bluuebunny/crossref_metadata_2025 huggingface dataset:
Prehospital emergency care nurses’ strategies while caring for patients with limited Swedish–English proficiency
Authors: Alm‐Pfrunder Annika B , Falk Ann‐Charlotte , Vicente Veronica , Lindström Veronica
Published: April 2018

Aims and objectives

To explore the strategies of nurses working in the ambulance service while caring for patients with limited Swedish–English proficiency.

Background

Communication difficulties due to lack of mutual language is a challenge in healthcare systems around the world. Little is known about nurses’ strategies while caring for patients with whom they do not share a mutual language in an unstructured, unplanned prehospital emergency environment, the ambulance service.

Design and Method

A qualitative study design based on interviews was used, and a purposeful sample and snowball technique were used to identify nurses with prehospital emergency experience of caring for patients with limited Swedish–English proficiency.

Results

Eleven nurses were interviewed, and the main strategy they used was adapting to the patients’ need and the caring situation. The nurses used their own body, and tone of voice for creating a sense of trust and security. The nurses also used structured assessment in accordance with medical guidelines. Translation devices and relatives/bystanders were used as interpreters when possible. Another strategy was to transport the patient directly to the emergency department as they had not found a secure way of assessing and caring for the patients in the ambulance.

Conclusion

The nurses used a palette of strategies while assessing and caring for patients when there was no mutual language between the caregiver and care seeker.

Relevance to clinical practice

The nurses need to be prepared for how to assess and care for patients when there is a lack of mutual language; otherwise, there is a risk of increased unequal care in the ambulance service. To further explore and learn about this field of research, studies exploring the patients’ perspective are needed.
Application of instant messaging software in the follow‐up of patients using peritoneal dialysis, a randomised controlled trial
Authors: Cao Fang , Li Lanfei , Lin Miao , Lin Qinyu , Ruan Yiping , Hong Fuyuan
Published: April 2018

Aims and objectives

This study aims to investigate the application value of Internet‐based instant messaging software in the follow‐up of patients using peritoneal dialysis.

Background

Peritoneal dialysis is an effective renal replacement treatment for end‐stage renal disease. The clinical usefulness of Internet‐based instant messaging software in the follow‐up of peritoneal dialysis patients, including the incidence of peritonitis and exit‐site infection, the levels of albumin and electrolytes and the degree of patients’ satisfaction, remains unknown.

Design

Between January 2009–April 2016, a total of 160 patients underwent continuous peritoneal dialysis in the Department of Nephrology, Fujian Provincial Hospital were invited to participate voluntarily in this study. The patients were randomly assigned to the instant messenger (QQ) follow‐up group (n = 80) and the traditional follow‐up group (n = 80). The differences in death, hospitalisation, peritonitis, exit‐site infection, and patients’ satisfaction were investigated during 1 year of follow‐up. The mean follow‐up duration is 11.4 ± 1.5 months.

Results

Compared with the patients in the traditional follow‐up group, patients in the QQ follow‐up group showed higher levels of serum albumin (p = .009) and haemoglobin (p = .009), lower levels of phosphorus (p < .001) and calcium‐phosphorus product (p = .001), and better degree of satisfaction (p < .001).

Relevance to clinical practice

Internet‐based follow‐up by instant messaging software appears to be a feasible and acceptable method of delivering peritoneal dialysis treatment for patients with end‐stage renal disease.
Increased care demand and medical costs after falls in nursing homes: A Delphi study
Authors: Sterke Carolyn Shanty , Panneman Martien J , Erasmus Vicki , Polinder Suzanne , van Beeck Ed F
Published: April 2018

Aims and objective

To estimate the increased care demand and medical costs caused by falls in nursing homes.

Background

There is compelling evidence that falls in nursing homes are preventable. However, proper implementation of evidence‐based guidelines to prevent falls is often hindered by insufficient management support, staff time and funding.

Design

A three‐round Delphi study.

Methods

A panel of 41 experts, all working in nursing homes in the Netherlands, received three online questionnaires to estimate the extra hours of care needed during the first year after the fall. This was estimated for ten falls categories with different levels of injury severity, in three scenarios, that is a best‐case, a typical‐case and a worst‐case scenario. We calculated the costs of falls by multiplying the mean amount of extra hours that the participants spent on the care for a resident after a fall with their hourly wages.

Results

In case of a noninjurious fall, the extra time spent on the faller is on average almost 5 hr, expressed in euros that add to € 193. The extra staff time and costs of falls increased with increasing severity of injury. In the case of a fracture of the lower limb, the extra staff time increased to 132 hr, expressed in euros that is € 4,604. In the worst‐case scenario of a fracture of the lower limb, the extra staff time increased to 284 hr, expressed in euros that is € 10,170.

Conclusions

Falls in nursing homes result in a great deal of extra staff time spent on care, with extra costs varying between € 193 for a noninjurious fall and € 10,170 for serious falls.

Relevance to clinical practice

This study could aid decision‐making on investing in appropriate implementation of falls prevention interventions in nursing homes.
Nature and scope of certified nurse‐midwifery practice: A workforce study
Authors: Hastings‐Tolsma Marie , Foster Sarah Wilcox , Brucker Mary C. , Nodine Priscilla , Burpo Rebecca , Camune Barbara , Griggs Jackie , Callahan Tiffany J.
Published: April 2018

Aims and Objectives

To describe the nature and scope of nurse‐midwifery practice in Texas and to determine legislative priorities and practice barriers.

Background

Across the globe, midwives are the largest group of maternity care providers despite little known about midwifery practice. With a looming shortage of midwives, there is a pressing need to understand midwives’ work environment and scope of practice.

Design

Mixed methods research utilising prospective descriptive survey and interview.

Methods

An online survey was administered to nurse‐midwives practicing in the state of Texas (N = 449) with a subset (n = 10) telephone interviewed. Descriptive and inferential statistics and content analysis was performed.

Results

The survey was completed by 141 midwives with eight interviewed. Most were older, Caucasian and held a master's degree. A majority worked full‐time, were in clinical practice in larger urban areas and were employed by a hospital or physician group. Care was most commonly provided for Hispanic and White women; approximately a quarter could care for greater numbers of patients. Most did not clinically teach midwifery students. Physician practice agreements were believed unnecessary and prescriptive authority requirements restrictive. Legislative issues were typically followed through the professional organisation or social media sites; most felt a lack of competence to influence health policy decisions. While most were satisfied with current clinical practice, a majority planned a change in the next 3 to 5 years.

Conclusions

An ageing midwifery workforce, not representative of the race/ethnicity of the populations served, is underutilised with practice requirements that limit provision of services. Health policy changes are needed to ensure unrestricted practice.

Relevance to clinical practice

Robust midwifery workforce data are needed as well as a midwifery board which tracks availability and accessibility of midwives. Educators should consider training models promoting long‐term service in underserved areas, and development of skills crucial for impacting health policy change.
Development of tools to measure dignity for older people in acute hospitals
Authors: Tauber‐Gilmore Marcelle , Norton Christine , Procter Sue , Murrells Trevor , Addis Gulen , Baillie Lesley , Velasco Pauline , Athwal Preet , Kayani Saeema , Zahran Zainab
Published: April 2018

Background

Dignity is a concept that applies to all patients. Older patients can be particularly vulnerable to experiencing a loss of dignity in hospital. Previous tools developed to measure dignity have been aimed at palliative and end‐of‐life care. No tools for measuring dignity in acute hospital care have been reported.

Objectives

To develop tools for measuring patient dignity in acute hospitals.

Setting

A large UK acute hospital. We purposively selected 17 wards where at least 50% of patients are 65 years or above.

Methods

Three methods of capturing data related to dignity were developed: an electronic patient dignity survey (possible score range 6–24); a format for nonparticipant observations; and individual face‐to‐face semi‐structured patient and staff interviews (reported elsewhere).

Results

A total of 5,693 surveys were completed. Mean score increased from 22.00 pre‐intervention to 23.03 after intervention (p < 0.001). Staff–patient interactions (581) were recorded. Overall 41% of interactions (239) were positive, 39% (228) were neutral, and 20% (114) were negative. The positive interactions ranged from 17%–59% between wards. Quality of interaction was highest for allied health professionals (76% positive), lowest for domestic staff (22% positive) and pharmacists (29% positive), and intermediate for doctors, nurses, healthcare assistants and student nurses (40%–48% positive). A positive interaction was more likely with increased length of interaction from 25% (brief)–63% (longer interactions) (F[2, 557] = 28.67, p < 0.001).

Conclusions

We have developed a simple format for a dignity survey and observations. Overall, most patients reported electronically that they received dignified care in hospital. However, observations identified a high percentage of interactions categorised as neutral/basic care, which, while not actively diminishing dignity, will not enhance dignity. There is an opportunity to make these interactions more positive.
The use of a logistic regression model to develop a risk assessment of intraoperatively acquired pressure ulcer
Authors: Gao Ling , Yang Lina , Li Xiaoqin , Chen Jin , Du Juan , Bai Xiaoxia , Yang Xianjun
Published: April 2018

Aims and objectives

To screen the factors of intraoperatively acquired pressure ulcer and establish a new risk assessment model of intraoperatively acquired pressure ulcer.

Design

This is a prospective study.

Methods

A total of 1,963 patients who received neurosurgery, orthopaedics, paediatric surgery and cardiac surgery therapy in Sichuan Academy of Medical Science and Provincial People's Hospital in China from October 2015–October 2016 were enrolled in the study, and their clinical parameters were collected. Multivariable logistic regression analysis and decision tree analysis were used to analyse and screen the factors of intraoperatively acquired pressure ulcer and establish the risk assessment model of intraoperatively acquired pressure ulcer.

Results

The risk factors for intraoperatively acquired pressure ulcer included the application of external force during operation (β = 1.10, OR = 3.20), lean body mass (β = 1.08, OR = 2.95), time of operation ≥6 hr (β = 2.66, OR = 14.30), prone position operation (β = 1.13, OR = 3.10), cardiopulmonary bypass during operation (β = 1.72, OR = 5.59) and intraoperative blood loss (β = 0.67, OR = 1.95). The new risk assessment model showed that the AUC of ROC curve was 0.897 (p < .001). According to the maximum principle of Youden's index, the sensitivity, specificity and Youden's index J of the model were 0.81, 0.88 and 0.69, respectively, when the cut‐off point was set at π = 0.025.

Conclusions

A new and relatively reliable assessment model for intraoperatively acquired pressure ulcer is established.

Relevance to clinical practice

Pressure ulcers remain a challenge in clinical nursing. A new risk assessment model of pressure ulcers that is applicable to surgical patients is highly recommended.
Exploring the meaning of home and its implications for the care of older people
Authors: Board Michele , McCormack Brendan
Published: April 2018

Aims and objectives

To explore the meaning of home for six baby boomers and consider how this insight can be used when caring for older people in hospital or residential settings.

Background

Feeling at home is important to help retain a sense of autonomy, security and well‐being, but home is a complex concept to understand. The baby boomers are a large cohort entering later life and understanding their sense of home is not only an example of anticipatory gerontology but it could also provide the tools to explore home with the current older population, who may be in a variety of care settings.

Design and methods

A qualitative hermeneutic approach was adopted to explore the meaning of home of six baby boomers. The participants were asked to take photographs showing what home meant to them and interpret these in a recorded photo‐elicitation interview. Small teams then reviewed the images to provide further insight. Finally, all the data were reviewed to provide an overall analysis of the revealed meaning of home.

Results

Having possessions or stuff was important for the meaning of home; being familiar with the local environment was also “homely,” as well as certain textures and familiar sounds and smells; relationships with others and the ability to have choice in where and how the participants live were also significant for their meaning of home.

Conclusions

The meaning of home is complex. Nevertheless, in this study, an evocative sense of home was revealed and these insights could be used in discussions with older people in care settings to help increase their sense of autonomy, security and well‐being. Furthermore, these insights could also be used to develop a framework to help nursing staff guide these discussions.

Relevance to clinical practice

By considering the multisensory nature of the meaning of home, nurses can create a sense of home for patients. Feeling at home can improve the well‐being and a sense of autonomy for patients. Enabling patients to feel more autonomous recognises the importance of a person‐centred approach to care.
Prosthetic rehabilitation of patients with hypohidrotic ectodermal dysplasia: A systematic review
Authors: Schnabl D. , Grunert I. , Schmuth M. , Kapferer‐Seebacher I.
Published: April 2018

Hypohidrotic ectodermal dysplasia (HED) comprises a large group of inherited disorders of ectodermal structures, characterised by hypo‐ or anhidrosis, hypotrichosis and hypo‐ or oligo‐ or anodontia. We aimed to systematically assess the spectrum of prosthodontic approaches with regard to the patients' age and to provide clinical implications for practicing dentists. An electronic and manual search was conducted in four databases (Medline, LIVIVO, Cochrane Library, Web of Science Core Collection). Publications of multiple study designs written in English or German without data restrictions, reporting on prosthodontic treatment of patients diagnosed with HED and afflicted with oligo‐ or anodontia, were included. In total, 75 articles on 146 patients were analysed according to the patients′ age. In children aged 2‐17 years, removable full or partial (over)dentures represented standard treatment. In the mandible, implant‐supported removable dentures on two interforaminal implants presented an alternative, already in young childhood. In cases with more than six teeth per jaw, also fixed (resin) bridges were used, frequently after orthodontic treatment. In adults, fixed or removable reconstructions with the help of up to eight implants per jaw, usually placed after bone augmentation procedures, were standard. Ten case reports/series with long‐term follow‐up illustrated the need for consistent maintenance including denture renewals. Prosthodontic rehabilitation should start in early childhood and needs to be revised in accordance with the patients' growth. Treatment should be carried out by a multidisciplinary team addressing variable demands in different age groups.
Informal housing, spatial structure, and city compactness
Authors: Posada Héctor M.
Published: April 2018

This paper develops a monocentric city model with a formal and an informal sector in the housing industry. While formal developers build houses renting land from landowners, informal developers use land for free. However, informal developers must incur defensive expenditures to avoid government intervention. In equilibrium, at any distance of the central business district (CBD), informal developers use land until the value of the marginal productivity of land equals the defensive expenditures per unit of land. The model shows the land allocated to produce short informal (tall formal) buildings increases (decreases) with distance to the CBD. Thus, the model introduces a new source of spatial variation of building height. The model also shows that a higher level of informal housing increases the spatial size of a city and reduces the height of its buildings.
State‐owned firms and private debt
Authors: Picard Pierre M. , Rusli Ridwan D.
Published: April 2018

We study the role of private debt financing in reducing government transfers and information costs in a state‐owned firm. We show that debt contracts allow the government to reduce socially costly subsidies by letting underperforming state‐owned firms default. When the firm has private information, the government uses debt to reduce the firm's information rents. The option of default and privatization allows the government to stop subsidizing the firm. We identify the conditions under which information costs outweigh privatization costs and a positive debt level benefits governments.
What's the damage? Environmental regulation with policy‐motivated bureaucrats
Authors: Voss Achim , Lingens Jörg
Published: April 2018

In choosing environmental policy, governments rely on information provided by bureaucrats, who may have a political motivation of their own. We analyze the ensuing principal–agent relationship and derive the government's optimal contract. We find that a regulatory agent who is more environmentalist than the government is rewarded for truthfully stating that the environmental impact of the regulated economic activity is low (and vice versa). The bureaucrat has a stronger influence on policy if there is greater uncertainty about the environmental impact, or if the policy choice has a strong weight in his utility function. For some impact values, the bureaucrat is permitted to set his own preferred policy, which is a form of optimal delegation.
Weight suppression as a predictor variable in the treatment of eating disorders: A systematic review
Authors: Jenkins P. E. , Lebow J. , Rienecke R. D.
Published: April 2018

Accessible summary

What is known on the subject?

Weight suppression (WS) has been suggested to predict outcome following psychological treatment for an eating disorder (ED).

Some findings are contradictory and have not been considered systematically.

What the paper adds to existing knowledge?

The review suggests that weight gain at post‐treatment is reliably predicted by pretreatment WS, but findings regarding other outcomes (e.g., treatment dropout) are less consistent.

Approximate effect sizes for observed relationships are identified, alongside support for biobehavioural theories of metabolic adaptation to weight loss.

What are the implications for practice?

Degree of WS at pretreatment is associated with weight gain and is important for clinicians to consider before offering treatment to patients with EDs.

Patients high in WS might benefit from further support (e.g., psychoeducation) prior to beginning treatment.

Introduction

Weight suppression (WS—the difference between highest body weight and current body weight) has been proposed as a predictor of treatment outcome within eating disorders (EDs), although this hypothesis has not been consistently supported.

Aim/Question

Review the association between pretreatment WS and outcome following psychological treatment for EDs.

Method

A comprehensive electronic database search for published and unpublished literature from 1979 to 2017. Reference lists were also inspected. Eligibility criteria were determined according to relevant guidelines and a quality appraisal was conducted.

Results

Twelve studies met inclusion criteria (one was subsequently excluded based on insufficient data). Greater WS was generally associated with weight gain at post‐treatment although not with other treatment outcomes.

Discussion

The existing evidence, with data from 1,566 participants, is summarized according to three main post‐treatment outcomes: weight change; treatment completion; and symptom abstinence. Patients with disordered eating and greater WS may need to gain more weight than others during treatment to achieve good outcomes. Recommendations for future studies are provided.

Implications for practice

Evidence‐based treatments for EDs may benefit from considering WS when planning treatment, such as further psychoeducation on weight changes. Societal interventions regarding promotion of healthy eating may also draw on these findings.
Phylogenetic analysis of Dunaliella (Chlorophyta) emphasizing new benthic and supralittoral isolates from Great Salt Lake
Authors: Henley William J. , Cobbs Michael , Novoveská Lucie , Buchheim Mark A.
Published: April 2018

Dunaliella, a commercially important chlorophyte, is globally distributed in saline habitats. Morphological species have not been definitively reconciled with phylogenetic analyses. Considerable genetic diversity continues to be discovered in new isolates, especially from soil and benthic habitats. Twenty‐nine new isolates from Great Salt Lake, Utah, many from benthic or supralittoral habitats, were phylogenetically analyzed using ITS1+5.8S+ITS2 in comparison to a broad sampling of available sequences. A few new isolates align in one branch of a bifurcated monophyletic Dunaliella salina clade and several cluster within monophyletic D. viridis. Several others align with relatively few unnamed strains from other locations, comprising a diverse clade that may represent two or more new species. The overall Dunaliella clade is relatively robust, but the nearest outgroups are ambiguously placed with extremely long branches. About half of the isolates, all from benthic or supralittoral habitats, have been persistently sarcinoid in liquid media since isolation. This trait is spread across the Dunaliella phylogeny. The morphology of two sarcinoid strains was documented with light microscopy, revealing an extensive glycocalyx. Clumping behavior of unicellular and sarcinoid strains was unaffected by presence or absence of Mg2+ or Ca2+, addition of lectin‐inhibiting monosaccharides, or water‐soluble factors from morphologically opposite strains. Results from this investigation have significantly expanded our current understanding of Dunaliella diversity, but it seems likely that much remains to be discovered with additional sampling.
Role of climate and herbivory on native and alien conifer seedling recruitment at and above the Fennoscandian tree line
Authors: Bognounou Fidele , Hulme Philip E. , Oksanen Lauri , Suominen Otso , Olofsson Johan
Published: April 2018

Questions

We investigated the importance of climate and herbivory on native and alien conifer colonization of the birch‐dominated Fennoscandian tree line by addressing the following questions: (a) are tree line and tundra habitats similarly suitable for conifer seedling recruitment; (b) do ungulate and rodent herbivores differentially impact seedling recruitment; and (c) how does the role of habitat and herbivory on seedling recruitment vary across a marked climate gradient?

Location

Northern Fennoscandia, Sweden (Vassijaure and Paddus), and Norway (Joatka and Seiland).

Methods

We conducted an experiment to assess the emergence rate, survival probability and height development of Norway spruce (Picea abies), Scots pine (Pinus sylvestris) and Siberian larch (Larix sibirica) seedlings. Three experimental plots (i.e., open control, reindeer exclosure and complete vertebrate exclosure) were established in both tree line and tundra habitats at each of the four locations. Seeds of the three conifer species were sown in each plot in June 1999 during three consecutive years. The surviving seedlings were counted in August to September 1999, 2000, 2001, 2002 and 2007. The height of all seedlings was measured in 2007.

Results

Our study reveals that Norway spruce, Scots pine and Siberian larch can regenerate from seed at and above the current tree line in northern Fennoscandia. Their performance was generally higher above tree line in tundra than at tree line, but depended on species identity, climate aridity and mammal herbivory, particularly by rodents. These results suggest that the species composition and latitudinal limit of the tree line in the future might depend not only on direct effects of the future climate on the current tree line species, but also on the intensity of alien and native conifer introductions, as well as changes in herbivore populations.

Conclusion

If sufficient seeds of Norway spruce, Scots pine and Siberian larch should reach the current tree line, their performances will increase with a warmer and wetter climate, and this effect will be markedly modulated by herbivores (particularly rodents). Further work is required to extend these results to determine the ability of these conifers to become tree line‐forming species in the future.
Insights into the post‐translational modifications of archaeal Sis10b (Alba): lysine‐16 is methylated, not acetylated, and this does not regulate transcription or growth
Authors: Cao Jingjing , Wang Qian , Liu Tao , Peng Nan , Huang Li
Published: April 2018

Nucleic acid‐binding proteins of the Sac10b family, also referred to as Alba (for acetylation lowers binding affinity), are highly conserved in Archaea. It was reported that Sso10b, a Sac10b homologue from Sulfolobus solfataricus, was acetylated at the ɛ‐amino group of K16 and the α‐amino group of the N‐terminal residue. Notably, acetylation of K16 reduced the affinity of Sso10b for DNA and de‐repressed transcription in vitro. Here, we show that Sis10b, a Sac10b homologue from Sulfolobus islandicus, underwent a range of post‐translational modifications (PTMs). K16 in Sis10b as well as Sso10b was not acetylated. Substitution of K16 for R16, which resulted in the loss of the PTMs at the site, showed little effect on the growth of the cell and resulted in only a slight change in the expression of a very small fraction of the genes. The N‐terminus of Sis10b was nearly completely Nα‐acetylated. The reduction or loss of the terminal acetylation led to a significant increase in the cellular concentration of Sis10b, suggesting the involvement of the modification in the control of the turnover of the protein. These results have clarified the PTMs of Sac10b homologues and shed light on the proposed roles of acetylation of the protein.
Paraneoplastic cerebellar degeneration: Yo antibody alters mitochondrial calcium buffering capacity
Authors: Panja D. , Vedeler C. A. , Schubert M.
Published: April 2018

Aim

Neurodegeneration is associated with dysfunction of calcium buffering capacity and thereby sustained cellular and mitochondrial calcium overload. Paraneoplastic cerebellar degeneration (PCD), characterized by progressive Purkinje neurone degeneration following paraneoplastic Yo antibody internalization and binding to cerebellar degeneration‐related protein CDR2 and CDR2L, has been linked to intracellular calcium homeostasis imbalance due to calbindin D28k malfunction. Therefore, we hypothesized that Yo antibody internalization affects not only calbindin calcium binding capacity, but also calcium‐sensitive mitochondrial‐associated signalling, causing mitochondrial calcium overload and thereby Purkinje neurone death.

Methods

Immunohistochemically, we evaluated cerebellar organotypic slice cultures of rat brains after inducing PCD through the application of Yo antibody‐positive PCD patient sera or purified antibodies against CDR2 and CDR2L how pharmacologically biased mitochondrial signalling affected PCD pathology.

Results

We found that Yo antibody internalization into Purkinje neurons caused depletion of Purkinje neurone calbindin‐immunoreactivity, cannabinoid 1 receptor over‐activation and alterations in the actions of the mitochondria permeability transition pore (MPTP), voltage‐dependent anion channels, reactive oxygen species (ROS) and Na+/Ca2+ exchangers (NCX). The pathological mechanisms caused by Yo antibody binding to CDR2 or CDR2L differed between the two targets. Yo‐CDR2 binding did not alter the mitochondrial calcium retention capacity, cyclophilin D‐independent opening of MPTP or activity of NCX.

Conclusion

These findings suggest that minimizing intracellular calcium overload toxicity either directly with cyclosporin‐A or indirectly with cannabidiol or the ROS scavenger butylated hydroxytoluene promotes mitochondrial calcium homeostasis and may therefore be used as future neuroprotective therapy for PCD patients.
Prominent microglial activation in cortical white matter is selectively associated with cortical atrophy in primary progressive aphasia
Authors: Ohm D. T. , Kim G. , Gefen T. , Rademaker A. , Weintraub S. , Bigio E. H. , Mesulam M.‐M. , Rogalski E. , Geula C.
Published: April 2018

Aims

Primary progressive aphasia (PPA) is a clinical syndrome characterized by selective language impairments associated with focal cortical atrophy favouring the language dominant hemisphere. PPA is associated with Alzheimer's disease (AD), frontotemporal lobar degeneration (FTLD) and significant accumulation of activated microglia. Activated microglia can initiate an inflammatory cascade that may contribute to neurodegeneration, but their quantitative distribution in cortical white matter and their relationship with cortical atrophy remain unknown. We investigated white matter activated microglia and their association with grey matter atrophy in 10 PPA cases with either AD or FTLD‐TDP pathology.

Methods

Activated microglia were quantified with optical density measures of HLA‐DR immunoreactivity in two regions with peak cortical atrophy, and one nonatrophied region within the language dominant hemisphere of each PPA case. Nonatrophied contralateral homologues of the language dominant regions were examined for hemispheric asymmetry.

Results

Qualitatively, greater densities of activated microglia were observed in cortical white matter when compared to grey matter. Quantitative analyses revealed significantly greater densities of activated microglia in the white matter of atrophied regions compared to nonatrophied regions in the language dominant hemisphere (P < 0.05). Atrophied regions of the language dominant hemisphere also showed significantly more activated microglia compared to contralateral homologues (P < 0.05).

Conclusions

White matter activated microglia accumulate more in atrophied regions in the language dominant hemisphere of PPA. While microglial activation may constitute a response to neurodegenerative processes in white matter, the resultant inflammatory processes may also exacerbate disease progression and contribute to cortical atrophy.
Anatomy of vegetative organs, inflorescence axis and pedicel in the Neoregelia bahiana complex (Bromeliaceae): taxonomic and ecological importance
Authors: Silva Kleber Resende , Versieux Leonardo M. , Oriani Aline
Published: April 2018

Delimitation of genera and species in Bromeliaceae is often problematic, for example in the Neoregelia bahiana complex which is distributed throughout the rocky fields of the Espinhaço Range, Brazil. Considering that the anatomical characterisation of different organs is potentially important for taxonomic and ecological interpretation of this complex, we analysed roots, stems (stolon), leaves, inflorescence axes (peduncle) and pedicels in individuals from different populations. In all the studied individuals, the roots are composed of velamen, a heterogeneous cortex, and a polyarch vascular cylinder with sclerenchymatous pith. The stolon features a parenchymatous cortex and collateral vascular bundles randomly distributed in the vascular cylinder. This organ may increase in diameter by the formation of new vascular bundles and a multi‐layered cork. The leaf blade has epidermal cells with U‐shaped thickened walls and peltate scales occur on the adaxial surface. The mesophyll consists of mechanical and water‐storage hypodermis and a heterogeneous chlorenchyma. The inflorescence axis and the pedicel have a parenchymatous cortex and vascular bundles randomly distributed in an aerenchyma. Some variable leaf characters, such as presence of air lacunae in the mesophyll, are related to the size of the individuals and were interpreted as phenotypic variations related mainly to sunlight incidence. In contrast, leaf characters such as lamina shape, distribution of the peltate scales, and number of cell layers forming the water‐storage hypodermis distinguish the populations of the Serra do Cabral and one population of the Diamantina (Minas Gerais) from the remaining studied populations, suggesting the existence of more than one taxon.
Transfer of Senecio karelinioides (Asteraceae−Senecioneae) to Synotis based on evidence from morphology, karyology and ITS/ETS sequence data
Authors: Li Hui‐Min , Lazkov Georgy A. , Illarionova Irina D. , Tong Tian‐Jing , Shao Yun‐Yun , Ren Chen
Published: April 2018

Senecio karelinioides (Asteraceae−Senecioneae) is a species with a rather distinctive habit and an uncertain position in the genus. Based on evidence from macro‐ and micro‐morphology, karyology and ITS and ETS sequence data, we demonstrate that it is actually a member of Synotis and closely related to Synotis atractylidifolia. The relationship is further supported by the approximately unbiased and the Swofford–Olsen–Waddell–Hillis statistical topology tests. We thus transfer the species to Synotis as Synotis karelinioides and place it in the same section as S. atractylidifolia. Senecio sect. Karelinioidei is recombined as Synotis sect. Karelinioidei for this section, and a lectotype of Synotis karelinioides is designated.
Prevalence and clinical characteristics of chronic spontaneous urticaria in pediatric patients
Authors: Balp Maria‐Magdalena , Weller Karsten , Carboni Veruska , Chirilov Alexandra , Papavassilis Charis , Severin Thomas , Tian Haijun , Zuberbier Torsten , Maurer Marcus
Published: April 2018

Background

Data on the prevalence and disease management of chronic urticaria (CU) and chronic spontaneous urticaria (CSU) in the pediatric population are scarce. This study assessed the prevalence of CU and CSU, and disease management among pediatric patients (0‐17 years).

Methods

A physician‐based online survey was conducted in 5 European countries (United Kingdom, Germany, Italy, France, and Spain) assessing the annual diagnosed prevalence, disease characteristics, and treatment patterns in the target population. Results are based on physician responses and analyzed using descriptive statistics. Prevalence estimates were calculated based on the number of CU/CSU pediatric patients diagnosed, seen, and treated by the respondents and extrapolated to the total pediatric population from each country.

Results

Across 5 European countries, the one‐year diagnosed prevalence of CU and CSU in pediatric patients was 1.38% (95% CI, 0.94‐1.86) and 0.75% (95% CI, 0.44‐1.08), respectively. Angioedema was reported in 6%‐14% of patients. A large proportion of CSU pediatric patients (40%‐60%) were treated with H1‐antihistamines at approved dose and 16%‐51% received H1‐antihistamines at higher doses. Approximately 1/3 of pediatric CSU patients remained uncontrolled with H1‐antihistamines at approved/higher doses. Other prescribed treatments were oral corticosteroids (10%‐28%) and topical creams (15%‐26%).

Conclusions

This study revealed a prevalence of CSU among pediatric population comparable to adults and also suggested an unmet need for approved treatments for inadequately controlled pediatric CSU patients. It is truly of concern that harmful (oral steroids) or insufficient (topical creams) treatments were frequently used despite better and guideline‐recommended alternatives.
Generation of 8‐oxo‐7,8‐dihydroguanine in G‐Quadruplexes Models of Human Telomere Sequences by One‐electron Oxidation
Authors: Merta Tomasz J. , Geacintov Nicholas E. , Shafirovich Vladimir
Published: April 2018

The mechanistic aspects of one‐electron oxidation of G‐quadruplexes in the basket (Na+ ions) and hybrid (K+ ions) conformations were investigated by transient absorption laser kinetic spectroscopy and HPLC detection of the 8‐oxo‐7,8‐dihydroguanine (8‐oxoG) oxidation product. The photo‐induced one‐electron abstraction from G‐quadruplexes was initiated by sulfate radical anions (SO4˙−) derived from the photolysis of persulfate ions by 308 nm excimer laser pulses. In neutral aqueous solutions (pH 7.0), the transient absorbance of neutral guanine radicals, G(‐H)˙, is observed following the complete decay of SO4˙− radicals (~10 μs after the actinic laser flash). In both basket and hybrid conformations, the G(‐H)˙ decay is biphasic with one component decaying with a lifetime of ~0.1 ms, and the other with a lifetime of 20–30 ms. The fast decay component (~0.1 ms) in G‐quadruplexes is correlated with the formation of 8‐oxoG lesions. We propose that in G‐quadruplexes, G(‐H)˙ radicals retain radical cation character by sharing the N1‐proton with the O6‐atom of G in the [G˙+: G] Hoogsteen base pair; this [G(‐H)˙: H+G G˙+: G] leads to the hydration of G˙+ radical cation within the millisecond time domain, and is followed by the formation of the 8‐oxoG lesions.
Captive to the Clinic: Phase I Clinical Trials as Temporal Total Institutions
Authors: Williams Quintin , Fisher Jill A.
Published: April 2018

This article develops the concept oftemporal total institutionsto describe how and why individuals voluntarily submit to highly controlled and often dehumanizing environments. We focus empirically on Phase I clinical trials, which offer compensation to healthy people in exchange for testing investigational pharmaceuticals. Analyzing the experiences of 67 U.S. healthy volunteers, we illustrate how comparisons between Phase I trials and prison are salient to participants as they reflect on their confinement in research facilities and their interactions with other participants and research staff. We argue that conditions of contemporary economic insecurity and/or poverty facilitate the existence of coercive temporal total institutions by undermining voluntariness. Phase I clinics take advantage of the steady supply of individuals who will submit to the organization's demands out of hope that the income gained will be transformative for their lives.
Religion and Partisan‐Ideological Sorting, 1984–2016*
Authors: Davis Nicholas T.
Published: April 2018

Objective

This article explores how religion affects the extent to which individuals connect their ideological to partisan identities—a process termed partisan‐ideological sorting.

Method

To explore this relationship, I analyze data from the American National Election Studies (ANES) Time‐Series surveys and the Youth‐Parent Socialization (YPS) panel study.

Results

I find that a matrix of belief, belonging, and behavior constrains the convergence between citizens’ political identities, with one important caveat: evangelical affiliation functions as the primary conduit through which religiosity shapes this sorting. Building on these results, I then estimate the direct impact of religion on sorting over time.

Conclusion

These findings show that religion has produced asymmetric sorting in the mass public among persons with right‐leaning identities. Further, they provide a social explanation for partisan‐ideological sorting that complements extant institutional ones.
A novel HLA‐B allele, HLA‐B*40:245 was identified in a patient with hepatitis B virus infection
Authors: Xia Y. , Gao S. , Cai C. , Shao C.
Published: April 2018

A novel allele HLA‐B*40:245 was discovered in a hepatitis B virus (HBV) infected patient.
High‐resolution HLA allele and haplotype frequencies in majority and minority populations of Costa Rica and Nicaragua: Differential admixture proportions in neighboring countries
Authors: Arrieta‐Bolaños E. , Madrigal‐Sánchez J. J. , Stein J. E. , Órlich‐Pérez P. , Moreira‐Espinoza M. J. , Paredes‐Carias E. , Vanegas‐Padilla Y. , Salazar‐Sánchez L. , Madrigal J. A. , Marsh S. G. E. , Shaw B. E.
Published: April 2018

The HLA system shows the most extensive polymorphism in the human genome. Allelic and haplotypic frequencies of HLA genes vary dramatically across human populations. Due to a complex history of migration, populations in Latin America show a broad variety of admixture proportions, usually varying not only between countries, but also within countries. Knowledge of HLA allele and haplotype frequencies is essential for medical fields such as transplantation, but also serves as a means to assess genetic diversity and ancestry in human populations. Here, we have determined high‐resolution HLA‐A, ‐B, ‐C, and ‐DRB1 allele and haplotype frequencies in a sample of 713 healthy subjects from three Mestizo populations, one population of African descent, and Amerindians of five different groups from Costa Rica and Nicaragua and compared their profiles to a large set of indigenous populations from Iberia, Sub‐Saharan Africa, and the Americas. Our results show a great degree of allelic and haplotypic diversity within and across these populations, with most extended haplotypes being private. Mestizo populations show alleles and haplotypes of putative European, Amerindian, and Sub‐Saharan African origin, albeit with differential proportions. Despite some degree of gene flow, Amerindians and Afro‐descendants show great similarity to other Amerindian and West African populations, respectively. This is the first comprehensive study reporting high‐resolution HLA diversity in Central America, and its results will shed light into the genetic history of this region while also supporting the development of medical programs for organ and stem cell transplantation.
The influence of mTOR inhibitors on the incidence of CMV infection in high‐risk donor positive–recipient negative (D+/R−) kidney transplant recipients
Authors: Cristelli Marina Pontello , Esmeraldo Ronaldo Matos , Pinto Cahue Motta , Sandes‐Freitas Taina Veras , Felipe Claudia , Lobo Clarissa Ferreira , Viana Laila , Mansur Juliana , Stopa Suelen , Santos Daniel Wagner Castro , Grenzi Patricia Cristina , Aguiar Wilson Ferreira , Tedesco‐Silva Helio , Pestana Jose Osmar Medina
Published: April 2018

Introduction

Several studies and meta‐analysis suggest the mTOR inhibitors are associated with reduced incidence of CMV infection after kidney transplantation, although their effects on the high‐risk population have not been investigated thoroughly.

Objective

This retrospective cohort study investigates the association between immunosuppression and CMV infection in D+/R− kidney transplant recipients receiving preemptive therapy.

Methods

All patients received rabbit anti‐thymocyte globulin, tacrolimus, prednisone and azathioprine (AZA), mycophenolate (MPA) or everolimus (EVR).

Results

Among 89 D+R−, the overall incidence of CMV infection was 76%, with no difference among the groups AZA vs MPA vs EVR (73 vs 83 vs 74%, P = 0.643). CMV infection occurred later (31 in AZA vs 31 in MPA vs 43 days in EVR group, P < 0.001) and showed a lower trend of recurrences (57% in AZA vs 79% in MPA vs 48% in EVR group, P = 0.058) in the everolimus group. There were no differences in the IgG seroconversion rate (82% in AZA vs 76% in MPA vs 72% in EVR group, P = 0.983). There were no differences in the incidence of biopsy‐proven acute rejection (10% in AZA vs 8% in MPA vs 6% in EVR group, P = 0.811) and renal function at 12 months (53.6 in AZA vs 60.3 in MPA vs. 55.4 mL/min/1.73 m2 in EVR group).

Conclusion

In this cohort of high‐risk CMV D+/R− kidney transplant recipients receiving rATG induction and tacrolimus, the use of mTOR inhibitors could only show a tendency towards but not a significant difference on the incidence of CMV events, when compared to antimetabolites.
Lomentospora prolificans fungemia in hematopoietic stem cell transplant patients: First report in South America and literature review
Authors: Penteado Fernando D. , Litvinov Nadia , Sztajnbok Jaques , Thomaz Danilo Y. , dos Santos Antonio M. , Vasconcelos Dewton M. , Motta Adriana L. , Rossi Flávia , Fernandes Juliana F. , Marques Heloisa Helena S. , Benard Gil , de Almeida João N.
Published: April 2018

Lomentospora prolificans is a filamentous fungus and an emerging pathogen in immunocompromised patients. It is encountered most commonly in Australia, Spain, and USA. We described the first case of Lomentospora prolificans fungemia in South America. The patient was a hematopoietic stem cell transplantation (HSCT) recipient who developed the infection 37 days after stem cells infusion. In addition, we performed a literature review of invasive lomentosporiosis in HSCT patients.
Molecular diagnosis of Strongyloides stercoralis among transplant candidates
Authors: Paula Fabiana M. , Malta Fernanda M. , Marques Priscilla D. , Melo Gessica B. , Corral Marcelo A. , Gottardi Maiara , Pinho João R. R. , Gonçalves Elenice M. N. , Castilho Vera L. P. , Pierrotti Ligia C. , Abdala Edson , Costa Silvia F. , Chieffi Pedro P. , Gryschek Ronaldo C. B.
Published: April 2018

Strongyloidiasis can occur without any symptoms or as a potentially fatal hyperinfection or disseminated infection, principally in immunosuppressed patients. Our study aimed to evaluate the application of conventional polymerase chain reaction (cPCR) and real‐time PCR (qPCR). Polymerase chain reaction (PCR) and real‐time PCR (qPCR) targeting the 18S rRNA gene for detection of Strongyloides stercoralis infection among transplant candidates were applied in stool samples obtained from 150 transplant candidates, preliminarily analyzed by parasitological methods. S. stercoralis larvae were visualized in 15/150 (10.0%) transplant candidates by parasitological methods. DNA from S. stercoralis was amplified in 26/150 (17.3%) and 49/150 (32.7%) stool samples of transplant candidates, using cPCR and qPCR, respectively. The results suggest that molecular methods, especially qPCR, should be used as an additional tool for diagnostic of S. stercoralis infection among transplant candidates.