included linkage to care (evaluation by a provider that can treat HCV) and sustained virologic response (SVR) or cure. Exploratory outcomes included other cascade data, like treatment initiation, which precedes SVR. PubMed was the primary database accessed for this scoping review. We characterized the HCV care cascade in people experiencing homelessness using sources of evidence published in 2014 onwards that reported the proportions of persons who were linked to care, achieved SVR, and completed other cascade steps. We synthesized our results into a scoping review. The proportion of persons linked to care among chronically infected cohorts with unstable housing ranged from 29.3% to 88.7%. Among those chronically infected, 5%–58.8% were started on DAAs and 5%–50% achieved SVR. In conclusion, these results show that persons experiencing homelessness achieve high rates of linkage to care in non‐specialist community‐based settings compared to the general U.S. population pre‐DAAs. However, DAA initiation was found to be a rate‐limiting step along the care cascade, resulting in commensurate low rates of cure.