bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex, gender and hormones in dry eye disease
Authors: Versura Piera
Published: December 2019

A variety of sex related differences in the eye have been identified, and many of these have been associated to the effects of sex steroids. Significant sex related differences have been demonstrated in the anterior chamber, iris, ciliary body, lens, vitreous, and retina. In the ocular surface, sex differences have been found in the lacrimal gland, Meibomian gland, cornea, conjunctiva, nasolacrimal duct and tear film, with reference in particular to the anatomy, immunity, pain perception. It is believed that these differences may contribute, at least in part, to the female prevalence of Dry Eye Disease (DED). Not only androgens, estrogens and progestins, but also the hypothalamic‐ pituitary hormones, glucocorticoids, insulin, and thyroid hormones have an influence in the sex related variations. The role of X‐chromosome genes has also been demonstrated. Gender (the person's self‐representation as male or female) can also lead to related differences in DED, including health care utilization, treatment outcomes, impact on the quality of life. Overall, sex, hormones and gender play a key role in the difference of DED prevalence between men and women, and are important variable to be taken into account to validate the scientific research of DED in the future.
Involvement of the PlGF/VEGFR1 pathway in diabetes and type 1 retinal telangiectasia
Authors: Kowalczuk Laura
Published: December 2019

Among all the factors implied in the angiogenic balance, the vascular endothelial growth factors (VEGF) superfamily and their receptors (VEGFR) play a decisive role in microvascular permeabilization, as well as in neovascularization. It is well known that VEGF‐A promotes vascular permeability through VEGFR‐1 binding and activates cell proliferation through VEGFR‐2 binding. However, its homologous, placental growth factor (PlGF), specifically binds to VEGFR‐1 but not to VEGFR‐2. A number of studies have examined the role of PlGF in vascular retinal diseases and suggested that the PlGF‐ VEGFR‐1 pathway is involved in microvascular permeabilization and in telangiectasia. This presentation will focus on its role in diabetic retinopathy and in macular telangiectasia type 1.
Glaucoma genetics: Can we predict who will get glaucoma, and response to treatment?
Authors: Hammond Chris
Published: December 2019

Few environmental risk factors are known for glaucoma, in contrast to other common age‐related eye diseases such as AMD and cataract. With the advent of genome‐wide association studies (GWAS), we are increasingly understanding the importance of genetic factors influencing risk of glaucoma. This presentation will discuss results from the largest GWAS of intraocular pressure from the UK Biobank study of over 100 000 people, showing that ~700 common genetic risk variants can predict risk of glaucoma, with an AUC (area under the curve) for high‐tension glaucoma of 0.75 and for normal tension glaucoma of 0.70. Pharmacogenomics is an increasingly important arena, and I will present novel work in large population‐based studies exploring the prediction of response to prostaglandin agonists using genetics. The International Glaucoma Genetics Consortium GWAS of over 30 000 people with glaucoma and 300,000 controls is currently being analysed and preliminary results will be discussed.
Xeno‐free Cultivated Limbal Epithelial Stem Cell Transplantation: result of an ongoingphase I/II clinical study
Authors: Ni Dhubhghaill Sorcha
Published: December 2019

Limbal stem cell deficiency (LSCD) is a condition that results from a loss of limbal stem cells or a dysfunctional limbal microenvironment. The term refers to a highly heterogeneous group of pathologies ranging from acquired diseases such as chemical burns to severe autoimmune conditions, iatrogenic trauma and genetic abnormalities such as aniridia. Here we report the clinical results of an ongoing clinical trial (2015–2020) using a cultivated limbal epithelial transplant (CLET) for a variety of LSCD causes including chemical burns, thermal burns and aniridia, both unilateral and bilateral. Currently 28 CLET surgeries have been performed on 23 eyes, with a median follow up of 19 months (range 2‐42 months). Seventeen patients were treated with autologous CLET, 4 patients with allogenic CLET from a living‐related HLA‐matched donor and 2 patients with HLA‐matched cadaveric donor CLET. Five patients required a second CLET and an elective penetrating keratoplasty (PK) was offered least one year after the CLET. Eleven patients are currently graded as a total anatomical success (47.8%), two patients are grade as partial success (8.7%), eight cases were deemed total failures (34.8%) and two patients were excluded due to a complication (8.7%). BCVA, pain and photophobia outcomes denoting functional success are also presented.
The role of Pax6 transcription factor in development of the anterior segment
Authors: Kozmik Zbynek
Published: December 2019

Eye development is extremely sensitive to the levels of Pax6. Reduction in the levels of Pax6 in heterozygotes for a Pax6 null allele results in ocular abnormalities including Aniridia in humans and Small eye in mice and rat. In the complete absence of Pax6 protein in Pax6‐deficient mice lens induction does not occur, and the neural retina as well as retinal pigment epithelium do not differentiate. It is well established that Pax6 function is required both in the lens placode and in the optic vesicle. Conditional gene inactivation in mice concomitant with lens induction established the critical and cell‐autonomous role of Pax6 for subsequent lens formation. Similarly, optic vesicle deficient for Pax6 transcription factor fails to develop into a proper neural retina. We used CRISPR/Cas9 genome engineering to mutagenize Pax6 gene in a mouse model. We were able to generate novel alleles of Pax6 that manifest profound lens phenotypes without showing apparent phenotypic changes in the neural retina or retinal pigment epithelium. Our data indicate an extreme sensitivity of early stages of lens development for the presence of intact, fully functional Pax6 protein.
Clinical signs of paraproteinemic keratopathy
Authors: Lisch Walter
Published: December 2019

Monoclonal gammopathies are much more common than previously known in Ophthalmology. In the so‐called benign form or MGUS (Monoclonal Gammopathy of Undetermined Significance) different corneal opacities can be observed, in which the patients having no subjective symptoms or conspicuous systemic findings other than corneal opacities which were summarized as Paraproteinemic Keratopathy (PPK). It is therefore to be demanded that in all elderly patients with bilateral unclear corneal findings, Serum Protein Electrophoresis (SPE) should be performed to include or exclude monoclonal gammopathy.
OCT findings in keratoconus. OCT is better?
Authors: Wowra Bogumil
Published: December 2019

Keratoconus as corneal ectasia is could be difficult to diagnosing especially in early stages. OCT of anterior segment is very helpful to recognize early stages of KC and useful to observe progression of the corneal changes. OCT is simple, repetable and non invasive method. KC grading is automatically estimated and progression is visible.
IOP measurement and cornea: Methods and limitations
Authors: Grieshaber Matthias
Published: December 2019

The intraocular pressure is still the major risk factor for development and progression of glaucoma. For decades the Goldmann applanation tonometry has been the gold standard for measuring intraocular pressure; however, there are newer methods of measuring intraocular pressure, each one has advantages and disadvantages and depends on the corneal properties like thickness and stiffness. This talk will focus on the different methods and their limitations with regard to measuring intraocular pressure.
Immune mediators of host defence at the Ocular surface and Cornea
Authors: DUA Harminder
Published: December 2019

Vision is of paramount importance for survival of sighted species. The cornea, the clear ‘window’ of the eye is a key component in both transmission and focusing of light. Being at the interface with the environment, it constantly interacts with allergens, chemicals and microbes. Its challenge is to maintain functionality despite its avascularity. This is achieved by the cornea being part of the ocular surface (OS) unit. The OS is endowed by a wide range of cellular and humoral immune mediators that constitute ‘host defence’. The mononuclear (and polymorphonuclear) cells of the conjunctival substantia propria provide the full range of cellular immune responses of the afferent and efferent limbs. Lysozyme, complement, lactoferrin, complement and immunoglobulins are mediators of innate and acquired immune responses. Another key family of molecules are the antimicrobial peptides (AMPs). AMPs are ubiquitous natural effectors of innate immunity conserved across plants and animals. The have broad spectrum of microbicidal activity and serve several other non‐immune functions related to wound healing and metabolism. Over a dozen AMPs have been identified at the OS. Their characteristics and functions will be presented and their therapeutic potential in corneal defence will be discussed.
The aims and scopes of the ERN‐EYE
Authors: Liskova Petra
Published: December 2019

Introduction of the European Reference Network for rare and low prevalent eye disorders (ERN‐EYE) will be presented. Rare eye diseases display major heterogeneity and represent the leading cause of visual impairment in children and young adults. Significant barriers remain for early diagnosis, patient management and research. ERN‐EYE has been created to improve diagnosis and management of patients with rare ocular disorders as well as to raise awareness, facilitate research and introduction of novel therapies.
Introduction, classification, therapeutic options
Authors: Zografos Leonidas
Published: December 2019

The management of intraocular lymphomas is often challenging. Various therapeutic approaches are currently available and they can be applied in selected cases. The aim of this SIS is to put together ocular oncologists and hemato‐oncologists in order to discuss the best management technique in every individual case.
Professor Dr. Reimond Speleers, the sad story of the man of Katyn
Authors: De Sutter Edward
Published: December 2019

The sad story of Prof. Dr. med. Speleers with emphasis on his role in the Katyn Red Cross commission. Prof. Dr. Speleers was a Flemish ophthalmologist. He was born in 1876. He received his education in high school and at the university in French as it was the rule at those times in the kingdom of Belgium. He attended the Hirschberg Clinic in Berlin in the beginning of his ophthalmological career. He was involved in the struggle for Flemish independence and use of the local language Flemish or Dutch in the education especially at the Ghent University. At the University of Ghent the teaching language was French and during the war, like in Poland, the Germans ruled that the teaching language has to be the language of the region. After the war he was sentenced for life and as Hirschberg, Axenfeld and others removed from the Belgian Ophthalmological Society as a member. In Holland he continued his ophthalmological career and his fight for his people. During the Second World War, he was appointed again at the State University of Ghent as ophthalmological Professor. He was a member of the Red Cross investigation on the mass murder of Katyn in 1942 in Poland by the Soviet Army. He was imprisoned for life after the ww2 for taking part in that commission by the Belgian justice.
Corneal dystrophies as a cause of recurrent erosions
Authors: Lisch Walter
Published: December 2019

Especially in anteriorly located corneal dystrophies, recurrent erosions can be observed and are associated with many different histopathological and genetic etiologies: with microcysts in Meesmann corneal dystrophy (MECD) from KRT3 and KRT12 mutations, with aberrant epithelial basement membrane in epithelial basement membrane dystrophy (EBMD), with gradual scarring from COL17A1 mutation in epithelial recurrent erosions dystrophy (ERED), with distinct deposits in the five epithelial‐stromal TGFBI‐related corneal dystrophies, and with deposits and epithelial thinning in macular corneal dystrophy (MCD) from CHST6 mutations. Rarely does a secondary form occur in the Fuchs endothelial corneal dystrophy (FECD) due to an erosive rupture of an epithelial bleb.
One or many? Are there benefits for using test batteries for the classification of congenital colour vision deficiencies?
Authors: Jordan Gabriele
Published: December 2019

For reasons of safety or quality control many professions require their potential employees to have normal colour‐vision. A variety of screening tests for colour‐vision deficiencies (CVD) exist, but there is a clear trade‐off between reliability of diagnoses and practical efficiency. For example, the Ishihara Plates are praised for their high sensitivity, speed and ease of use and are the most common primary test in occupational settings. However, the test does not reliably classify type or severity of known CVDs, different versions may give slightly different results, and false positives are common. On the other hand, the gold standard for characterising CVD is the anomaloscope, where an individual’s Rayleigh match provides an index of the relative spectral sensitivities of the L and M cones and gives a definitive classification of CVD type and severity. However, the instrument is expensive, needs a highly experienced examiner and often requires extended testing time. More recent, sophisticated tests such as the ‘Cambridge Colour Test’ and the ‘Colour Assessment and Diagnosis’ test’ show good selectivity and specificity, but are expensive and therefore not widely used by many employers. Given the variety of choice in standardised tests available to recruiters, the presentation will consider the reliability and consistency in the classifications of CVD for a battery of potential tests.
How to properly assess a patient for biologic therapy
Authors: Carreño Ester
Published: December 2019

The presentation will focus in the relevant tests and investigations for the safe use of biologic therapy in non‐infectious uveitis. Biologic therapy when used appropriately in the treatment of non‐infectious uveitis is a very safe alternative, but some considerations are needed to take into account before starting treatment.
Filaggrin marker in ocular allergy
Authors: Heegaard Steffen
Published: December 2019

Background

Filaggrin (filament aggregating protein) is a filament‐associated protein that binds to keratin fibers in epithelial cells. Mutation of the filaggrin gene can interfere with the skin's ability to act as a barrier. Filaggrin also plays an important role in keeping the physiological acidic pH of the skin. This allows water to be lost from the skin, but also that bacteria can enter. This can lead to allergies, irritation and infection of the skin. Loss‐of‐function mutations in FLG, the human gene encoding profilaggrin and filaggrin, have been identified as the cause of severe forms of dry skin and/or eczem. These mutations, which are carried by up to 10% of people, also represent a strong genetic predisposing factor for atopic eczema, asthma and allergies. Around half of all those with the more severe forms of atopic eczema are thought to have a filaggrin deficiency.

Purpose

To investigate 13 French children with atopic excema for mutation of the filaggrin gene.

Results

Only one French child had mutation in FLG.

Discussion

The incidence of mutations in the filaggrin gene is much rarer in France in contrast to the Nordic countries where mutations are seen in 10%. The meaning of this will be evaluated and discussed.
Immunotherapy and systemic chemotherapy for the treatment of intraocular lymphoma. Indications and results
Authors: Soussain Carole
Published: December 2019

Primary vitreo‐retinal lymphoma (PVRL), which is part of the primary central nervous system lymphoma (PCNSL) group, is a rare presentation with a dismal prognosis. In addition to the functional prognosis on the vision, PVRL are at high risk of dissemination in the CNS. The therapeutic management of PVRL remains controversial, ranging from local treatment, systemic chemotherapy and even intensive chemotherapy with autologous stem cell transplantation. Targeted therapies have recently shown encouraging result in relapse or refractory PVRL. We will review the different options for systemic treatments of PVRL in front‐line and at relapse and highlight the needs for improving the outcome of patients with PVRL. Although intra‐ocular (IO) involvement of PCNSL does not appear to worsen the prognosis of PCNSL, the management of IO involvement is still controversial and suboptimal.
Retinal diseases after irradiation
Authors: Baillif Stephanie
Published: December 2019

"Radiation retinopathy is a slowly progressive, delayed‐onset occlusive microangiopathy of the retinal vasculature that occurs with variable latency after exposure of the retina to ionizing radiation. Within the retina, the posterior pole is particularly sensitive to this pathology. Radiation maculopathy has grave implications for visual prognosis. In this presentation, the wide spectrum of radiation retinopathic manifestations is described with ophthalmoscopic signs and multimodal imaging. The management of radiation retinopathy/maculopathy is discussed."
Corneal endothelial cell‐matrix interactions in Fuchs corneal endothelial dystrophy
Authors: Brunette Isabelle
Published: December 2019

Fuchs endothelial corneal dystrophy (FECD) is characterized by progressive loss of corneal endothelial cells (CECs) and excessive deposition of extracellular matrix, resulting in Descemet's membrane thickening and formation of excrescences (guttae) on its posterior surface. The role of the endothelium being to keep the cornea dehydrated and transparent, loss of corneal endothelial function leads to corneal edema and vision loss. FECD etiology is multifactorial, involving a combination of parameters such as age, environmental factors and genetic predisposition, and genetic and proteomic studies have given rise to several hypotheses regarding the pathogenesis of FECD. Up to recently, however, most of the work has focused on CECs as the primary site of the disease, while several clues suggest that interactions between CECs and their environment are significantly involved in the development of FECD. The influence of the altered topography and composition of diseased Descemet's membrane and guttae on CECs in FECD will be discussed.
NAD+/NADH precursor treatment protects against retinal degeneration
Authors: Boatright Jeffrey
Published: December 2019

Purpose

The retina is highly metabolically active, suggesting that metabolic dysfunction could underlie many retinal degenerative diseases. Nicotinamide adenine dinucleotide (NAD+) is a coenzyme and a co‐substrate in several cellular energetic metabolic pathways. Retinal NAD+ levels decline with age and during retinal damage or degeneration. Maintaining NAD+ levels may be therapeutic in retinal disease. The purpose of this study was to investigate whether systemic treatment with nicotinamide riboside (NR), a NAD+ precursor, is protective in disparate models of retinal damage or degeneration.

Methods

Four mouse models of retinal degeneration were tested: a mouse model of light‐induced retinal degeneration, the IRBP knock‐out mouse, rhodopsin‐Tvrm4 mutant mouse, and the rd10 mouse. Mice were IP injected with various concentrations of NR at various times relative to degeneration onset. Retinal function was assessed by ERG, retinal morphology was assessed by OCT and H & E or TUNEL staining, and visual function was assessed by OMR. Retinal NAD+/NADH levels were enzymatically assayed.

Results

Each retinal degeneration model exhibited significantly suppressed retinal and visual function, a severely disrupted photoreceptor cell layer, and significantly decreased numbers of nuclei and increased accumulation of TUNEL‐labeled cells in the outer nuclear layer. These effects were prevented by various NR treatment regimens. Treatment with NR also resulted in increased levels of NAD+ in retina.

Conclusions

This is the first study to report protective effects of NR treatment in models of retinal degeneration and suggests that maintaining retinal NAD+ via systemic NR treatment should be further explored for clinical relevance.
Targeting cGMP‐signalling to protect photoreceptors in hereditary retinal degeneration
Authors: Paquet‐Durand Francois ,   François Paquet‐Durand on behalf of the DRUGSFORD consortium
Published: December 2019

cGMP‐signalling is fundamental to the phototransduction cascade in retinal photoreceptors. Paradoxically, high levels of cGMP lead to photoreceptor loss in hereditary retinal degeneration (RD) caused by a variety of different gene mutations. This makes cGMP‐signalling a prime target for the development of new treatment approaches. The presentation will give details about the development of compounds and drug delivery technology designed for a targeted interference with cGMP‐signalling in photoreceptors. As an example, in vivo treatment data on a liposomal formulation of the inhibitory cGMP analogue DF003/CN03 will be presented. Overall, cGMP analogues may constitute a new class of compounds for RD treatment and, when combined with suitable drug delivery vehicles, they provide a clear perspective for clinical translation, potentially bringing the very first pharmacological treatment to patients suffering from RD.
Pupil dilation during visuospatial orienting differentiates between autism spectrum disorder and attention‐deficit/hyperactivity disorder
Authors: Boxhoorn Sara , Bast Nico , Supèr Hans , Polzer Leonie , Cholemkery Hannah , Freitag Christine M.
Published: December 2019

Background

Previous research demonstrated atypical attention in children with attention‐deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Regarding visual orienting, findings suggest a differential impairment: Atypical orienting to relatively unexpected targets in ASD, and atypical processing of alerting cues in ADHD. The locus coeruleus‐norepinephrine (LC‐NE) system plays an important role in exploiting alerting cues to increase attention and task performance. The present study’s aim was to examine differential subcortical processes underlying visual orienting in ASD and ADHD with pupil dilation (PD) as index of LC activity.

Methods

Pupil dilation (PD) progression metrics during visual orienting were calculated for task‐evoked PD locked to cue, stimulus onset, and behavioral response. Group differences in PD and reaction time (RT) were compared between children with ASD without ADHD (ASD‐) (N = 18), ADHD without ASD (ADHD‐) (N = 28), both disorders (ASD + ADHD) (N = 14), and typically developing children (TD) (N = 31) using linear mixed models (LMM). To further explore the modulatory role of the LC‐NE system group differences in the effect of task‐evoked PD metrics on RT were examined exploratively.

Results

ASD (+ADHD) showed slower orienting responses to relatively unexpected spatial target stimuli as compared to TD, which was accompanied by higher PD amplitudes relative to ADHD− and TD. In ADHD−, shorter cue‐evoked PD latencies relative to ASD−, ASD + ADHD, and TD were found. Group differences in the effect of cue‐ and stimulus‐evoked PD amplitudes on RT were found in ASD− relative to TD.

Conclusions

Study findings provide new evidence for a specific role of the LC‐NE system in impaired reflexive orienting responses in ASD, and atypical visual processing of alerting cues in ADHD.
Merkel cell carcinoma update: the case for two tumours
Authors: Nirenberg A. , Steinman H. , Dixon J. , Dixon A.
Published: December 2019

Merkel cell carcinoma (MCC) is an aggressive tumour with neuroendocrine differentiation. Clinically significant differences within the entity we know as MCC are apparent. This review aims to evaluate the evidence for differences in tumours within Merkel cell carcinoma and to stratify these. A literature search of research pertaining to various characteristics MCC was undertaken from 1972, when Merkel cell carcinoma was first described, to 2018, using PubMed and similar search engines. A total of 41 papers were analysed, including clinical trials, laboratory‐based research and reviews. A proportion of MCC has Merkel cell polyomavirus genome integrated (MCPyV+) while others do not (MCPyV−). Both types have a different mutation burden. MCPyV+ tumours are likely true neuroendocrine carcinomas, with a dermal origin, probably from fibroblasts which have been transformed by integration of the viral genome. MCPyV−tumours are likely derived from either keratinocytes or epidermal stem cells, are probably squamous cell carcinomas with neuroendocrine differentiation, and are related to sun damage. Prognostic factors (apart from tumour stage) include the MCPyV status, with MCPyV+ tumours having a better prognosis. P63 expression confers a worse prognosis in most studies. CD8+ lymphocytes play an important role, providing a possible target for PD1/PD‐L1 blockade treatment. The incidence of MCC varies from country to country. Countries such as Australia have a high rate and a far greater proportion of MCPyV− tumours than places such as the United Kingdom. MCC doubtlessly encompasses two tumours. The two tumours have demonstrated differences in prognosis and management. One is a neuroendocrine carcinoma related to MCPyV integration likely derived from fibroblasts, and the other is a UV‐related squamous cell carcinoma with neuroendocrine differentiation, presumptively derived from either keratinocytes or epidermal stem cells. We propose naming the former Merkel type sarcoma and the latter squamous cell carcinoma, Merkel type.
Recombinant Treponema pallidum protein Tp0136 promotes fibroblast migration by modulating MCP‐1/CCR2 through TLR4
Authors: Luo X. , Gao Z.‐X. , Lin S.‐W. , Tong M.‐L. , Liu L.‐L. , Lin L.‐R. , Ke W.‐J. , Yang T.‐C.
Published: December 2019

Background

Chancre self‐healing is an important clinical feature in the early stages of syphilis infection. Wound healing may involve an important mechanism by the migration of fibroblasts filling the injured lesion. However, the specific mechanism underlying this process is still unknown.

Objectives

We aimed to analyse the role of Tp0136 in the migration of fibroblasts and the related mechanism.

Methods

The migration ability of fibroblasts was detected by a wound‐healing assay. RT‐PCR and ELISA detected the expression of MCP‐1, IL‐6 and MMP‐9. TLR4 expression was detected by RT‐PCR. The protein levels of CCR2 and relevant signalling pathway molecules were measured by Western blotting.

Results

Tp0136 significantly promoted fibroblast migration. Subsequently, the levels of MCP‐1 and its receptor CCR2 were increased in this process. The migration of fibroblasts was significantly inhibited by an anti‐MCP‐1 neutralizing antibody or CCR2 inhibitors. Furthermore, studies demonstrated that Tp0136 could activate the ERK/JNK/PI3K/NF‐κB signalling pathways through TLR4 activity and that signalling pathways inhibitors could weaken MCP‐1 secretion and fibroblast migration.

Conclusions

These findings demonstrate that Tp0136 promotes the migration of fibroblasts by inducing MCP‐1/CCR2 expression through signalling involving the TLR4, ERK, JNK, PI3K and NF‐κB signalling pathways, which could contribute to the mechanism of chancre self‐healing in syphilis.
Factors associated with spiritual care competencies in Taiwan’s clinical nurses: A descriptive correlational study
Authors: Hsieh Suh‐Ing , Hsu Li‐Ling , Kao Chen‐Yi , Breckenridge‐Sproat Sara , Lin Hui‐Ling , Tai Hsiu‐Chen , Huang Tzu‐Hsin , Chu Tsung‐Lan
Published: December 2019

Aims and objectives

To determine factors associated with nurses’ spiritual care competencies.

Background

Holistic nursing care includes biopsychosocial and spiritual care. However, nurses are limited by a lack of knowledge, time constraints and apprehension of assessing spiritual issues, which leaves them unable to assess and meet patients’ spiritual needs. Thus, when patients experience spiritual distress, clinical nurses lose the opportunity to support spiritual growth and self‐actualisation. In Taiwan, spiritual care, religion and culture are unique compared to those in other countries. Overall, factors associated with Taiwanese nurses’ spiritual care competencies lack comprehensive exploration.

Methods

This study adopted a descriptive correlational design using cross‐sectional survey (see AppendixS1). Cluster sampling was used to select clinical nurses from fourteen units of a medical centre and a regional hospital. Data were collected from January–June 2018 with a 97.03% response rate. Clinical nurses completed a background questionnaire, spiritual care practice questionnaire, spirituality and spiritual care‐related scales. Data were analysed using descriptive and linear regression. This report followed the STROBE checklist.

Results

Spiritual care competence ranged from 44–123 (mean 84.67 ± 12.88; range 27–135). The majority of clinical nurses rated their spiritual care competence as moderate (64–98). The significant factors associated with nurses’ spiritual care competence were education, religion, interest in spiritual care, having role models, past life events, barriers to providing spiritual care of the spiritual care practice score, and spiritual attitude and involvement score. The overall model was significant (p < .001) and accounted for 55.0% of variance (adjustedR2 = .488).

Conclusions

Most clinical nurses have moderate spiritual care competence. Objective factors identified affect clinical nurses’ spiritual care competencies.

Relevance to clinical practice

To improve nurses’ spiritual care competencies, objective factors that affect clinical nurses’ spiritual care competencies must be emphasised. Multiple strategies for enhancing nurses’ own spiritual well‐being can be provided via employee health promotion projects and activities, and promoting nurses’ spirituality and spiritual care competencies can be explored in clinical settings through bedside teaching, situational simulation, objective structured clinical examinations and self‐reflection.
A taxonomy to assess the interaction between nurses and children: Development and reliability
Authors: van Ingen Schenau‐Veldman Ina S. A. , Niemeijer Anuschka S. , Zuiker Jan‐Kees , Scholten‐Jaegers Sonja M. H. J. , Lamberts Kirsten F. , Nieuwenhuis Marianne K.
Published: December 2019

Aims and objectives

The aim of this study was to develop a valid and reliable instrument to assess the nurse‐child interaction during medical or nursing interventions.

Background

Communication is an important competency for the professional practice of nurses and physicians. The nurse‐patient relationship is fundamental for high‐quality care. It has been suggested that if nurses have more skills to interact with children, care will be less distressing and less painful for the children.

Design

A qualitative observational psychometric study; the GRRAS checklist was used.

Methods

In‐depth video‐analyses, taxonomy development (19 videos) and testing it is psychometric properties (10 videos). Three observers micro‐analysed video recordings of experienced nurses changing children's wound dressing in a specialised Burn Centre.

Results

The nurse‐child interaction taxonomy (NCIT) was developed to observe and score the interactional behaviour between nurse and child. The taxonomy has three main patterns: being considerate, attuning oneself, and procedural interventions, subdivided in eight dimensions. These dimensions contain 16 elements that can be observed and scored on a 7‐point scale. Intra‐rater, inter‐rater reliability and agreement were good.

Conclusions

This study shows that interaction between nurses and children can be assessed reliably with the NCIT by an experienced observer or alternatively, scoring by two observers is recommended.

Relevance to clinical practice

The development of the taxonomy is an important step to find evidence for the best way for nurses to interact with children during nursing interventions or medical events and as such, ultimately, contributes to providing the best care possible.
Frailty screening in hospitalised older adults: How does the brief Dutch National Safety Management Program perform compared to a more extensive approach?
Authors: Warnier Ron M. J. , van Rossum Erik , van Kuijk Sander M. J. , Magdelijns Fabienne , Schols Jos M. G. A. , Kempen Gertrudis I. J. M.
Published: December 2019

Aims and objectives

To examine the predictive properties of the brief Dutch National Safety Management Program for the screening of frail hospitalised older patients (VMS) and to compare these with the more extensive Maastricht Frailty Screening Tool for Hospitalised Patients (MFST‐HP).

Background

Screening of older patients during admission may help to detect frailty and underlying geriatric conditions. The VMS screening assesses patients on four domains (i.e. functional decline, delirium risk, fall risk and nutrition). The 15‐item MFST‐HP assesses patients on three domains of frailty (physical, social and psychological).

Design

Retrospective cohort study.

Methods

Data of 2,573 hospitalised patients (70+) admitted in 2013 were included, and relative risks, sensitivity and specificity and area under the receiver operating characteristic (AUC) curve of the two tools were calculated for discharge destination, readmissions and mortality. The data were derived from the patients nursing files. A STARD checklist was completed.

Results

Different proportions of frail patients were identified by means of both tools: 1,369 (53.2%) based on the VMS and 414 (16.1%) based on the MFST‐HP. The specificity was low for the VMS, and the sensitivity was low for the MFST‐HP. The overall AUC for the VMS varied from 0.50 to 0.76 and from 0.49 to 0.69 for the MFST‐HP.

Conclusion

The predictive properties of the VMS and the more extended MFST‐HP on the screening of frailty among older hospitalised patients are poor to moderate and not very promising.

Relevance to clinical practice

The VMS labels a high proportion of older patients as potentially frail, while the MFST‐HP labels over 80% as nonfrail. An extended tool did not increase the predictive ability of the VMS. However, information derived from the individual items of the screening tools may help nurses in daily practice to intervene on potential geriatric risks such as delirium risk or fall risk.
Prevalence and risk factors for sexual dysfunction in reproductive‐aged married women: A cross‐sectional epidemiological study
Authors: Yilmaz Banu A. , Sonmez Yonca , Sezik Mekin
Published: December 2019

Aim

We aimed (i) to evaluate the point prevalence for sexual dysfunction in a population of reproductive‐aged married women living in an urban area in Isparta, Turkey, (ii) to examine demographic and psychosocial risk factors for sexual dysfunction.

Methods

In a cross‐sectional design, following single‐stage cluster sampling all married women living in three representative areas (n = 1323) were approached at their place of residence. Female sexual dysfunction, poor mental health and marital adjustment were assessed with the 9‐item Index of Female Sexual Function, the 12‐item General Health Questionnaire, and Locke‐Wallace Short Marital‐Adjustment Test, respectively. Descriptive data were presented as frequencies, percentages and mean ± standard deviations. Chi‐square and independent samples t‐test were used for univariate analysis. Logistic regression model was constructed to define independent risk factors for sexual dysfunction. P < 0.05 was considered statistically significant.

Results

Of the 1216 women included in analyses (response rate 91.9%), 45.0% experience sexual dysfunction. Poor marital adjustment and poor mental health are associated with sexual dysfunction (odds ratio = 4.06; 95% confidence interval = 2.97–5.54; odds ratio = 2.74; 95% confidence interval = 2.00–3.72, respectively). Lack of social insurance, chronic disease of the spouse, perception of deficient knowledge on sexuality‐related topics, perceived sexual problems, and increasing duration of marriage were also associated with sexual dysfunction (P < 0.05 for all).

Conclusion

Screening of married women for sexual dysfunction and the risk factors revealed in the present study may permit appropriate preventive interventions.
The Bribery Paradox in Transition Economies and the Enactment of ‘New Normal’ Business Environments
Authors: Eddleston Kimberly A. , Banalieva Elitsa R. , Verbeke Alain
Published: December 2019

We develop a novel, sense‐making perspective on corruption in transition economies. Prior research has focused on understanding why some entrepreneurs are more likely to pay bribes than others. It typically assumes that paying bribes will lead to an intended – albeit unfair – competitive advantage. We challenge this assumption and uncover a bribery paradox: drawing upon sense‐making logic, we argue that beyond gaining an immediate benefit from bribing, entrepreneurs who frequently pay bribes may in the longer run be enacting a ‘new normal’ business environment perceived as high in obstacles, especially in transition countries. As sense making is grounded in identity construction and one’s social context, we argue that owners of family firms will be especially vulnerable to the dangers of perceiving greater obstacles over time and enacting an obstacle‐ridden ‘new normal’ business environment. We find empirical support for our framework on a sample of 310 privately held small and medium‐sized enterprises (SMEs) from 22 transition economies.
Pharmacokinetics and bioavailability of carbetocin after intravenous and intramuscular administration in cows and gilts
Authors: Sun Pan , Xiao Hongzhi , Wang Jianzhong , Zhang Suxia , Cao Xingyuan
Published: December 2019

The pharmacokinetics of carbetocin, which is used to control postpartum hemorrhage after giving birth, was studied in cows and gilts after a single intravenous (IV) or intramuscular (IM) injection. Blood samples from animals were assessed by oxytocin radioimmunoassay, and then the pharmacokinetic parameters were calculated using a noncompartmental model. For gilts, there was no significant difference between half‐life (T1/2λZ), mean residue time (MRT), and maximum concentration (Cmax) between IM and IV administration. Conversely, the time to reach the Cmax (Tmax) and MRT were higher following administration of 350 μg/animal in cows via the IM administration compared with IV. The longest T1/2λZ was 0.85 hr, indicating carbetocin was absorbed and eliminated rapidly in both animal species after administration. The Tmax was similar between cows and gilts following IM administration. Moreover, the Cmax after IM injection was about half that of IV administration in both animals. The bioavailability was more than 80% in cows, suggesting administration via the IM route is efficient. This is in agreement with the longer T1/2λZ in cows after IM administration. However, the IV route is recommended for gilts due to a lower bioavailability (35%) and shorter T1/2λZ after IM administration compared with IV.
Pharmacokinetics of morphine in combination with dexmedetomidine and maropitant following intramuscular injection in dogs anaesthetized with halothane
Authors: Karna Sandeep Raj , Singh Preet , Chambers Paul , Kongara Kavitha
Published: December 2019

The purpose of this study was to evaluate the pharmacokinetics of morphine in combination with dexmedetomidine and maropitant injected intramuscularly in dogs under general anaesthesia. Eight healthy dogs weighing 25.76 ± 3.16 kg and 3.87 ± 1.64 years of age were used in a crossover study. Dogs were randomly allocated to four groups: (1) morphine 0.6 mg/kg; (2) morphine 0.3 mg/kg + dexmedetomidine 5 μg/kg; (3) morphine 0.3 mg/kg + maropitant 1 mg/kg; (4) morphine 0.2 mg/kg + dexmedetomidine 3 μg/kg + maropitant 0.7 mg/kg. Blood samples were collected before, 15 and 30 min, and 1, 2, 3 4, 6 and 8 hr after injection of the test drugs. Plasma concentration of the drugs was determined by liquid chromatography‐mass spectrometry. The elimination half‐life (T1/2) of morphine was higher and the clearance rate (CL) was lower when combined with dexmedetomidine (T1/2 = 77.72 ± 20.27 min, CL = 119.41 ± 23.34 ml kg−1 min−1) compared to maropitant (T1/2 = 52.73 min ± 13.823 ml kg−1 min−1, CL = 178.57 ± 70.55) or morphine alone at higher doses (T1/2 = 50.53 ± 12.55 min, CL = 187.24 ± 34.45 ml kg−1 min−1). Combining morphine with dexmedetomidine may increase the dosing interval of morphine and may have a clinical advantage.
Does Diversity Undermine the Welfare State? Evidence from the Provision of Local Public Services in European Regions
Authors: Filippetti Andrea
Published: December 2019

The management of the welfare state in a heterogeneous society is a growing challenge in Europe. This paper investigates the relationship between diversity and the welfare state by studying the citizens’ satisfaction about public services across European regions; it also establishes a link between research on diversity and the welfare state, and fiscal federalism theory, by focusing on the provision of local public services. We employ region level indicators of the citizens’ perception of local public services, regional autonomy, and regional diversity based on nationalities. We find that i) diversity is negatively correlated with the quality of local public services; and ii) regional autonomy partially improves the quality in the presence of diversity. When using objective measures of public services, the results are less robust; this raises an issue about the citizens’ perception about the functioning of the welfare state in heterogeneous communities which deserves attention from policy makers.
“We're Playing Sisters, on Paper!”: children composing on graphic playgrounds
Authors: Dyson Anne Haas
Published: December 2019

In this paper, I draw on two childhood ethnographies to ask basic questions about the foundation of child writing. The first question is,where does writing come from in young children's lives?Answering this question will lead us to childhood play as the foundation of writing. The second question is,how do educators negotiate an inclusive, playful classroom culture in racially divisive and neoliberal times?This question will lead to a critical consideration of forming an inclusive culture in a racially and culturally diverse classroom. In this time of uniform, mandated curricula, rampant in the United States and elsewhere, and of the dismissive attitude towards play and towards childhood diversity (e.g., in race, culture and socioeconomic class), it is worth revisiting basic questions about the beginnings of writing in childhoods. The questions are relevant whether a child is writing on paper, screen, slate, or sand.
When Do Low Roll Rates Indicate Party Influence? Evidence from Counterfactual Roll Rates
Authors: Richman Jesse , Roberts Ryan
Published: December 2019

A simulation‐based counterfactual is one way to solve the observational equivalence challenge that seemingly “partisan” majority‐party roll rates can be observed in the absence of any actual party influence. We simulate no‐partisan‐agenda‐control counterfactual roll rates and apply them across sessions of the US House of Representatives and 86 state legislative chambers to evaluate the extent to which observed roll rates provide evidence for party influence on the legislative agenda. After assessing and controlling for the baseline risk of majority‐party rolls, there is significant evidence of party influence on roll rates in some state legislatures, particularly those with rules that grant parties more agenda power, and in the post‐Reed’s‐rules House of Representatives. Institutional rules interact with the (simulated) risk of a majority roll to shape observed roll rates across chambers and across time.
How long does the effect of botulinum toxin in neurogenic patients last? An analysis of the subset of “good responders”
Authors: Dominique Inès , Tremblais Benjamin , Charvier Kathleen , Nogueira Maria C. S. , Paparel Philippe , Journel Nicolas Morel , Ruffion Alain
Published: December 2019

Background

The aim of this study was to assess long‐term efficacity of botulinum neurotoxin A (BoNT‐A) in the treatment of neurogenic detrusor overactivity (NDO).

Materials and Methods

This was a retrospective monocentric study in a reference center. We included patients who received intradetrusor BoNT‐A for NDO between 2001 and 2015. The focus of our analysis was on patients defined as “good responders” (≥ 5 injections of intradetrusor BoNT‐A over a period of ≥5 years). The primary endpoint was the evaluation of long‐term efficacity of BoNT‐A. Recurrent NDO was monitored by the use of cystomanometry before the first injection and 1 month after each injection.

The secondary objective was to assess the influence of NDO's etiology, age, and sex on the long‐term efficacity of the treatment.

Results

A total of 107 patients were included (60.7% with spinal cord injury [SCI] and 36.4% with multiple sclerosis [MS]). The mean follow‐up period was 83.7 months (66; 120). The mean number of injections was of 8.9 (5; 21). A total of 67.3% (n = 72) of patients were still controlled by treatment at the end of their follow‐up period. Therapeutic failure occurred in 30 patients (26.1%) with a cessation of BoNT‐A treatment at 76 months on average (median: 82.5 months). There was no significant impact of age (P = .42), sex (P = .35), or NDO's etiology (MS vs SCI; P = .54) on long‐term efficacy of BoNT‐A treatment.

Conclusion

The results of our study indicate that the application of BoNT‐A seems to be an effective and durable treatment in a large number of neurogenic patients after more than 10 years of follow‐up. However, botulinum toxin tolerance occurred in approximately 25% of patients.
Hydrogen fluence in Genesis collectors: Implications for acceleration of solar wind and for solar metallicity
Authors: Huss Gary R. , Koeman‐Shields Elizabeth , Jurewicz Amy J. G. , Burnett Donald S. , Nagashima Kazuhide , Ogliore Ryan , Olinger Chad T.
Published: December 2019

NASA's Genesis mission was flown to capture samples of the solar wind and return them to the Earth for measurement. The purpose of the mission was to determine the chemical and isotopic composition of the Sun with significantly better precision than known before. Abundance data are now available for noble gases, magnesium, sodium, calcium, potassium, aluminum, chromium, iron, and other elements. Here, we report abundance data for hydrogen in four solar wind regimes collected by the Genesis mission (bulk solar wind, interstream low‐energy wind, coronal hole high‐energy wind, and coronal mass ejections). The mission was not designed to collect hydrogen, and in order to measure it, we had to overcome a variety of technical problems, as described herein. The relative hydrogen fluences among the four regimes should be accurate to better than ±5–6%, and the absolute fluences should be accurate to ±10%. We use the data to investigate elemental fractionations due to the first ionization potential during acceleration of the solar wind. We also use our data, combined with regime data for neon and argon, to estimate the solar neon and argon abundances, elements that cannot be measured spectroscopically in the solar photosphere.
We just estimated twenty million fiscal multipliers
Authors: Čapek Jan , Crespo Cuaresma Jesús
Published: December 2019

We analyse the role played by data and specification choices as determinants of the size of the fiscal multipliers obtained using structural vector autoregressive models. The results, based on over twenty million fiscal multipliers estimated for European countries, indicate that many seemingly harmless modelling choices have a significant effect on the size and precision of fiscal multiplier estimates. In addition to the structural shock identification strategy, these modelling choices include the definition of spending and taxes, the national accounts system employed, the use of particular interest rates or inflation measures, or whether data are smoothed prior to estimation. The cumulative effects of such arguably innocuous methodological choices can lead to a change in the spending multipliers of as much as 0.4 points.