bluuebunny/crossref_metadata_2025 huggingface dataset:
Presenting a new defamilization and familization framework for investigating the residualization of old‐age income security measures—The case study of Hong Kong
Authors: Yu Sam Wai Kam , Chau Ruby Chui Man , Jung Min‐a
Published: December 2019

Familization and defamilization studies are increasingly seen as an important component of welfare research. They are concerned with the threats to the welfare of individuals caused by involuntary participation in the unwanted family relationship. Moreover, they address the idea that governments have the potential to reduce these threats through the provision of welfare measures. This article contributes to the familization and defamilizaion studies with the focus on the link between these studies and the studies of residualization strategies. It carries out three analytical tasks. The first is to present a new defamilization and familization framework. The second is to demonstrate the usefulness of this framework in analyzing the problem of employing the residualization strategies to reform the old‐age income security system. Our focus is particularly on the insufficient sensitivity of these strategies to women's (and men's) diverse preferences relating to ways of organizing their family life. The third is to demonstrate the empirical significance of this framework. To meet this objective, we apply the framework to the investigation of two old‐age income security measures in Hong Kong—the Mandatory Provident Fund and the Comprehensive Social Security Assistance scheme.
Unexpected low expression of platelet fibrinogen receptor in patients with chronic myeloproliferative neoplasms: how does it change with aspirin?
Authors: Lucchesi Alessandro , Carloni Silvia , De Matteis Serena , Ghetti Martina , Musuraca Gerardo , Poggiaspalla Monica , Augello Accursio F. , Giordano Giulio , Fattori Pier P. , Martinelli Giovanni , Napolitano Roberta
Published: December 2019

This study was conducted to evaluate the expression of fibrinogen receptors on platelets of Philadelphia‐negative chronic myeloproliferative neoplasm (MPN) patients. We collected blood samples from 40 consecutive MPN patients and healthy volunteers. We performed flow cytometry analysis of P‐selectin expression and integrin beta‐3, activation of glycoprotein (GP) IIb/IIIa and fibrinogen receptor exposure (PAC‐1 binding). Surprisingly, we found a very low PAC‐1 binding capacity in MPN patients; however, the expression of PAC‐1 was almost completely recovered with aspirin intake. We hypothesize that the hypercoagulable states observed in MPN patients could depend on a primarily plasma‐driven impairment of fibrin turnover and thrombin generation.
Full‐zirconia single‐tooth molar implant‐supported restorations with angulated screw channel abutments: A 1‐year prospective case series study
Authors: Pol Christiaan W. P. , Raghoebar Gerry M. , Maragkou Zakelina , Cune Marco S. , Meijer Henny J. A.
Published: December 2019

Background

Implant‐supported restorations in the posterior region are subjected to various complications that could be prevented by changing either the design or the material.

Purpose

The aim of this prospective case series study was to evaluate full‐zirconia implant‐supported restorations with angulated screw channel abutments in the molar region of the maxilla and mandible and their effect on hard and soft peri‐implant tissues, during a 1‐year follow‐up period.

Materials and Methods

Thirty consecutive patients with a single missing molar, sufficient bone height, and implant site free of infection were included. Each patient was to receive a parallel‐walled implant with conical connection according to a two‐staged surgical protocol. After 3 months, a full‐contour screw‐retained zirconia restoration with angulated screw channel abutment was provided. Clinical and radiographic examinations were performed 1 and 12 months after placement of the restoration. Patients' satisfaction was scored prior to treatment and after 12 months with the restoration in function. Primary outcome measure was success of the restoration.

Results

All patients could be evaluated after 12 months. Success of the restorations was 100%. From loading to the 12‐month follow‐up, the mean marginal bone loss was 0.16 mm (SD: 0.26). Mean scores for plaque, calculus, peri‐implant mucosa, bleeding, and pocket probing depth were low, depicting healthy peri‐implant conditions. Patients' satisfaction was high and had improved after treatment.

Conclusion

Full‐contour zirconia implant‐supported restorations with angulated screw channel abutments in the molar region have an excellent clinical performance after 1 year of function.
Clinical encounters about obesity: Systematic review of patients' perspectives
Authors: Ananthakumar Thanusha , Jones Nicholas R. , Hinton Lisa , Aveyard Paul
Published: December 2019

Guidelines recommend clinicians intervene on obesity but it is unclear how people with overweight react. In this systematic review, we searched 20 online databases for qualitative studies interviewing people with overweight or obesity who had consulted a primary care clinician. Framework synthesis was used to analyse 21 studies to produce a new theoretical understanding. Consultations in which patients discussed their weight were more infrequent than patients would have liked, which some perceived was because they were unworthy of medical time; others that it indicated doctors feel being overweight is not a serious risk. Patients reported that doctors offered banal advice assuming that the patient ate unhealthily or was not trying to address their weight. Patients reported doctors assumed that their symptoms were due to overweight without a proper history or examination, creating concern that serious illness may be missed. Patients responded positively to offers of support for weight loss and active monitoring of weight. Patients with overweight internalize weight stigma sensitizing them to clues that clinicians are judging them negatively, even if weight is not discussed. Patients' negative experiences in consultations relate to perceived snap judgements and flippant advice and negative experiences appear more salient than positive ones.
Effects of sequential treatment with lixisenatide, insulin glargine, or their combination on meal‐related glycaemic excursions, insulin and glucagon secretion, and gastric emptying in patients with type 2 diabetes
Authors: Meier Juris J. , Menge Björn A. , Schenker Nina , Erdmann Silke , Kahle‐Stephan Melanie , Schliess Freimut , Kapitza Christoph , Nauck Michael A.
Published: December 2019

Aim

To examine the glucose‐lowering mechanisms of the glucagon‐like peptide‐1 receptor agonist lixisenatide after two subsequent meals and in combination with basal insulin.

Materials and Methods

Twenty‐eight metformin‐treated patients with type 2 diabetes were randomly assigned to treatment sequences with either lixisenatide or insulin glargine alone for 4 weeks, and a combination of both treatments for 4 weeks. Metabolic examinations were performed before and after each treatment period following breakfast and a late lunch 8 hours later.

Results

Lixisenatide mainly reduced postprandial glycaemia, while insulin glargine mainly reduced fasting glucose after breakfast (P < 0.05). This was partially preserved after a late lunch (P < 0.05). After breakfast, lixisenatide reduced insulin secretion and glucagon levels significantly. These effects were lost after a late lunch. Insulin glargine did not significantly reduce glucagon or insulin secretion. Gastric emptying was slowed by lixisenatide, but not by insulin glargine after breakfast. After the late lunch, lixisenatide slightly accelerated gastric emptying.

Conclusions

Lixisenatide decelerates gastric emptying after breakfast, thereby reducing glycaemic excursions, insulin secretion and glucagon levels. The glycaemic reduction persists until after a late lunch, despite accelerated gastric emptying. The combination with insulin glargine enhances the glucose‐lowering effect because of complementary modes of action.
Pollen availability for the Horned mason bee (Osmia cornuta) in regions of different land use and landscape structures
Authors: Kratschmer Sophie , Petrović Božana , Curto Manuel , Meimberg Harald , Pachinger Bärbel
Published: December 2019

1. Osmia cornuta is a generalist regarding its habitat requirements and is used for pollination in orchards. The species collects pollen from different plant taxa, but pollen richness and pollen quantity in a nest may be affected by land use and landscape structures.

2. The availability of pollen resources for O. cornuta was studied across different land use types (one urban, village‐structured, agricultural, and viticultural region each) by pollen analysis in the context of landscape structures.

3. In total, 16 pollen types were identified in 1180 brood cells of O. cornuta. On average (± SD), the highest pollen richness per region (n = 4) was found in the viticultural region (4.75 ± 0.96) and the lowest in the agricultural region (1 ± 2). Osmia cornuta collected predominantly pollen from the Sorbus‐pollen group, which includes Prunus species. Salix was primarily collected in the village‐structured and agricultural regions, and Quercus was frequently found in samples from the viticulture region. The highest mean (± SD) number of brood cells per region (n = 4) was found in the viticulture region (136.35 ± 57.45) and the lowest in the agricultural region (20.25 ± 40.5). Increasing proportions of green areas in urban and village‐structured regions affected the pollen richness positively, whereas agricultural areas had a negative impact on pollen richness and the number of brood cells.

4. It was concluded that the polylectic O. cornuta uses a wide range of flowering plants dependent on their availability. The maintenance of fruit trees as well as willow and oak trees enhances floral resources qualitatively and quantitatively for O.cornuta specifically in intensively farmed agricultural areas.
The cytokine IL‐17A as a marker of treatment resistance in major depressive disorder?
Authors: Nothdurfter Caroline , Milenkovic Vladimir M. , Sarubin Nina , Hilbert Sven , Manook André , Weigl Johannes , Almeqbaali Khalifa , Wetzel Christian H. , Rupprecht Rainer , Baghai Thomas C.
Published: December 2019

Major depression is a complex disease and—among others, inflammation appears to play an important role in its pathophysiology. In this study, we investigated a broad range of cytokines in depressed patients. Plasma levels of interleukin (IL)‐12/ IL‐23p40, IL‐15, IL‐16, IL‐17A, IL‐1α, IL‐7, tumor necrosis factorβ and vascular endothelial growth factor were compared in 48 patients suffering from major depression before, after one and after six weeks of antidepressive treatment in relation to therapy response. Interestingly, the level of IL‐17A turned out to rise significantly in the non‐responder group compared to responder during antidepressive treatment. IL‐17A is a pro‐inflammatory cytokine that initiates the production of other cytokines, thereby inducing and mediating immune response. It is also involved in allergic and autoimmune‐related diseases. The database investigating the role of IL‐17A in major depressive disorder has grown within the last few years comparing levels of this cytokine in depressed patients versus healthy subjects. However, little is known about the expression of IL‐17A during the course of antidepressive treatment. In summary, our study provides valuable evidence that this cytokine might serve as a marker of therapy resistance to antidepressants.
Computed tomography characteristics of equine paranasal sinus cysts
Authors: Ostrowska Justyna , Lindström Lisa , Tóth Tamás , Hansson Kerstin , Uhlhorn Margareta , Ley Charles J.
Published: December 2019

Background

Computed tomography (CT) is commonly used to investigate equine paranasal sinus disease, however, only limited information is available in the literature about the detailed CT appearance of equine paranasal sinus cysts.

Objectives

To investigate if paranasal sinus cysts have specific characteristics in CT images that allow differentiation from other sinus diseases.

Study design

Retrospective observational study.

Methods

Evaluation and comparison of CT studies of eight horses with surgically and/or histopathologically confirmed paranasal sinus cysts and 10 horses with other confirmed paranasal sinus diseases.

Results

A discrete hyperattenuating wall‐like structure was detected in the periphery of the sinus lesion in precontrast acquisition in 7/8 horses with paranasal sinus cysts. A similar wall‐like structure was detected in 3/10 horses with other sinus diseases, however, in contrast to horses with paranasal sinus cysts, two of these also had hyperattenuating regions within the contents of the sinus lesion. Bone destruction and formation affecting cancellous and cortical bone and dental disease were frequent in horses with paranasal sinus cysts. No significant difference in attenuation values was found when the fluid/soft tissue attenuation contents of lesions in horses with paranasal sinus cysts (mean 28.9 ± SD 9.2 HU) were compared with other sinus diseases when ethmoid haematomas were excluded (30.4 ± 12.9 HU, P = .8).

Main limitations

Low number of cases.

Conclusions

Detection of a hyperattenuating cystic wall is a helpful feature for identifying paranasal sinus cysts in CT images of horses. In contrast, measurement of attenuation values of the soft tissue/fluid contents of the sinus lesions was not helpful in identifying paranasal sinus cysts.
The effect of continuous digital hypothermia on lamellar energy metabolism and perfusion during laminitis development in two experimental models
Authors: Stokes Simon M. , Bertin Francois‐Rene , Stefanovski Darko , Poulsen Lea , Belknap James K. , Medina‐Torres Carlos E. , Pollitt Christopher C. , van Eps Andrew W.
Published: December 2019

Background

Continuous digital hypothermia (CDH) prevents lamellar failure in the euglycaemic hyperinsulinaemic clamp (EHC) and oligofructose (OF) laminitis models, but the mechanisms remain unclear.

Objectives

To evaluate the effects of CDH on lamellar energy metabolism and perfusion in healthy horses and during EHC and OF laminitis models.

Study design

In vivo experiment.

Methods

Archived samples were used from Standardbred geldings that received no treatment (CON) (n = 8) or underwent EHC (n = 8) or OF (n = 6) laminitis models. Both forelimbs were instrumented with a lamellar microdialysis system, and one forelimb was cooled (CDH) with the other maintained at ambient temperature (AMB). Microdialysate was collected every 6 hours and analysed for glucose, lactate and pyruvate concentrations and lactate to pyruvate ratio (L:P). Microdialysis urea clearance was used to estimate lamellar tissue perfusion. Data were analysed using a mixed‐effects linear regression model.

Results

Glucose did not change in CDH limbs relative to AMB in CON (P = .3), EHC (P = .3) or OF (P = .6) groups. There was a decrease in lactate (P < .001) and pyruvate (P < .01) in CDH limbs relative to AMB in all groups. L:P decreased in CON CDH relative to CON AMB (P < .001) but was not different in EHC (P = .6) and OF (P = .07) groups. Urea clearance decreased in CDH limbs relative to AMB in CON (P = .002) and EHC (P < .001), but not in OF (P = .4).

Main limitations

The EHC model may not mimic natural endocrinopathic laminitis.

Conclusions

CDH caused a marked decrease in lamellar glucose metabolism (CON, EHC and OF) and perfusion (CON and EHC) without affecting lamellar glucose concentration. Although cellular energy failure is not a primary pathophysiological event in EHC and OF laminitis models, CDH may act by limiting energy supply to pathologic cellular processes whilst preserving those critical to lamellar homoeostasis.
Inappropriate initial urinary catheter placement among older Chinese hospital inpatients: An observational study
Authors: Jiang Wei , Song Yunling , Zhang Huanhuan , Huang Rongzhong , Yin Ying , Tan Botao
Published: December 2019

Aim

The aim of this study is to evaluate incidences of inappropriate initial urinary catheter placements within an older inpatient cohort.

Methods

A total of 200 inpatients that received urinary catheterizations within 24 hours of admission were recruited for this observational study. The key demographic and clinical factors were recorded. Adverse outcomes were assessed by examining incidences of catheter‐associated urinary tract infection (CAUTI) during hospitalization, after transfer to skilled nursing facilities, second, duration of hospital stay and by scoring changes on the Katz Index of Independence in Activities of Daily Living. Correlative relationships between demographic data and clinical factors with adverse outcomes were analyzed.

Results

Inappropriate initial urinary catheterization in our cohort was approximately 39%. This was associated with elevated Charlson comorbidity index scores and increased dependency, with correlations to medical diagnosis. We also observed that the primary rationale for the procedure (inappropriate catheterization) was for neurogenic bladder (where intermittent catheterization was indicated) and in ‘convenience‐of‐care’ catheterizations. Inappropriate catheter placement was ultimately associated with an elevated CAUTI at point of discharge, with transfers to skilled nursing facilities and also with an increased duration of hospital stay.

Conclusions

Inappropriate catheter placement was prevalence in southwestern China and associated with adverse outcomes.
Bacillus Calmette–Guérin‐unresponsive non‐muscle‐invasive bladder cancer: Its definition and future therapeutic strategies
Authors: Kikuchi Eiji , Hayakawa Nozomi , Fukumoto Keishiro , Shigeta Keisuke , Matsumoto Kazuhiro
Published: December 2019

Bacillus Calmette–Guérin induction with or without maintenance is the gold standard therapy for intermediate‐/high‐risk non‐muscle‐invasive bladder cancer; however, one‐third of patients treated with adequate bacillus Calmette–Guérin therapy do not achieve sufficient responses, and this is referred to as “bacillus Calmette–Guérin failure.” The term, bacillus Calmette–Guérin failure, is ambiguous and includes a very heterogeneous population of patients. By strictly focusing on patients who are unlikely to benefit from additional bacillus Calmette–Guérin therapy and who need to be treated with radical cystectomy, the new concept of “bacillus Calmette–Guérin unresponsive” was recently proposed, and might accelerate the development of novel therapeutic options for bacillus Calmette–Guérin‐unresponsive disease. A promising therapeutic strategy for bacillus Calmette–Guérin‐unresponsive disease is the blockade of the programmed cell death‐1/programmed cell death‐ligand 1 pathway, which is considered to be activated by bacillus Calmette–Guérin therapy. Several large clinical trials have been carried out to assess the potential of programmed cell death‐1/programmed cell death‐ligand 1 blockade in bacillus Calmette–Guérin‐naïve high‐risk non‐muscle‐invasive bladder cancer and bacillus Calmette–Guérin‐unresponsive disease. Furthermore, clinical trials that are targeting bacillus Calmette–Guérin‐unresponsive disease with other strategies, such as vaccines, gene therapy, and targeted and cytotoxic therapies, are ongoing. The findings of these trials are awaited in order to establish appropriate bladder‐sparing approaches for patients with bacillus Calmette–Guérin‐unresponsive disease.
Regulation of barrier immunity and homeostasis by integrin‐mediated transforming growth factor β activation
Authors: McEntee Craig P. , Gunaltay Sezin , Travis Mark A.
Published: December 2019

Transforming growth factor β (TGF‐β) is a multifunctional cytokine that regulates cell growth, differentiation, adhesion, migration and death dependent on cell type, developmental stage, or tissue conditions. Various cell types secrete TGF‐β, but always as an inactive complex. Hence, for TGF‐β to function, this latent complex must somehow be activated. Work in recent years has highlighted a critical role for members of the αv integrin family, including αvβ1, αvβ3, αvβ5, αvβ6 and αvβ8 that are involved in TGF‐β activation in various contexts, particularly at barrier sites such as the gut, lung and skin. The integrins facilitating this context‐ and location‐specific regulation can be dysregulated in certain diseases, so are potential therapeutic targets in a number of disorders. In this review, we discuss the role of TGF‐β at these barrier sites with a focus on how integrin‐mediated TGF‐β activation regulates tissue and immune homeostasis, and how this is altered in disease.
Improving physical health outcomes for people with severe mental illness: A proof‐of‐concept study of nurse practitioner candidate practice
Authors: Furness Trentham , Giandinoto Jo‐Ann , Wordie‐Thompson Emily , Woolley Steve , Dempster Vesna , Foster Kim
Published: December 2019

People with severe mental illness have significantly reduced life expectancy and higher risk of cardiovascular diseases than the general population. There is a critical need for quality physical health care to improve consumers’ health outcomes. There is minimal knowledge, however, on the impact of mental health nurse practitioner candidate (NPC) practices on consumers’ health outcomes. The aim of this proof‐of‐concept study was to describe the impacts of NPC practices on the quality of physical healthcare provision and physical health outcomes (cardiovascular and cardiometabolic) of consumers in community mental health service settings. Using a mixed methods design, quantitative data were collected for 12 months prior to (Period 1), and 12 months during (Period 2), the candidacy period. Qualitative interviews were conducted with a purposive sample of n = 10 consumers to explore their perspectives on physical healthcare provision by the NPCs. During the 12‐month candidacy period, the number of metabolic monitoring assessments rose from n = 55 in Period 1 to n = 146 in Period 2 (P < 0.01, χ2 = 41.20). Advanced practices provided by NPCs included taking an extensive holistic history and clinical examination, ordering diagnostic pathology, and clinical simulation of physical health medication prescription (under medical supervision). Analysis of consumer interviews resulted in two themes: (i) positive and helpful NPC health care and (ii) improvements in physical and mental health. The findings add new knowledge on specialist mental health nurse practitioner candidate roles and demonstrate the benefits these roles can have in reducing the significant morbidity and mortality of mental health consumers.
Hidden, visceral and traumatic: a dramaturgical approach to men talking about their penis after surgery for penile cancer
Authors: Branney Peter , Witty Karl
Published: December 2019

Drawing upon concepts of expressive equipment and body image, the aim of this study is to explore how men diagnosed and treated for penile cancer construct their penis and its surgical disfigurement (penectomy). Using maximum variation sampling with the intention to acquire the broadest range of experiences of stage of disease and treatment, 27 cisgender men (aged 48–83, x=63) who had surgical treatment consented for their data to be archived for analysis. From a dramaturgical perspective, the constructionist thematic analysis explored direct and indirect talk about the penis after surgery. The analysis showed that through the graphic and sequential narratives of dismemberment revealed, participants constructed a post‐surgery period in which they both wanted and did not want to see their penis. Additionally, participants constructed themselves managing difficult emotions through others and seeing themselves being rejected by a potentially desiring (female) Other. The findings extend research on male genitals by showing how the post‐surgery penis can function as something hidden but visceral and traumatic when revealed. Importantly, this paper illustrates body image as expressive equipment where body and identity are formed in the image of manhood, which is an intersubjective (sexual) object between self and other.
Editing decolonised and Africanised texts for higher education institutions: a review of strategies
Authors: Scott Linda
Published: December 2019

In South Africa there is an urgent call for decolonisation and Africanisation in academia, including appeals for Africanised research. This study aims at investigating the role of the academic editor in ensuring effective cross‐cultural collaboration to guarantee that the curricula and higher education research remain rooted in Africa. In the context of higher education, while remaining invisible, editors should ensure they do not silence the African voice and are guided by the quest for decolonisation and Africanisation of academic research. This call for social change, brought about by the student‐led 2015 #FeesMustFall protest movement, needs to be promoted through the editing process

This study, which is a preliminary investigation into possible guidelines and strategies for editors involved in editing decolonised and African texts, identified a number of strategies for further exploration, namely: a journey of self‐exploration; changing the mindset and attitude of the editor; ensuring diverse representation on editorial boards; immersion of self in the indigenous text; creating new styles and terminologies; and collaboration with authors.
PNPLA3 I148M mediates the regulatory effect of NF‐kB on inflammation in PA‐treated HepG2 cells
Authors: Yuan Shuhua , Liu Hongxia , Yuan Ding , Xu Jing , Chen Yunzhi , Xu Xiao , Xu Fen , Liang Hua
Published: December 2019

Both PNPLA3 I148M and hepatic inflammation are associated with nonalcoholic fatty liver disease (NAFLD) progression. This study aimed to elucidate whether PNPLA3 I148M is involved in NF‐kB‐related inflammation regulation in NAFLD. HepG2 cells homozygous for the PNPLA3 I148M mutation were used. The human PNPLA3 promoter sequence was screened for NF‐kB binding sites using the MATCH and PATCH tools. NF‐kB‐mediated transcriptional regulation of the PNPLA3 gene was assessed by luciferase reporter assay, EMSA and ChIP‐qPCR. Wild‐type (I148I) and mutant (M148M) PNPLA3 were overexpressed using stable lentivirus‐mediated transfection. The pCMV vector and siRNA were transiently transfected into cells to direct NF‐kB overexpression and PNPLA3 silencing, respectively. A putative NF‐kB binding site in the human PNPLA3 promoter was shown to be necessary for basal and NF‐kB‐driven transcriptional activation of PNPLA3 and protein/DNA complex formation. Supershift analysis demonstrated a protein/DNA complex specifically containing the NF‐kB p65 and p50 subunits. ChIP‐qPCR confirmed the endogenous binding of NF‐kB to the human PNPLA3 promoter in response to NF‐kB overexpression and palmitic acid (PA) challenge. The silencing of PNPLA3 blocked the overexpression of NF‐kB or PA‐induced TNF‐α up‐regulation. Moreover, mutant PNPLA3 overexpression prevented NF‐kB inhibitor–induced down‐regulation of TNF‐α expression in PA‐treated HepG2 cells. Finally, the overexpression of mutant but not wild‐type PNPLA3 increased TNF‐α expression and activated the ER stress–mediated and NF‐kB‐independent inflammatory IRE‐1α/JNK/c‐Jun pathway. Human PNPLA3 was shown to be a target of NF‐kB, and PNPLA3 I148M mediated the regulatory effect of NF‐kB on inflammation in PA‐treated HepG2 cells, most likely via the IRE‐1α/JNK/c‐Jun ER stress pathway.
Synergistic effect of ozonated and electrolyzed water on the inactivation kinetics of Escherichia coli on goat meat
Authors: Degala Hema L. , Scott Jasmine R. , Rico Espinoza Francisco I. , Mahapatra Ajit K. , Kannan Govind
Published: December 2019

Ozonated and electrolyzed water have been reported to have bactericidal activities against most pathogenic and spoilage microorganisms associated with fresh meat and contact surfaces in meat processing facilities at room temperature. However, antimicrobial effects of these two treatments combined are not known. Therefore, the objective of this study was to evaluate the effectiveness of ozonated and electrolyzed water in combination for inactivating Escherichia coli K12 on goat meat. The combination of ozonated water and alkaline electrolyzed water resulted in higher log reductions (1.03 CFU/ml) compared to ozonated water alone (0.53 CFU/ml). Regression analysis performed using the GInaFiT tool showed that nonlinear Weibull models were more effective than log‐linear models for describing the inactivation kinetics of E. coli K12 on goat meat.
MoCA Test Mandatory Training and Certification: What Is the Purpose?
Authors: Nasreddine Ziad S.
Published: December 2019

See the Reply by Borson et al.
GP‐Led Deprescribing in Community‐Living Older Australians: An Exploratory Controlled Trial
Authors: Anderson Kristen , Freeman Christopher , Foster Michele , Scott Ian
Published: December 2019

OBJECTIVE

To assess feasibility, effectiveness, and safety of a multifaceted general practitioner (GP) led intervention to reduce potentially inappropriate polypharmacy in community‐living older people.

DESIGN

Pragmatic, controlled, pre‐post design.

SETTING

Five general practices in southeast Queensland, Australia.

PARTICIPANTS

Ten GPs from three practices, two pharmacists, and 78 patients comprised the intervention group, and 10 GPs from two practices and 67 patients comprised the usual care group. Patients were aged 65 years or older, receiving five or more regularly prescribed medicines, and capable of participating in telephone interviews in English.

INTERVENTION

A 5‐hour interactive deprescribing training workshop for clinicians; an extended deprescribing consultation between GPs and enrolled patients, entailing a comprehensive review of their medicines using a standardized software template codesigned by GPs; and comprehensive medicine review by a pharmacist, at the GP's discretion.

OUTCOME MEASURES

Primary outcome was mean difference in number of regular medicines deprescribed (ie, ceased or dose reduced) per patient over an 18‐week follow‐up period. Medicine‐specific and patient‐reported outcomes, safety, and process measures were also evaluated.

RESULTS

At study completion, mean (SD) number of regular medicines deprescribed per patient was 0.99 (1.23) in the intervention group vs 0.43 (0.84) in the usual care group, equaling a mean difference of 0.55 (95% confidence interval = −0.90 to −0.21; P = .002). Crude totals showed 77 of 649 (11.9%) vs 29 of 571 (5.1%) regular medicines deprescribed in intervention and usual care groups, respectively (P < .001). Supplements, gastric acid suppressants, statins, oral hypoglycemics, and diuretics were medicine classes more frequently deprescribed. There were no statistically significant between‐group differences in numbers of medicines commenced, self‐reported unplanned hospitalizations, or worsened health‐related quality of life. A subset of intervention patients reported greater certainty in the necessity and appropriateness of their medicines at study end.

CONCLUSION

The deprescribing intervention appears feasible, was modestly effective, and was not associated with any major safety events. J Am Geriatr Soc 68:403–410, 2020
Exploring the provision of diabetes nutrition education by practice nurses in primary care settings
Authors: Gianfrancesco C. , Johnson M.
Published: December 2019

Background

High‐quality nutrition education is recommended as an essential component of diabetes care. In the UK, there has been a gradual shift of inter‐professional boundaries with respect to providing nutritional care for people with type 2 diabetes. Only a minority now regularly receive advice from a dietitian. Instead, increased demands for nutrition education are being absorbed by practice nurses. The present study seeks to explore this situation through the views of practice nurses on the services that they provide and the issues they face.

Methods

A qualitative approach using semi‐structured interviews was employed. Practice nurses were recruited using purposive sampling, and nine were interviewed. Data were analysed using the Framework Method. The Theoretical Domains Framework from the COM‐B (‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’) model of behaviour change, as increasingly employed to explore the behaviour of healthcare professionals, was used to further frame the findings.

Results

Practice nurses reported that ongoing diabetes nutrition education only took place at annual review appointments and was limited to 5–10 min. They described how they are expected to take on a more advanced role in diabetes nutrition education than they can provide and are becoming increasingly isolated in this role as a result of a lack of time, practical and informational support, and training standards and provision.

Conclusions

A range of service improvements led by dietitians, which focus on strengthening the working environment and enhancing professional support available for practice nurses who provide diabetes nutrition education, could improve quality of care and health outcomes in people with diabetes within current time restraints.
Age‐related changes of tendon fibril micro‐morphology and gene expression
Authors: Ribitsch Iris , Gueltekin Sinan , Keith Marlies Franziska , Minichmair Kristina , Peham Christian , Jenner Florien , Egerbacher Monika
Published: December 2019

Aging is hypothesized to be associated with changes in tendon matrix composition which may lead to alteration of tendon material properties and hence propensity to injury. Altered gene expression may offer insights into disease pathophysiology and thus open new perspectives toward designing pathophysiology‐driven therapeutics. Therefore, the current study aimed at identifying naturally occurring differences in tendon micro‐morphology and gene expression of newborn, young and old horses. Age‐related differences in the distribution pattern of tendon fibril thickness and in the expression of the tendon relevant genescollagen type 1 (Col1), Col3, Col5, tenascin‐C, decorin, tenomodulin, versican, scleraxisandcartilage oligomeric matrix proteinwere investigated. A qualitative and quantitative gene expression and collagen fibril diameter analysis was performed for the most frequently injured equine tendon, the superficial digital flexor tendon, in comparison with the deep digital flexor tendon. Most analyzed genes (Col1, Col3, Col5, tenascin‐C, tenomodulin, scleraxis) were expressed at a higher level in foals (age ≤ 6 months) than in horses of 2.75 years (age at which flexor tendons become mature in structure) and older,decorinexpression increased with age. Decorin was previously reported to inhibit the lateral fusion of collagen fibrils, causing a thinner fibril diameter with increased decorin concentration. The results of this study suggested that reduction of tendon fibril diameters commonly seen in equine tendons with increasing age might be a natural age‐related phenomenon leading to greater fibril surface areas with increased fibrillar interaction and reduced sliding at the fascicular/fibrillar interface and hence a stiffer interfascicular/interfibrillar matrix. This may be a potential reason for the higher propensity to tendinopathies with increasing age.
Vichy mineralizing water with hyaluronic acid is effective and well tolerated as an adjunct to the management of various dermatoses and after esthetic procedures
Authors: Tan Jerry , Spada Julieta , Orlandi Cecilia , Kerscher Martina , Anfilova Maryna , Abdulla Sonya , Floriánová Adriana , Preisz Klaudia , Altmayer Anita , Delva Catherine , Kerob Delphine , Goldobina Maiia , Arenbergerová Monika , Tuz Svyatoslav , Araviiskaia Elena
Published: December 2019

Introduction

M89, containing 89% of Vichy mineralizing water and hyaluronic acid, has been developed to reinforce the skin barrier and to improve skin quality.

Aim

To assess efficacy and tolerability of M89.

Method

Observational survey of subjects with facial dermatoses or after esthetic procedures. M89 served as adjunct to conventional therapy. Clinician assessments of erythema, desquamation, irritation and patient‐reported dryness, burning, itching, and stinging/tingling were conducted at baseline and 4 weeks. At 1 week and 4 weeks, patient assessed tolerance and satisfaction with M89.

Results

A total of 1630 subjects participated; 92.5% were females. Mean age was 41.1 ± 11.3 years. Dermatological indications accounted for 32.5%, procedures for 67.5%. At 4 weeks, in subjects with dermatoses, erythema had resolved or improved in 68.0%, desquamation in 83.4%, and irritation in 93.3%. Dryness, burning, itching, and stinging/tingling scores had decreased by 63.8%, 81.8%, 70.9%, and 85.2%, respectively (all P ≤ .0001); 75.7% considered that their skin was sufficiently hydrated. In the procedure group, erythema had resolved or improved in 72.5%, desquamation in 75.2%, and irritation in 88.1%. Dryness, burning, itching, and stinging/tingling scores had decreased by 62.1%, 78.8%, 70.0%, and 84.2%, respectively (all P ≤ .0001); 74.1% considered that their skin was sufficiently hydrated. Almost all subjects reported soothed skin and satisfaction with product texture. Subject and investigator satisfaction was very high.

Conclusion

M89 significantly improves skin signs and symptoms after 4 weeks of continued use with no tolerance issues in subjects with dermatological indications. Moreover, subjects who have had recently undergone esthetic procedures M89 allowed a satisfying skin recovery.
The dissimilarity between myocardial infarction patients’ and spouses’ illness perception and its relation to patients’ lifestyle
Authors: Qin Xiangjun , Chen Jing , Suo Rongfei , Feng Liqin , Zhang Yuening , Jun Yan
Published: December 2019

Aim and objectives

To examine the dissimilarity between Chinese myocardial infarction (MI) patients’ and spouses’ illness perceptions (IPs), and to explore the relationship between patients’ IP, differences in couples’ IP and patients’ lifestyle after discharge.

Background

An individual's IP is affected and moderated by several factors, including the social context. One of the most influential members of the social network of patients is the spouse.

Design

Cross‐sectional design.

Methods

From April 2016–April 2017, 111 MI patients and their spouses were recruited. Before discharge from hospital, revised Illness Perception Questionnaire was administered to MI patients and their spouses separately. Two months after discharge, patients’ lifestyle was assessed using Health Promoting Lifestyle Profile II. The manuscript was organised according to STROBE guidelines.

Results

Spouses were more likely to believe that the illness would last for a long time, and patients perceived MI as being more controllable than their spouses did. The patient–spouse dissimilarity in the perception of consequences was negatively correlated with both nutrition and stress control behaviours. Patients in couples with more dissimilar perception of environmental factors as a cause were more likely to choose a healthy diet, while patients in couples with more dissimilar perceived treatment control were more able to control stress.

Conclusion

There are both similarities and dissimilarities between MI patients’ and spouses’ IP, and these dissimilarities contributed the majority of the explained variance in patients’ lifestyle after discharge.

Relevance to clinical practice

We should consider both couples when examining how a patient copes with a chronic illness.
Pricing schemes and market efficiency in private retirement systems
Authors: Flanders Sam , Nungsari Melati , Parada‐Contzen Marcela
Published: December 2019

We study the effects of different pricing schemes on the overall surplus in a privately managed retirement system with multiple service providers and switching costs. We develop a theoretical model based on the Chilean retirement system and consider a repeated auction for monopoly rights over new enrollees. We consider a dynamic model solved by pension fund administrators and by consumers. We compare three different pricing schemes: (a) fees on contributions, (b) fees on returns, and (c) a two‐part tariff including an auction over a guaranteed rate of return and allowing the firm to keep a portion of returns generated above this guaranteed rate. We also consider heterogeneity across individuals where agents earn high or low wages and high‐wage customers have proportionally lower switching costs due to more cost‐effective access to financial planning services. We find that auction participants subsidize consumers. We also treat savings as a durable good. In this case, pricing over returns worsens the switching related inefficiencies just described relative to pricing over contributions, despite the better incentives it provides. These inefficiencies can be resolved by allowing firms to price discriminate.
Coexpression of parental homeologs of leaf dissection related genes are associated with intermediate leaf forms of two allotetraploid yarrows (Achillea, Asteraceae)
Authors: Chen Duo , Ke Jin‐Xiu , Shen Chu‐Ze , Zhang Yu‐Fen , Guo Yan‐Ping
Published: December 2019

Allopolyploidization usually causes prominent genomic and transcriptional changes, and consequently, promotes the occurrence of phenotypic modifications and/or novelties. The tetraploid Achillea alpina L. species complex in the daisy family has been clearly studied concerning genetic variations and parentage. Population genetic data point to their progenitors as the diploid A. acuminata (Ledeb.) Sch. Bip. and A. asiatica Serg., and show that they have kept two distinct parental genomes relatively intact. Phenotypically, this complex displays a range of leaf form variation between the parental species. To better understand the source of variation at the transcriptional level of the allotetraploid species, we undertook morphological and gene expression analyses with regard to leaf dissection patterns. Morphometrics of leaf traits were carried out on two members of the tetraploid complex, A. alpina and A. wilsoniana Heimerl ex Hand.‐Mazz. and their diploid progenitor species, A. acuminata and A. asiatica. In parallel, the expression patterns of a dozen leaf dissection‐related genes were detected using reverse transcription real‐time quantitative polymerase chain reaction (RT‐qPCR) method. In the allotetraploid species, important leaf dissection‐related genes, such as NAM and PIN, were expressed at the intermediate level between the two diploid species. In general, most of the genes examined in the allotetraploids were expressed at mid‐parent levels or close to one of the parental species. Considering the relative contribution of parental homeologs to the allotetraploids, there is no consistent pattern among the genes analyzed. Overall, lack of transgressive expression of leaf dissection‐related genes could be correlated with the intermediate leaf phenotypes of the allotetraploids A. alpina and A. wilsoniana between their parental species.
Embodying empathy: A phenomenological study of physician touch
Authors: Kelly Martina , Svrcek Clark , King Nigel , Scherpbier Albert , Dornan Tim
Published: December 2019

Context

Empathic physician behaviour is associated with improved patient outcomes. One way to demonstrate empathy is through the use of non‐verbal communication (NVC) including touch. To date, research on NVC, and specifically touch, has been relatively limited in medicine, which is surprising given the central role it plays in conveying affective and empathic messages. To inform curriculum development on NVC, this study aimed to examine physicians' experiences of communicating by touch.

Methods

We conducted an interpretative phenomenological study. A total of 15 physicians (seven women and eight men) from different specialties, including both recent graduates and experienced doctors, described in detail specific instances of touch drawn from their clinical practices. Interview prompts encouraged participants to recall exact details such as the context, their relationship with the patient they touched and their physical experience of touching. Interviews (45‐100 minutes) were analysed with template analysis, followed by a process of dialectic questioning, moving back and forth between the data and researchers' personal reflections on them, drawing on phenomenological literature to synthesise a final interpretation.

Results

Participants described two dimensions of the experience of touch: ‘choosing and inviting touch’ and ‘expressing empathy.’ Touch was a personal and fragile process. Participants interpreted non‐verbal patient cues in order to determine whether or not touch was appropriate. They interpreted facial expressions and body language in the present to make meaning of patients' experiences. They used touch to share emotions, and to demonstrate empathy and presence. Participants' experiences of touch framed it as a form of embodied empathic communication.

Conclusions

Touch is a powerful form of NVC that can establish human connection. Phenomenological accounts of empathy, which emphasise its embodied intersubjective nature, can be used to theoretically enrich pedagogical approaches to touch in medical education and to deepen our understanding of empathy.
Chemotaxis and cyclic‐di‐GMP signalling control surface attachment of Escherichia coli
Authors: Suchanek Verena Maria , Esteban‐López María , Colin Rémy , Besharova Olga , Fritz Kirstin , Sourjik Victor
Published: December 2019

Attachment to surfaces is an important early step during bacterial infection and during formation of submerged biofilms. Although flagella‐mediated motility is known to be important for attachment of Escherichia coli and other bacteria, implications of motility regulation by cellular signalling remain to be understood. Here, we show that motility largely promotes attachment of E. coli, including that mediated by type 1 fimbriae, by allowing cells to reach, get hydrodynamically trapped at and explore the surface. Inactivation or inhibition of the chemotaxis signalling pathway improves attachment by suppressing cell reorientations and thereby increasing surface residence times. The attachment is further enhanced by deletion of genes encoding the cyclic diguanosine monophosphate (c‐di‐GMP)‐dependent flagellar brake YcgR or the diguanylate cyclase DgcE. Such increased attachment in absence of c‐di‐GMP signalling is in contrast to its commonly accepted function as a positive regulator of the sessile state. It is apparently due to the increased swimming speed of E. coli in absence of YcgR‐mediated motor control, which strengthens adhesion mediated by the type 1 fimbriae. Thus, both signalling networks that regulate motility of E. coli also control its engagement with both biotic and abiotic surfaces, which has likely implications for infection and biofilm formation.
Synthesis and structure−activity relationships of teixobactin
Authors: Karas John A. , Chen Fan , Schneider‐Futschik Elena K. , Kang Zhisen , Hussein Maytham , Swarbrick James , Hoyer Daniel , Giltrap Andrew M. , Payne Richard J. , Li Jian , Velkov Tony
Published: December 2019

The discovery of antibiotics has led to the effective treatment of bacterial infections that were otherwise fatal and has had a transformative effect on modern medicine. Teixobactin is an unusual depsipeptide natural product that was recently discovered from a previously unculturable soil bacterium and found to possess potent antibacterial activity against several Gram positive pathogens, including methicillin‐resistant Staphylococcus aureus and vancomycin‐resistant Enterococci. One of the key features of teixobactin as an antibiotic lead is that resistance could not be generated in a laboratory setting. This is proposed to be a result of a mechanism of action that involves binding to essential cell wall synthesis building blocks, lipid II and lipid III. Since the initial isolation report in 2015, significant efforts have been made to understand its unique mechanism of action, develop efficient synthetic routes for its production, and thus enable the generation of analogues for structure−activity relationship studies and optimization of its pharmacological properties. Our review provides a comprehensive treatise on the progress in understanding teixobactin chemistry, structure−activity relationships, and mechanisms of antibacterial activity. Teixobactin represents an exciting starting point for the development of new antibiotics that can be used to combat multidrug‐resistant bacterial (“superbug”) infections.