bluuebunny/crossref_metadata_2025 huggingface dataset:
Tissue engineering scaffolds in the treatment of brain disorders in geriatric patients
Authors: Dehqan Niri Alireza , Karimi Zarchi Ali Akbar , Ghadiri Harati Parisa , Salimi Ali , Mujokoro Basil
Published: May 2019

The world population is ageing at an alarming rate, currently increasing at around 3% per year for people over 60 years. This fast growing demography is largely unproductive and prone to many brain disorders such as Alzheimer's disease, Parkinson's disease, and brain tumors. Currently available treatment modalities are inadequate to stop neural degeneration or to completely eradicate cancer cells. Exogenously engineered scaffolds hold great potential for in vivo brain regeneration and functional restoration. Ideally, scaffolds for brain tissue engineering should be biocompatible, non‐toxic, and electroactive with the ability to encourage neural elongation. These scaffolds have been successfully fabricated from a wide range of materials and techniques. Different types of stem cells have also been investigated for their ability to differentiate to nerve or glial tissue. The success of tissue engineering can thus be envisioned as a panacea for “retooling” of both individual’s ability and for immense long‐term benefit of society.
Factors that confound the prediction of renal medullary oxygenation and risk of acute kidney injury from measurement of bladder urine oxygen tension
Authors: Ngo Jennifer P. , Lankadeva Yugeesh R. , Zhu Michael Z. L. , Martin Andrew , Kanki Monica , Cochrane Andrew D. , Smith Julian A. , Thrift Amanda G. , May Clive N. , Evans Roger G.
Published: May 2019

Aim

Urinary oxygen tension (uPO2) may provide an estimate of renal medullary PO2 (mPO2) and thus risk of acute kidney injury (AKI). We assessed the potential for variations in urine flow and arterial PO2 (aPO2) to confound these estimates.

Methods

In 28 sheep urine flow, uPO2, aPO2 and mPO2 were measured during development of septic AKI. In 65 human patients undergoing cardiac surgery requiring cardiopulmonary bypass (CPB) uPO2 and aPO2 were measured continuously during CPB, and in a subset of 20 patients, urine flow was estimated every 5 minutes.

Results

In conscious sheep breathing room air, uPO2 was more closely correlated with mPO2 than with aPO2 or urine flow. The difference between mPO2 and uPO2 varied little with urine flow or aPO2. In patients, urine flow increased abruptly from 3.42 ± 0.29 mL min−1 to 6.94 ± 0.26 mL min−1 upon commencement of CPB, usually coincident with reduced uPO2. During hyperoxic CPB high values of uPO2 were often observed at low urine flow. Low urinary PO2 during CPB (<10 mm Hg at any time during CPB) was associated with greater (4.5‐fold) risk of AKI. However, low urine flow during CPB was not significantly associated with risk of AKI.

Conclusions

uPO2 provides a robust estimate of mPO2, but this relationship is confounded by the simultaneous presence of systemic hyperoxia and low urine flow. Urine flow increases and uPO2 decreases during CPB. Thus, CPB is probably the best time to use uPO2 to detect renal medullary hypoxia and risk of post‐operative AKI.
Corporate responsibility and the plurality of market aims
Authors: Smith Jeffery
Published: May 2019

A number of recent authors, most notably Joseph Heath, have persausively defended a market‐centered account of corporate responsibility that grounds standards of business conduct upon the normative presuppositions of the market. They have us focus on two important items: first, the value of welfare, or Pareto efficient outcomes, which underwrites the legitimacy of market arrangements; and second, the behavioral requirements needed to assure that corporations conduct business in a manner consistent with this value. This article critically examines the aspirations of this literature by embracing its basic method but questioning how well it understands the aim of the market. It puts forth a limited case for corporate responsibility anchored in other dimensions of the public good, distinct from the value of efficiency, and argues that a plausible understanding of corporate responsibility arises from the notion that market arrangements are sites of delegated social authority to provision other aspects of the common good.
ER alpha selective chromone, isoxazolylchromones, induces ROS‐mediated cell death without autophagy
Authors: Kaushik Swati , Sanawar Rahul , Lekshmi Asha , Chandrasekhar Leena , Nair Mydhily , Bhatnagar Seema , Santhoshkumar Thankayyan Retnabai
Published: May 2019

Chromones are recognized as privileged structures and useful templates for the design of novel compounds with promising pharmacological activity. Several reports implicate chromone scaffold as an antitumor agent. The present study highlights synthesis, docking, and potential activity of isoxazolylchromones, 3(a–f), a new class of compounds as potential agents exhibiting ERα antagonism and ERβ agonism. Molecular docking studies determined the binding site of compounds 3(a–f) in ERα and ERβ. All the analogues synthesized showed preferential cytotoxicity in ERα+ cell line (MCF‐7) compared to ERα‐ cell line (MDA‐MB‐231). Among the analogues synthesized, analogue 3d exhibited increased cytotoxicity. ERα silencing experiments confirmed the ERα selective nature of ligands. Transactivation assay on compound 3d indicated the down‐regulation of ERα luciferase reporter gene expression and induction of ERβ GFP in the treated cells. Cell cycle analysis revealed an increase in sub‐G0/G1 population on treatment with analogue 3d as compared to control. Similar to tamoxifen, 3d‐induced cell death is mediated through an increase in ROS as evidenced by change in roGFP ratio. Interestingly, the compound 3d induced mitochondrial trans‐membrane potential loss and caspase activation without indication of autophagy compared to tamoxifen that induced autophagy in the treated cells. Lack of significant autophagy and induction of ERβ signaling by the new compound place them as a better ERα antagonist.
Clinical assessment of implant‐supported full‐arch immediate prostheses over 6 months of function
Authors: Shen Huidan , Di Ping , Luo Jia , Lin Ye
Published: May 2019

Objective

To assess the clinical outcomes of implant‐supported full‐arch immediate prosthesis over 6 months of functions and analyze the risk factors of prosthetic complications.

Materials and Methods

This retrospective cohort study included patients who were treated with implant‐supported full‐arch restoration under immediate loading protocol between April 2008 and June 2016, and who wore the immediate prosthesis for more than 6 months. Medical charts were reviewed for the patients' general information, implant information, prosthetic information, and details of any prosthetic complications. Prosthetic complications were classified as follows: class I, prosthesis loosening; class II, fewer than three artificial teeth fractured; class III, three or more artificial teeth fractured; and class IV, resin base fractures. A cox proportional hazards ratio model was adopted to analyze the potential risk factors for class IV complications.

Results

A total of 114 patients (mean age, 56.73 ± 10.19 years) and 144 prostheses were included. The average wearing time for the immediate prosthesis was 21.9 months, and 62 (54.39%) patients experienced prosthetic complications, 30 of whom suffered from complications more than once. The most common complications were class II complications (12.3%) during the first 6 months of functioning and class IV complications (28.1%) during the entire function period. Class II complications were more common in the anterior region, while class IV complications occurred more often in the posterior region. The multivariable Cox proportional hazards regression model showed that a prosthesis in the maxilla (HR = 3.37, P = .001) and fiber reinforcement (HR = 0.39, P = .021) were significantly related to class IV complications.

Conclusions

Implant‐supported full‐arch immediate prosthesis functioning over 6 months have a high prevalence of prosthetic complications. Fiber‐reinforcement could reduce the prevalence of class IV complications when acrylic immediate prosthesis functioned longer than 6 months. Avoiding using the anterior teeth of the immediate prosthesis to tear pliable but strong food may prevent tooth fracture.
Differences in outcome between patients readmitted to index vs non‐index hospital trusts after colorectal resection
Authors: Nepogodiev Dmitri , Coupland Ben , Mytton Jemma , Pinkney Thomas , Smart Neil , Bhangu Aneel
Published: May 2019

Aim

The clinical consequences of readmission following major surgery in the English National Health Service are unknown. This study aimed to determine differences in outcome between patients readmitted to index vs non‐index trusts after major surgery.

Method

Adult patients who underwent colorectal resection in England in April 2006 to March 2017 were identified in the national Hospital Episodes Statistics dataset. Patients were included if they were readmitted as emergencies within 30 days of initial discharge. The primary outcome measure was all‐cause mortality within 90 days of readmission. Comparisons between patients readmitted to index vs non‐index trusts were adjusted for confounders using multivariable logistic regression. Rectal resection patients were a planned subgroup.

Results

The readmission rate following colorectal resection was 15.1% (54 680/364 481), with 7.1% (3905/54 680) readmitted to a non‐index trust. The 90‐day mortality following readmission was 7.1% (3874/54 680) overall and 3.9% (652/16 736) in the rectal resection subgroup. The reoperation rate was 19.2% (10 498/54 680) overall and 23.1% (3859/16 736) after rectal resection. Mortality was significantly higher in non‐index [10.9% (427/3905)] vs index trusts [6.8% (3447/507 75), adjusted OR 1.50, 95% CI 1.34–1.68, P < 0.001]. There was an annual average of 14.7 excess deaths in non‐index trusts; only 1.9 of these followed surgical reoperation. In patients who underwent rectal resection, only 0.3 of the total 1.9 excess deaths each year in non‐index trusts followed surgical reoperation.

Conclusion

Despite a statistical difference, the absolute number of excess deaths attributable to readmission to a non‐index trust is very low, particularly amongst patients requiring reoperation.
Evaluation of cellular adequacy in endometrial liquid‐based cytology
Authors: Nimura Azusa , Ishitani Ken , Norimatsu Yoshiaki , Okada Kaoruko , Akizawa Yoshika , Yanoh Kenji , Hirai Yasuo , Nagashima Yoji , Irino Satoshi , Kobayashi Tadao K. , Tabata Tsutomu
Published: May 2019

Objective

This study evaluated cellular adequacy in endometrial liquid‐based cytology (LBC) specimens.

Methods

In total, 1267 cases were obtained and the rate of unsatisfactory specimen and diagnostic accuracy for malignancy were assessed. If ≥10 cellular clusters composed of ≤30 endometrial cells were found per specimen, then the sample was provisionally considered adequate.

Results

The unsatisfactory rate (with fewer than 10 clusters) was 15.4%. Diagnostic accuracy in specimens with ≥10 clusters was significantly higher (90.5% vs 36.4%) than that in specimens with fewer than10 clusters. Moreover, the unsatisfactory rate in patients aged ≥60 years was significantly higher (33.8% vs 13.2%) than that in patients younger than 60 years. Although the unsatisfactory rate was decreased, significant differences were not found between cases with fewer than five clusters (22.6%) and fewer than 10 clusters (33.8%) in patients aged ≥60 years. Diagnostic accuracy in cases with five or more clusters was significantly higher (90.3% vs 0%) than that in cases with fewer than five clusters.

Conclusions

We propose that ≥10 clusters with ≥30 endometrial cells per cluster could be used as a specimen adequacy criterion for endometrial LBC. If ≥10 clusters cannot be found in patients aged ≥60 years, then the use of the alternative criterion of five or more clusters may yield satisfactory specimen adequacy.
S2k guidelines for Merkel cell carcinoma (MCC, neuroendocrine carcinoma of the skin) – update 2018
Authors: Becker Jürgen C. , Eigentler Thomas , Frerich Bernhard , Gambichler Thilo , Grabbe Stephan , Höller Ulrike , Klumpp Bernhard , Loquai Carmen , Krause‐Bergmann Albrecht , Müller‐Richter Urs , Pföhler Claudia , Schneider‐Burrus Sylke , Stang Andreas , Terheyden Patrick , Ugurel Selma , Veith Johannes , Mauch Cornelia
Published: May 2019

Merkel cell carcinoma (MCC, ICD‐O M8247 / 3) is a rare malignant primary skin tumor with epithelial and neuroendocrine differentiation. The neoplastic cells share many morphological, immunohistochemical and ultrastructural characteristics with Merkel cells of the skin. The diagnosis of MCC is rarely made on clinical grounds. Histological and immunohistochemical studies are usually required to confirm the clinical suspicion. Given the frequent occurrence of occult lymph node metastasis, sentinel lymph node biopsy should be performed once distant metastasis has been ruled out by cross‐sectional imaging. Primary tumors without evidence of organ metastases are treated with complete surgical excision with appropriate surgical margins. Radiation therapy should be considered at all stages of the disease.

For advanced MCC that is no longer amenable to curative treatment by surgery or radiation therapy, there is currently no established systemic therapy for which an improvement in recurrence‐free survival or overall survival has been demonstrated in a prospective randomized trial. However, immunotherapy using PD‐1/PD‐L1 blockade seems to be superior to chemotherapy.

Various factors warrant that further diagnostic and therapeutic interventions be determined by an interdisciplinary tumor board. These factors include the tumor's aggressiveness, the frequent indication for sentinel lymph node biopsy along with the frequent occurrence in the head and neck region, the potential indication for adjuvant radiation therapy as well as the complexity of the required diagnostic workup.
Risk or resource: Does school climate moderate the influence of community violence on children’s social‐emotional development in the Democratic Republic of Congo?
Authors: Starkey Leighann , Aber J. Lawrence , Crossman Angela
Published: May 2019

Exposure to community violence is thought to create risk for the social and emotional development of children, including those children living in low‐income, conflict‐affected countries. In the absence of other types of community resources, schools may be one of the few community resources that can help buffer children from the negative effects of community violence exposure. We sampled 8,300 students ranging in age from 6–18 years in 123 schools from the eastern Democratic Republic of Congo to examine whether and how two distinct dimensions of positive school climate can protect two key features of children's social‐emotional development in the presence of community violence. Multi‐level models tested the hypothesis that students’ perceptions of a positive school climate moderated the relation between community violence and self‐reported mental health problems and peer victimization. Findings support the hypothesis. Specifically, a positive school climate protected against mental health problems and peer victimization in the presence of high community violence. Students who experienced high community violence and a negative school climate generally demonstrated the worst development. We find complex interactions between the dimensions of school climate and exposure to violence on student social‐emotional development that highlight the salience of children's contexts for developmental studies in low‐income countries. We use dynamic developmental systems theory and differential impact to discuss the dual potential of schools as a buffer against the effects of violence or as a source of compounded risk.
Biomass production and energy balance of Miscanthus over a period of 11 years: A case study in a large‐scale farm in Poland
Authors: Dubis Bogdan , Jankowski Krzysztof Józef , Załuski Dariusz , Bórawski Piotr , Szempliński Władysław
Published: May 2019

Giant miscanthus (Miscanthus × giganteus Greef and Deuter) and Amur silver grass (Miscanthus sacchariflorus Maxim./Hack) are rhizomatous grasses with a C4 photosynthetic pathway that are widely cultivated as energy crops. For those species to be successfully used in bioenergy generation, their yields have to be maintained at a high level in the long term. The biomass yield (fresh and dry matter [DM] yield) and energy efficiency (energy inputs, energy output, energy gain, and energy efficiency ratio) of giant miscanthus and Amur silver grass were compared in a field experiment conducted in 2007–2017 in North‐Eastern Poland. Both species were characterized by high above‐ground biomass yields, and the productive performance of M. × giganteus was higher in comparison with M. sacchariflorus (15.5 vs. 9.3 Mg DM ha−1 year−1 averaged for 1–11 years of growth). In the first year of the experiment, the energy inputs associated with the production of M. × giganteus and M. sacchariflorus were determined at 70.5 and 71.5 GJ/ha, respectively, and rhizomes accounted for around 78%–79% of total energy inputs. In the remaining years of cultivation, the total energy inputs associated with the production of both perennial rhizomatous grasses reached 13.6–15.7 (M. × giganteus) and 16.9–17.5 GJ ha−1 year−1 (M. sacchariflorus). Beginning from the second year of cultivation, mineral fertilizers were the predominant energy inputs in the production of M. × giganteus (78%–86%) and M. sacchariflorus (80%–82%). In years 2–11, the energy gain of M. × giganteus reached 50 (year 2) and 264–350 GJ ha−1 year−1 (years 3–11), and its energy efficiency ratio was determined at 4.7 (year 2) and 18.6–23.3 (years 3–11). The energy gain and the energy efficiency ratio of M. sacchariflorus biomass in the corresponding periods were determined at 87–234 GJ ha−1 year−1 and 6.1–14.3, respectively. Both grasses are significant and environmentally compatible sources of bioenergy, and they can be regarded as potential energy crops for Central‐Eastern Europe.
Geographies of aesthetic labour and the creative work of grime DJs
Authors: Willment Nina
Published: May 2019

This paper undertakes a close examination of the work of grime DJs to demonstrate the value of Cultural Geography scholarship in developing new ways of thinking about work in general, and specifically in approaching the concept of aesthetic labour. In particular, the paper examines three ways in which we can theorise this kind of work and performance. First, the paper notes how value is constituted within fields of cultural judgement and taste, through a discussion of the aesthetic labour involved in the workers' self‐fashioning. Second, it expands the concept of aesthetic labour beyond this self‐fashioning to encompass the staging of value and the associated spaces of embodied performance and the generation of placed atmospherics. Finally, the paper discusses how aesthetic labour has expanded through its implication in the digital geographies and spatialities of creative work. Through these three foci, the paper therefore highlights how Cultural Geography's engagements with aesthetic labour may be productively expanded to help us to investigate the cultural character and spatialities of contemporary creative work.
Effects of intervention intensity on skill acquisition and task persistence in children with Down syndrome
Authors: Neil Nicole M. , Jones Emily A.
Published: May 2019

Background

Modifying intensity is one approach to tailoring intervention to meet the needs of learners with developmental disabilities. This study examined the effects of varying intensity levels of a behaviour analytic intervention on the efficiency of acquisition and task persistence in young children with Down syndrome.

Methods

Using adapted alternating treatment designs, three children were taught expressive language targets when three aspects of the dose of intervention intensity varied: number of opportunities, spacing of opportunities and session duration.

Results

Children acquired targets faster in conditions in which the spacing of opportunities was shorter than conditions in which the spacing was longer. Two children showed greater expression of positive affect in moderate levels of intensity. Children showed idiosyncratic differences in off‐task behaviour.

Discussion

This research suggests that pacing of opportunities may be an important for understanding acquisition outcomes in a behaviour analytic approach to intervention for communication among young children with Down syndrome.
Inhibition of the type III secretion system by syringaldehyde protects mice from Salmonella enterica serovar Typhimurium
Authors: Lv Qianghua , Chu Xiao , Yao Xinyu , Ma Kelong , Zhang Yong , Deng Xuming
Published: May 2019

The invasiveness of Salmonella enterica serovar Typhimurium (S. Typhimurium) is closely associated with the Salmonella pathogenicity island (SPI)‐encoded type Ⅲ secretion system (T3SS), which can directly inject a series of effector proteins into eukaryotic cells to enable bacterial infection. In this study, syringaldehyde was identified as an effective inhibitor of the S. Typhimurium T3SS using an effector protein‐lactamase fusion reporter system. Syringaldehyde treatment could inhibit the expression of important effector proteins (SipA, SipB and SipC) at a concentration of 0.18 mM without affecting bacterial growth. Additionally, significant inhibition of bacterial invasion and cellular injury was observed following the syringaldehyde treatment in the co‐infection system of HeLa cells and S. Typhimurium. Furthermore, treatment with syringaldehyde provided systemic protection to mice infected with S. Typhimurium, reducing mortality (40.00%) and bacterial loads and relieving caecal damage and systemic inflammation. The results presented in this study indicate that syringaldehyde significantly affects T3SS activity and is a potential leading compound for treating S. Typhimurium infections.
Molecular characterization and functional analysis of interferon regulatory factor 9 (irf9) in common carp Cyprinus carpio: a pivotal molecule in the Ifn response against pathogens
Authors: Zhu Yaoyao , Shan Shijuan , Feng Hanxiao , Jiang Lei , An Liguo , Yang Guiwen , Li Hua
Published: May 2019

In the present study, interferon (IFN) regulatory factor (IRF) 9 gene (irf9) was identified and characterized in common carp Cyprinus carpio. The predicted protein sequence of Irf9 contains a DNA binding domain (DBD) that possess five tryptophans, an IRF association domain (IAD) and two nuclear localisation signals (NLS). Alignment of Irf9 of C. carpio with the corresponding Irf9 proteins of other species showed that the DBD is more highly conserved than the IAD. The putative Irf9 protein sequence of C. carpio shares higher identities with teleosts (53.8–82.3%) and lower identities with mammals (30.2–31.0%). Phylogenetic studies of the putative amino‐acid sequence of IRF9 based on the neighbour‐joining method showed that Irf9 of C. carpio has the closest relationship with the grass carp Ctenopharyngodon idella. Tissue distribution analysis showed that irf9 transcripts were detectable in all examined tissues with the highest expression in the skin and the lowest expression in the head kidney. Poly I:C and Aeromonas hydrophila stimulation up‐regulated irf9 expression in the spleen, head kidney, foregut and hindgut at different time intervals. In addition, irf9 was induced by Poly I:C and lipopolysaccharides (LPS) in vitro. These results indicate that Irf9 participates in antiviral and antibacterial immunity. Transfection of irf9 up‐regulated the expression of cytokines, including type I IFN, protein kinase R (PKR), interferon‐stimulated gene (ISG)15 and tumour necrosis factor (TNF)α in epithelioma papulosum cyprini cells (EPC) upon poly I:C and LPS stimulation. A dual‐luciferase reporter assay revealed that Irf9 has no effect on NF‐κB activation. The present study on Irf9 provides new insights into the IFN system of C. carpio and a valuable experimental platform for future studies on the immune system of fish.
Experimental and computational fluid dynamics modeling of Satureja khuzestanica essential oil extraction during ohmic‐hydrodistillation
Authors: Roohi Reza , Hashemi Seyed Mohammad Bagher
Published: May 2019

A 3D computational model was presented to simulate the essential oil extraction process using ohmic‐hydrodistillation. The extraction of Satureja khuzestanica essential oil was performed at three voltages (80, 120, and 160 V) and three NaCl concentrations (0.5, 1, and 1.5% (w/v)). The effect of electrical conductivity variations with temperature and salinity concentration, the imposed electrical potential as well as evaporation‐condensation mechanisms were also taking into account. The variations of system temperature along with the amount of the extracted essential oil during the procedure were numerically calculated and good agreement with the measured experimental data was observed. The evaporation nucleation happened at two distinct locations, namely at the tips of electrodes and near the midsection at regions below the outlet tube. Increasing the NaCl concentration from 0.5 to 1.5% (w/v), led to a 10 min reduction of extraction process for 80 volts’ potential difference while the same amount of salt addition caused twice time reduction (20 min) for 160 volts’ case. Both of NaCl concentration and applied voltage parameters accelerated the extraction process. However, the effect of increasing of the system salinity was more pronounced at higher voltages.

Practical applications

There are several methods to extract essential oils from different parts of herbs, such as hydro and steam‐distillation. However, these usual techniques have shown some drawbacks. Ohmic heating is a new thermal process that can enhance temperature of products during the passage of electric currents. This technology has many advantages including shorter process time and better energy efficiency compare to usual heating. The utilization of fluid flow and heat transfer governing equations to investigate the performance of ohmic‐hydrodistillation can help design and optimization of this process.
Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review
Authors: Batsis John A. , DiMilia Peter R. , Seo Lillian M. , Fortuna Karen L. , Kennedy Meaghan A. , Blunt Heather B. , Bagley Pamela J. , Brooks Jessica , Brooks Emma , Kim Soo Yeon , Masutani Rebecca K. , Bruce Martha L. , Bartels Stephen J.
Published: May 2019

BACKGROUND

Disparities in healthcare access and delivery, caused by transportation and health workforce difficulties, negatively impact individuals living in rural areas. These challenges are especially prominent in older adults.

DESIGN

We systematically evaluated the feasibility, acceptability, and effectiveness in providing telemedicine (TMed), searching the English‐language literature for studies (January 2012 to July 2018) in the following databases: Medline (PubMed); Cochrane Library (Wiley); Web of Science; CINAHL; EMBASE (Ovid); and PsycINFO (EBSCO).

PARTICIPANTS

Older adults (mean age = 65 years or older, and none were younger than 60 years).

INTERVENTIONS

Interventions consisted of live, synchronous, two‐way videoconferencing communication in nonhospital settings. All medical interventions were included.

MEASUREMENTS

Quality assessment, using the Cochrane Collaboration's Risk‐of‐Bias Tool, was applied on all included articles, including a qualitative summary of all articles.

RESULTS

Of 6616 citations, we reviewed the full text of 1173 articles, excluding 1047 that did not meet criteria. Of the 17 randomized controlled trials, the United States was the country with the most trials (6 [35%]), with cohort sizes ranging from 3 to 844 (median = 35) participants. Risk of bias among included studies varied from low to high. Our qualitative analysis suggests that TMed can improve health outcomes in older adults and that it could be used in this population.

CONCLUSIONS

TMed is feasible and acceptable in delivering care to older adults. Research should focus on well‐designed randomized trials to overcome the high degree of bias observed in our synthesis. Clinicians should consider using TMed in routine practice to overcome barriers of distance and access to care. J Am Geriatr Soc 67:1737–1749, 2019
Improved patient satisfaction 2 years after introducing person‐centred handover in an oncological inpatient care setting
Authors: Kullberg Anna , Sharp Lena , Johansson Hemming , Brandberg Yvonne , Bergenmar Mia
Published: May 2019

Aims and objectives

To investigate patients’ satisfaction with care, 2 years after the introduction of person‐centred handover (PCH) in an oncological inpatient setting, and to describe patients’ perceptions of individualised care.

Background

To obtain higher levels of patient satisfaction, bedside nursing handovers have been evaluated with positive results. One such model is PCH, which blends aspects of person‐centred care with the bedside report and provides the opportunity for nursing staff and patients to perform the handover together.

Design

A survey‐based design was used with one data collection period. Patient satisfaction scores were compared with baseline data from a previous study that has been conducted in the same wards.

Method

Patient satisfaction was measured with the EORTC IN‐PATSAT32 questionnaire, and individualised care was assessed with the Individualized Care Scale. A total of 120 adult patients with cancer were invited to participate from August 2017–March 2018. Of these, 90 chose to participate. The STROBE checklist for cross‐sectional studies was used when preparing the paper.

Results

Compared to the previous study, statistically significant improvements in patient satisfaction were observed in the subscales “Exchange of information between caregivers” and “Nurses’ information provision” postimplementation of PCH. Regarding patients’ perceptions of individualised care, the highest scores were in the ICS‐A subscale “Clinical situation” and ICS‐B “Decisional control,” while “Personal life situation” scored the lowest overall.

Conclusions

Person‐centred handover seems to have sustainable positive effects on important outcomes regarding patient satisfaction. A novel finding is the positive impact on nurses’ information provision, indicating that PCH can facilitate effective information exchange between patients and nurses.

Relevance to clinical practice

Person‐centred handover seems to improve patients’ satisfaction with nurses’ provision and exchange of information. Nurses and managers should carefully consider the implementation process of PCH and evaluate its long‐term effects. PCH can be recommended in the oncology inpatient setting.
The mediating and moderating effects of meaning in life on the relationship between depression and quality of life in patients with dysphagia
Authors: Kim Ju‐Yeun , Lee Young Whee , Kim Hwa‐Soon , Lee Eun‐Hyun
Published: May 2019

Aims and objectives

To identify whether meaning in life has moderating and mediating effects on the relationship between depression and quality of life in patients with dysphagia.

Background

Dysphagic patients typically have multidimensional problems, such as depression, which can negatively influence their quality of life. Meaning in life, therefore, can be used as a psychological resource that may enhance quality of life for these patients.

Design

A descriptive cross‐sectional research design was used.

Methods

Ninety patients with dysphagia were recruited for a survey from eight general and rehabilitation hospitals in Korea. The questionnaires, which included the Korean version of the Swallowing Quality of Life scale developed by Cha, the Center for Epidemiological Studies‐Depression Scale developed by Radloff, and the Purpose in Life test developed by Crumbaugh and Maholick, were used for data collection. Descriptive statistics, Hayes' PROCESS macro and Cronbach's alpha were used for data analyses.

Results

Meaning in life was found to mediate the relationship between depression and quality of life in patients with dysphagia. However, the index of moderation was not statistically significant, which mean that meaning in life did not moderate the relationship between the patients' depression and quality of life.

Conclusions

Meaning in life had a mediating effect on the relationship between depression and quality of life in patients with dysphagia. Thus, to improve the quality of life of patients with dysphagia, nurses should apply interventions to help them find meaning in life.

Relevance to clinical practice

Meaning in life can be used as a nursing intervention strategy to improve the quality of life for patients living with dysphagia and depression.
Optimization of a Multifrequency Magnetic Resonance Elastography Protocol for the Human Brain
Authors: Kurt Mehmet , Wu Lyndia , Laksari Kaveh , Ozkaya Efe , Suar Zeynep M. , Lv Han , Epperson Karla , Epperson Kevin , Sawyer Anne M. , Camarillo David , Pauly Kim Butts , Wintermark Max
Published: May 2019

BACKGROUND AND PURPOSE

The brain's stiffness measurements from magnetic resonance elastography (MRE) strongly depend on actuation frequencies, which makes cross‐study comparisons challenging. We performed a preliminary study to acquire optimal sets of actuation frequencies to accurately obtain rheological parameters for the whole brain (WB), white matter (WM), and gray matter (GM).

METHODS

Six healthy volunteers aged between 26 and 72 years old went through MRE with a modified single‐shot spin‐echo echo planar imaging pulse sequence embedded with motion encoding gradients on a 3T scanner. Frequency‐independent brain material properties and best‐fit material model were determined from the frequency‐dependent brain tissue response data (20 ‐80 Hz), by comparing four different linear viscoelastic material models (Maxwell, Kelvin‐Voigt, Springpot, and Zener). During the material fitting, spatial averaging of complex shear moduli (G*) obtained under single actuation frequency was performed, and then rheological parameters were acquired. Since clinical scan time is limited, a combination of three actuation frequencies that would provide the most accurate approximation and lowest fitting error was determined for WB, WM, and GM by optimizing for the lowest Bayesian information criterion (BIC).

RESULTS

BIC scores for the Zener and Springpot models showed these models approximate the multifrequency response of the tissue best. The best‐fit frequency combinations for the reference Zener and Springpot models were identified to be 30‐60‐70 and 30‐40‐80 Hz, respectively, for the WB.

CONCLUSIONS

Optimal sets of actuation frequencies to accurately obtain rheological parameters for WB, WM, and GM were determined from shear moduli measurements obtained via 3‐dimensional direct inversion. We believe that our study is a first‐step in developing a region‐specific multifrequency MRE protocol for the human brain.
The Significance of Person‐Centered Care for Satisfaction With Care and Well‐Being Among Informal Caregivers of Persons With Severe Intellectual Disability
Authors: Hakobyan Liana , Nieboer Anna P. , Finkenflügel Harry , Cramm Jane M.
Published: May 2019

Person‐centered care (PCC) delivery and co‐creation of care (establishing productive patient‐professional interaction) are expected to lead to better patient outcomes. Given the prominent role of informal caregivers in care delivery processes to persons with intellectual disabilities (PWID), they are expected to benefit from person‐centered care (PCC) and co‐creation of care as well. This study aims to identify the relationship between PCC, co‐creation of care and outcomes among informal caregivers of PWID. A cross‐sectional survey was conducted in 2015 among informal caregivers of PWID (45.8% parents, 44.1% siblings, 10.1% other family member). All PWID were living in residential homes of a long‐term care organization in the Eastern part of the Netherlands. For every PWID, the most important informal caregiver was invited to participate. Nine hundred and forty‐one invitations were sent out and 289 of them responded (31% response rate). Mean age of informal caregivers was 61.80 (SD 11.21; range 23–90) years old. About half of the respondents (55%) were female and 23% were single. Most of the respondents (83%) were providing informal care for more than 10 years and 29% provided informal care for 8 hours per week or more. Correlation analyses indicated that PCC and co‐creation of care were positively related to informal caregivers' satisfaction with care and their own well‐being. Regression analyses showed that PCC is associated with satisfaction with care (β = 0.60, p < 0.001) and well‐being (β = 0.22, p < 0.01) while controlling for background characteristics. Relational co‐creation was also positively associated with satisfaction with care (β = 0.15, p < 0.01) and well‐being (β = 0.20, p < 0.01). This study provided the first empirical evidence that PCC and co‐creation of care matter for satisfaction with care and the well‐being of informal caregivers of PWID.
Asymptotic Behavior of Optimal Weighting in Generalized Self‐Normalization for Time Series
Authors: Zhang Ting , Lavitas Liliya , Pan Qiao
Published: May 2019

Self‐normalization has been celebrated for its ability to avoid direct estimation of the nuisance long‐run variance and its versatility in handling the mean and other quantities. The self‐normalizer in its original form uses only recursive estimators of one direction, and generalizations involving both forward and backward estimators were recently given. Unlike existing results that weigh the forward and backward estimators in a deterministic manner, the current article focuses on a data‐driven weight that corresponds to confidence intervals with minimal lengths. We study the asymptotic behavior of such a data‐driven weight choice, and find an interesting dichotomy between linear and nonlinear quantities. Another interesting phenomenon is that, for nonlinear quantities, the data‐driven weight typically distributes over an uncountable set in finite‐sample problems but in the limit it converges to a discrete distribution with a finite support.
Disturbance, microclimate and historical habitat connectivity determine the population performance of the threatened grassland specialist Carex caryophyllea in remnant grasslands
Authors: Lampinen Jussi
Published: May 2019

Many grassland specialist plant populations in Europe have become restricted to remnant habitats. The performance of these populations depends on both species‐specific traits and local and landscape level aspects of habitat quality. Understanding which specific local or landscape level conditions determine the performance of grassland species populations in remnant habitats would help design the restoration of the habitats and to detect the conditions that favour the long‐term persistence of grassland species in them. Such information is especially needed in urbanised landscapes, where remnant habitats engulfed by urban land use types may experience increased erosion, higher temperatures and invasion by alien species. This study investigates the population performance determinants of Carex caryophyllea (VU), a grassland specialist, in 43 remnant grasslands in an urban‐rural gradient in Finland. The population performance was assessed with metrics of persistence, establishment and reproduction, and related to environmental conditions with generalized additive models and redundancy analysis. The most important positive determinants for the performance of C. caryophyllea populations were disturbance through management or ground erosion, a warm microclimate, large habitat area and high historical connectivity to suitable grassland habitats. Present connectivity to other C. caryophyllea populations had a weak and near‐significant positive relationship with population performance. Urbanisation of the surrounding landscape correlated with population performance as well, possibly due to the high historical cover of grasslands in presently urbanised landscapes. The results imply that the most effective restoration method of remnant C. caryophyllea populations would be reinstating disturbance regimes in overgrown habitats with warm microclimates close to suitable habitats and other existing populations, whether urban or rural. This would counteract the species future decline due to possible extinction debts and help the species persist in the study area in the long term.
Anxiety and depression in irritable bowel syndrome: Exploring the interaction with other symptoms and pathophysiology using multivariate analyses
Authors: Midenfjord Irina , Polster Annikka , Sjövall Henrik , Törnblom Hans , Simrén Magnus
Published: May 2019

Background

Anxiety or depression, in other words, psychological distress, are common comorbidities in patients with irritable bowel syndrome (IBS), but their interaction with pathophysiological factors and other symptoms are unclear.

Methods

Patients with IBS (Rome III criteria), thoroughly characterized regarding pathophysiology (colonic transit time, visceral sensitivity, and autonomic nervous system [ANS] function), symptom profile (IBS severity, somatic symptoms, gastrointestinal [GI]‐specific anxiety and fatigue), and quality of life, were explored for differences regarding pathophysiology and symptoms between patients with and without reported psychological distress in univariate and multivariate analyses (Principal Component Analysis [PCA] with Hotelling's T2 and Orthogonal Partial Least Squares‐Discriminant Analysis [OPLS‐DA]).

Key Results

When using Hospital Anxiety and Depression Scale score ≥8 as cut‐off score, including both borderline and clinically significant cases, 345 (44.9%) out of 769 IBS patients reported anxiety, and 198 (25.7%) depression. In univariate analyses, patients reporting psychological distress demonstrated more severe GI and non‐GI symptoms, fatigue, GI‐specific anxiety and lower quality of life, and differences for some pathophysiological measures. IBS patients with and without reported psychological distress showed significant differences between the multivariate means in symptom reporting (PCA; both P < 0.001), and in pathophysiological measures in patients with and without anxiety (P = 0.018). Visceral hypersensitivity, altered ANS function, more severe GI‐specific anxiety, fatigue, and higher somatic non‐GI symptoms were the factors that most strongly separated patients with and without psychological distress (OPLS‐DA).

Conclusions and Inferences

Reported anxiety and depression are common in IBS patients, and our study demonstrates that they are interwoven in the complex pathophysiological and clinical picture of IBS.
No local adaptation in leaf or stem xylem vulnerability to embolism, but consistent vulnerability segmentation in a North American oak
Authors: Skelton Robert P. , Anderegg Leander D. L. , Papper Prahlad , Reich Emma , Dawson Todd E. , Kling Matthew , Thompson Sally E. , Diaz Jessica , Ackerly David D.
Published: May 2019

Vulnerability to embolism varies between con‐generic species distributed along aridity gradients, yet little is known about intraspecific variation and its drivers. Even less is known about intraspecific variation in tissues other than stems, despite results suggesting that roots, stems and leaves can differ in vulnerability. We hypothesized that intraspecific variation in vulnerability in leaves and stems is adaptive and driven by aridity.

We quantified leaf and stem vulnerability of Quercus douglasii using the optical technique. To assess contributions of genetic variation and phenotypic plasticity to within‐species variation, we quantified the vulnerability of individuals growing in a common garden, but originating from populations along an aridity gradient, as well as individuals from the same wild populations.

Intraspecific variation in water potential at which 50% of total embolism in a tissue is observed (P50) was explained mostly by differences between individuals (>66% of total variance) and tissues (16%). There was little between‐population variation in leaf/stem P50 in the garden, which was not related to site of origin aridity. Unexpectedly, we observed a positive relationship between wild individual stem P50 and aridity.

Although there is no local adaptation and only minor phenotypic plasticity in leaf/stem vulnerability in Q. douglasii, high levels of potentially heritable variation within populations or strong environmental selection could contribute to adaptive responses under future climate change.
Towards an urban marine ecology: characterizing the drivers, patterns and processes of marine ecosystems in coastal cities
Authors: Todd Peter A. , Heery Eliza C. , Loke Lynette H. L. , Thurstan Ruth H. , Kotze D. Johan , Swan Christopher
Published: May 2019

Human population density within 100 km of the sea is approximately three times higher than the global average. People in this zone are concentrated in coastal cities that are hubs for transport and trade – which transform the marine environment. Here, we review the impacts of three interacting drivers of marine urbanization (resource exploitation, pollution pathways and ocean sprawl) and discuss key characteristics that are symptomatic of urban marine ecosystems. Current evidence suggests these systems comprise spatially heterogeneous mosaics with respect to artificial structures, pollutants and community composition, while also undergoing biotic homogenization over time. Urban marine ecosystem dynamics are often influenced by several commonly observed patterns and processes, including the loss of foundation species, changes in biodiversity and productivity, and the establishment of ruderal species, synanthropes and novel assemblages. We discuss potential urban acclimatization and adaptation among marine taxa, interactive effects of climate change and marine urbanization, and ecological engineering strategies for enhancing urban marine ecosystems. By assimilating research findings across disparate disciplines, we aim to build the groundwork for urban marine ecology – a nascent field; we also discuss research challenges and future directions for this new field as it advances and matures. Ultimately, all sides of coastal city design: architecture, urban planning and civil and municipal engineering, will need to prioritize the marine environment if negative effects of urbanization are to be minimized. In particular, planning strategies that account for the interactive effects of urban drivers and accommodate complex system dynamics could enhance the ecological and human functions of future urban marine ecosystems.