bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and content validation of the Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey
Authors: Brown Janie A. , Cooper Alannah L. , Albrecht Matthew A.
Published: February 2020

Aim

To develop a validated tool to measure nursing and midwifery documentation burden.

Background

While an important record of care, documentation can be burdensome for nurses and midwives and may remove them from direct patient care, resulting in decreased job satisfaction, associated with decreased patient satisfaction. The amount of documentation is increasing at a time where staff rationalisation results in decreasing numbers of clinicians at the bedside. No instrument is available to measure staff perceptions of the burden of clinical documentation.

Design

Survey development, followed by rwo rounds of content validation (April and May 2019).

Methods

Based on the literature a 28 item survey, with items in 6 subscales, representing key areas of documentation burden was developed. Item (I‐CVI), subscale (S‐CVI/Ave by subscale) and overall content validity indexes (S‐CVI/Ave) were calculated following two review rounds by an expert panel of clinical and academic nurses and midwives.

Results

Level of agreement for the first iteration of the survey was low, with many items failing to reach the critical I‐CVI threshold of 0.78. No subscale reached a S‐CVI/Ave above 0.8 and the overall scale only achieved a S‐CVI/Ave score of 0.67. Thirteen items were removed, seven were edited and five new items added, based on the expert panel feedback, substantially improving the content validity. All individual items achieved an I‐CVI ≥0.78, the S‐CVI/Ave was above 0.85 for all subscales and the total S‐CVI/Ave was 0.94.

Conclusion

The Burden of Documentation for Nurses and Midwives (BurDoNsaM) survey can be considered as content valid, according to the content validity analysis by an expert panel.

Impact

The BurDoNsaM survey may be used by nurse leaders and researchers to measure the burden of documentation, providing the opportunity to review practice and implement strategies to decrease documentation burden, potentially improving patient satisfaction with the care received.
No evidence of sex ratio manipulation by Galápagos mockingbirds in response to environment
Authors: McNew Sabrina M. , Knutie Sarah A. , Clayton Dale H.
Published: February 2020

Birds can adjust investment in reproduction by altering the sex ratios of their broods. When one sex is more costly to raise than the other, producing either more male or female offspring can lower the costs of reproduction. Biasing sex ratios can also be advantageous if the expected fitness of male versus female offspring differs. Here, we investigated whether Galápagos mockingbirds Mimus parvulus bias sex ratios in response to variation in rainfall. Female mockingbirds are smaller and thus females may reduce the costs of reproduction by biasing sex ratios in favor of female offspring. We quantified sex ratios in 131 mockingbird broods over four years with variable rainfall (2012, 2013, 2015 and 2016). We found no evidence that mockingbirds adjusted sex ratios in response to environmental conditions. Mockingbirds may not adjust sex ratios either because they lack the ability to do so, or because the costs of manipulation outweigh its benefits.
Flash glucose monitoring in type 1 diabetes: A comparison with self‐monitoring blood glucose
Authors: Babaya Naru , Noso Shinsuke , Hiromine Yoshihisa , Taketomo Yasunori , Niwano Fumimaru , Yoshida Sawa , Yasutake Sara , Kawabata Yumiko , Ikegami Hiroshi
Published: February 2020

Aims/Introduction

A flash glucose monitoring (FGM) system has become available. To clarify the relationship between FGM and self‐monitoring blood glucose (SMBG) values, we compared the two values after simultaneous measurement in Japanese patients with type 1 diabetes, under daily life settings.

Materials and Methods

A total of 20 outpatients with type 1 diabetes were analyzed. When FGM and SMBG were carried out simultaneously (within ±3 min), the values were adopted and each FGM value was matched and compared with the corresponding SMBG value. In addition, we analyzed other cases of simultaneity defined as “within ±2 min,” “within ±1 min” and “at the exact same time.”

Results

The percentage of SMBG and FGM values in the clinically acceptable zone A + B in Clarke and consensus error grid analyses were 97.9 and 99.2%, respectively. Deming regression (x‐axis: FGM values, y‐axis: SMBG values) determined a slope of 0.9128 (95% confidence interval 0.9008–0.9247) and an intercept of +15.94 mg/dL (95% confidence interval 14.05–17.84). FGM values were lower than SMBG values in the lower glucose range, and higher in the higher glucose range. The shorter the time lag between measurements, the higher the rate of concordance between FGM and SMBG values.

Conclusions

The results of this study provided evidence on the reliability of FGM in Japanese patients with type 1 diabetes in home conditions. Based on the results, if an abnormal glucose value is detected by FGM, SBMG should then be used to confirm the result.
Decisional conflict associated with clinicians discouraging particular contraceptive methods
Authors: Grant Rachel L. , Paul Rachel , Zeal Carley , Madden Tessa , Politi Mary C.
Published: February 2020

Rationale, aims, and objectives

Approximately 45% of pregnancies in the United States are unintended. The use of contraception reduces the risk of unintended pregnancy. The initiation of several contraceptive methods requires seeing a clinician. This study explored how clinicians' expressed preferences against particular contraceptive methods impacted participants' confidence in their method choice and perception of shared contraceptive decision making.

Methods

Eligible individuals were 18 to 45 years of age, assigned female sex at birth, English speaking, and either using or had previously used contraception. Participants completed an anonymous survey via web link on Amazon Mechanical Turk. Primary self‐reported outcomes were (a) proportion of participants being discouraged from a particular contraceptive method, (b) decisional conflict, and (c) extent of shared decision making. Secondary self‐reported outcomes were (a) importance of contraceptive attributes and (b) self‐reported quality of care.

Results

Six hundred sixty‐nine participants completed the survey. Most were white (74.0%), non‐Hispanic (84.5%), married or cohabitating (69.4%), and nulliparous (47.2%). A total of 33.8% reported that a clinician had discouraged them from using a particular contraceptive method, most commonly because of side effects, usability, and/or method effectiveness. Effectiveness, affordability, and side effects were the self‐reported most important contraceptive features. Those who were discouraged from using a method (versus those who were not) were more likely to report decisional conflict (41.2% vs 30.0%, P = .004), yet reported a higher extent of shared decision making (median: 76 vs 71; P = .03). Adjusting for age and nulliparity did not impact results, except nulliparity made the relationship between being discouraged from using a method and shared decision making no longer significant (P = .06).

Conclusions

Decisional conflict might arise when clinicians discourage individuals using particular contraceptive methods. Clinicians' reasons for discouraging methods might not always align with patients' preferences. More research is needed to examine how to reduce decisional conflict and support contraceptive method selection.
“I'm Black, I'm Strong, and I Need Help”: Toxic Black Femininity and Intimate Partner Violence
Authors: Kelly Lorin C. , Spencer Chelsea M. , Stith Sandra M. , Beliard Christine
Published: February 2020

Intimate partner violence (IPV) is a serious threat to the lives of Black women in the United States. Research has shown that Black women report more serious injuries and mental health consequences, are less likely to report IPV, and receive fewer services related to IPV victimization than White women do. This article proposes the new concept of toxic Black femininity, which refers to the constant attempts for Black women to uphold a stereotype of being militantly strong and responsible for the overall well‐being of the Black image while simultaneously denying their own needs in an attempt to maintain the status quo. We describe the theoretical framework behind the term toxic Black femininity, its historical origins, how the need for survival has led to the manifestation of toxic Black femininity, and the importance of dismantling these toxic ideologies.
Prediction of neonatal acne based on maternal lipidomic profiling
Authors: Wang Hecong , Wang Jiateng , Zhou Mingyue , Jia Yan , Yang Ming , He Congfen
Published: February 2020

Background

Neonatal acne occurs in the first few weeks after birth. Some lesions are more serious and leave scars. Maternal surface skin lipids (SSL) have a strong correlation with SSL of infants. The establishment of prediction rank model based on maternal SSL is essential to the prevention and treatment of neonatal acne.

Method

Surface skin lipids samples were collected from the mothers (M) of 56 neonatal acne patients and the mothers (HM) of 19 healthy infants. Surface skin lipids from the right forehead were collected using a noninvasive method. UPLC‐QTOF‐MS was applied to detect SSL. Partial least squares discriminant analysis and receiver operating characteristic (ROC) analysis were performed to screen and validate potential lipids. Random forest (RF) and ROC analysis were used to establish a prediction model and evaluate its accuracy.

Results

Sixteen altered potential lipids belonging to fatty acids, sphingomyelins, and glycerides were associated with M. M had less lipids than HM. Spearman's correlation of 16 lipids revealed 9 with high correlation. They were chosen as characteristic values of the RF prediction model. And the model showed an average accuracy of 98% in the validation set.

Conclusion

We have established an RF model for predicting neonatal acne and have shown that high skin barrier‐related lipids were markers for predicting neonatal acne.
Successful heterotopic pregnancy with prior radical trachelectomy after transabdominal cervico isthimic cerclage with methotrexate treatment
Authors: Lee Kyong‐No , Ham Hee‐Jin , Whang Eun‐Jee , Eun‐ji Jo , Seung‐hye Choi , Lee Keun‐Young
Published: February 2020

Heterotopic pregnancy with cervical incompetence is very uncommon. And yet there is no definite treatment for cervical incompetence occurring after radical trachelectomy. We are reporting a rare and novel case of a following in vitro fertilization combined intrauterine pregnancy and interstitial pregnancy which was successfully treated with maintenance of the pregnancy to term.
A qualitative study exploring how Practitioners within Early Intervention in Psychosis Services engage with Service Users’ experiences of voice hearing?
Authors: Bogen‐Johnston Leanne , deVisser Richard , Strauss Clara , Hayward Mark
Published: February 2020

Accessible Summary

What is known on the subject?

The experience of hearing distressing voices is commonly reported by service users with a diagnosis of first‐episode psychosis, but their access to formal conversations about voices in the form of psychological therapies can be limited.

Service users within Early Intervention in Psychosis (EIP) services can benefit from informal opportunities to talk about their voice hearing experiences. However, they can be reluctant to engage with these conversations.

Little is known about the experiences of EIP practitioners as they try to engage service users in conversations about their voices.

What does the paper add to existing knowledge?

Despite EIP Services specializing in the treatment of the symptoms of psychosis such as voice hearing, practitioners can still be reluctant to initiate and continue informal conversations about voices.

What are the implications for practice?

EIP practitioners may benefit from the introduction of interview guides and brief interventions to assist them with the initiation and continuation of conversations about voices.

Introduction

Hearing voices is a common and distressing symptom of first‐episode psychosis. Formal and informal conversations about voices are helpful, but service users within Early Intervention in Psychosis (EIP) Services can be reluctant to discuss their voice hearing experiences. There is currently no literature that explores the experiences of EIP practitioners as they try to facilitate conversations about distressing voices.

Aim/Question

A qualitative methodology was used to investigate how EIP practitioners work with service users who hear voices. Ten practitioners were interviewed, and interviews were analysed using template analysis.

Results

Two themes that offer novel insights are presented: “starting a conversation about voices” and “continuing the conversation about voices.”

Discussion

Starting and continuing a conversation about voices was considered important but not all practitioners were confident in this respect. The initiation and continuation of these conversations may need to be systematically supported.

Implications for practice

To support the initiation of informal conversations, a standardized interview guide for voice hearing could be introduced and systematically utilized. The continuation of these conversations could be supported by practitioners being given the opportunity to receive training in and the opportunity to deliver brief symptom‐specific therapies for distressing voices.
The effects of dietary iodine and its consumption duration on performance, carcass characteristics, meat iodine, thyroid hormones and some blood indices in broiler chickens
Authors: Behroozlak Morteza , Daneshyar Mohsen , Farhomand Parviz
Published: February 2020

This study was conducted to determine the effects of dietary inclusion levels of iodine supplementation and duration of feeding on performance, carcass characteristics, meat iodine, thyroid hormones and some indices including red blood cell, haematocrit, haemoglobin, aspartate transaminase, alanine transaminase and alkaline phosphatase in broilers. A total of 450 one‐day‐old male broiler chicks were used during a 42 days experiment in 9 treatments with five replicates pen for each treatment. The experimental design was a 3 × 3 factorial arrangement of treatments including three levels of iodine (0, 2.5 and 5 mg/kg as a source of potassium iodide) during the T (total, 1–42 days), GF (grower and finisher, 11–42 days) and F (finisher, 25–42 days) periods (p < .05). The results demonstrated that none of the performance data (feed intake, body weight gain and feed conversion ratio) were influenced by level and duration of iodine consumption (p > .05). The diet supplemented with 5 mg/kg iodine had no effects on relative weights during total (T) and grower and finisher (GF) periods, but there was an effect on the finisher (F) period. Moreover, increasing the iodine level from 0 to 5 mg/kg linearly decreased the relative weights of the both small intestine and jejunum (p < .05). Increasing the iodine level from 0 to 5 mg/kg linearly increased the breast iodine content. Also, the highest breast meat enrichment was observed during the T period (p < .05). Blood triiodothyronine concentration was not changed by any of the iodine level and duration of consumption, but tetraiodothyronine concentration was higher for T period than GF and F ones (p < .05) and even linearly increased by increasing the level of dietary iodine for 0 to 5 mg/kg (p < .05). It was concluded that 5 mg/kg iodine from day 1 to day 42 of age is needed in the diet to enrich the broiler meat.
Central uplift collapse in acoustically fluidized granular targets: Insights from analog modeling
Authors: Dörfler M. A. , Kenkmann T.
Published: February 2020

Depending on their sizes, impact craters have either simple or complex geometries. Peak‐ring craters such as the Chicxulub impact structure possess a single interior ring of peaks and hills and a flat interior floor. The exact mechanisms leading to the formation of a morphological peak‐ring are still a matter of debate. In this study, analog modeling was used to study the flow field of a collapsing central uplift. A 3‐D‐printed cast was used to bring the analog material in the shape of an overheightened central uplift that was based on numerical modeling. The cast was then quickly removed and the central peak collapsed, forming a flattened broad mound that spread out onto the annular moat of the crater cavity. A subwoofer was used to fluidize the granular target material. The kinematics of the collapse were analyzed with the aid of particle image velocimetry, revealing a downward and outward collapse of the central uplift. This mode of collapse is partly in agreement with numerical models, in particular for the initial and middle phases. The overthrusting of the collapsing central peak onto the inward moving crater floor predicted by numerical modeling was observed, though to a lesser degree. A peak‐ring, however, could not be reproduced since the collapse came to a halt before the central peak was completely leveled. Nevertheless, the method provides qualitative insights into the kinematics of collapse phenomena. This experimental study provides independent support of the theory of acoustic fluidization, in addition to numerical simulations.
Structural vulnerabilities and breastfeeding among female sex workers in Mumbai
Authors: Reno Rebecca , Karandikar Sharvari , McCloskey Rebecca J. , España Megan
Published: February 2020

Breastfeeding has numerous health, environmental, and economic benefits, and the promotion and support of breastfeeding has been at the centre of efforts from many global organizations such as WHO and UNICEF to promote maternal and child health. Interventions developed from such policies tend to be inaccessible to those who are economically marginalized, however, and thus may further inequities. Understanding the lived experiences of women occupying this segment of society, such as sex workers, illuminates the social and structural determinants of breastfeeding and how they constitute structural vulnerability that renders breastfeeding difficult. This qualitative study explores breastfeeding practices and decisions among sex workers in Mumbai and the factors shaping their experiences. We look at proximal factors—those that women directly indicate as influencing their breastfeeding decision‐making or behaviour, and distal factors—macrolevel forces identified by the women, as indication of their structural vulnerability, particularly in relationship to the decision to initiate and sustain breastfeeding. We conclude with discussing the need to promote appropriate infant feeding practices through culturally responsive interventions and mechanisms, taking both proximal and distal factors into account, to work towards equity in health outcomes.
Geometrical methods for analyzing the optimal management of tipping point dynamics
Authors: Wagener Florian
Published: February 2020

Natural resources are not infinitely resilient and should not be modeled as being such. Finitely resilient resources feature tipping points and history dependence. This paper provides a didactical discussion of mathematical methods that are needed to understand the optimal management of such resources: viscosity solutions of Hamilton–Jacobi–Bellman equations, the costate equation and the associated canonical equations, exact root counting, and geometrical methods to analyze the geometry of the invariant manifolds of the canonical equations.

Recommendations for Resource Managers

Management of natural resources has to take into account the possible breakdown of resilience and induced regime shifts.

Depending on the characteristics of the resource and on its present and future economic importance, either for all initial states the same kind of management policy is optimal, or the type of the optimal management policy depends on the initial state.

Modeling should reflect the finiteness of the data.
Policy statement of enteral nutrition for preterm and very low birthweight infants
Authors: Mizuno Katsumi , Shimizu Toshiaki , Ida Shinobu , Ito Setsuko , Inokuchi Mikako , Ohura Toshihiro , Okumura Akihisa , Kawai Masanobu , Kikuchi Toru , Sakurai Motoichiro , Sugihara Shigetaka , Suzuki Mitsuyoshi , Takitani Kimitaka , Tanaka Daisuke , Mushiake Sotaro , Yoshiike Nobuo , Kodama Hiroko , Okada Kazuo , Tsutsumi Chiharu , Hara Mitsuhiko , Hanawa Yoshio , Kawakami Kazue , Inomata Hiroaki , Oguni Tatsuya , Bito Yuko , Uchida Keiichi , Sugiyama Akihide
Published: February 2020

For preterm and very low birthweight infants, the mother’s own milk is the best nutrition. Based on the latest information for mothers who give birth to preterm and very low birthweight infants, medical staff should encourage and assist mothers to pump or express and provide their own milk whenever possible.

If the supply of maternal milk is insufficient even though they receive adequate support, or the mother’s own milk cannot be given to her infant for any reason, donor human milk should be used.

Donors who donate their breast milk need to meet the Guideline of the Japan Human Milk Bank Association.

Donor human milk should be provided according to the medical needs of preterm and very low birthweight infants, regardless of their family’s financial status.

In the future, it will be necessary to create a system to supply an exclusive human milk‐based diet (EHMD), consisting of human milk with the addition of a human milk‐derived human milk fortifier, to preterm and very low birthweight infants.
Evaluation of sunscreen efficacy over time and re‐application using hybrid diffuse reflectance spectroscopy
Authors: Ruvolo Eduardo , Aeschliman Lisa , Cole Curtis
Published: February 2020

Background

In 2007, the FDA added requirements for sunscreens to be labeled “re‐apply at least every 2 hours” based on very limited data. This study used hybrid diffuse reflectance spectroscopy (HDRS) to evaluate the persistence of protection by 80 minutes water‐resistant sunscreen formulation with and without re‐application, and with and without sweat‐inducing activity over 6 hours.

Methods

Sunscreens were applied to subject's foreheads and backs, and they remained at rest or exercised to induce sweating in a heated environment. Efficacy of a sun protection factor (SPF 50) very water‐resistant sunscreen was measured with HDRS instrumentation and ultraviolet (UV) photography to determine the sunscreen protection over time.

Results

The sunscreen maintained SPF 50 efficacy over 6 hours for the non‐active group with a single application, and for 2 hours for the active group, dropping slowly to SPF 30 level after 6 hours of sweating. Re‐application of sunscreen gave additive SPF, with two applications resulting in SPF >100 and three applications approximately SPF 150. UV photography was insensitive to the differences in protection detected with HDRS instrumentation.

Conclusions

Sunscreen efficacy is maintained over time in the absence of sweating or rub‐off. After two hours of sweating, an 80 minutes water‐resistant sunscreen does not need to be re‐applied “at least every 2 hours.”
IL‐33 is essential to prevent high‐fat diet–induced obesity in mice infected with an intestinal helminth
Authors: Obi Seiji , Shimokawa Chikako , Katsuura Mizuki , Olia Alex , Imai Takashi , Suzue Kazutomo , Hisaeda Hajime
Published: February 2020

Intestinal helminthes induce immunosuppressive responses as well as type 2 immunity. Their suppressive properties are intended to regulate inflammatory diseases such as allergies and autoimmune diseases. This study evaluated whether helminthic infections suppress obesity, a chronic inflammatory state, using an intestinal nematode, Heligmosomoides polygyrus (Hp). Infection with Hp at the same time as feeding a high‐fat diet (HFD) prevented weight gain, dyslipidaemia and glucose intolerance observed in uninfected obese mice. Immunologically, Hp infection skewed M1 macrophages to M2 macrophages and induced type 2 innate lymphoid cells in adipose tissues. The expression of interleukin (IL)‐33, a potent initiator of type 2 responses, was also increased in association with uncoupled protein 1 (UCP1). To further investigate the anti‐obesity effects of IL‐33 in mice infected with Hp, IL‐33‐deficient mice were fed the HFD and infected with Hp. These mutant mice rapidly gained weight compared with wild‐type mice, indicating the anti‐obesity effect of IL‐33. In the absence of IL‐33, the rapid increase in weight was not prevented, and type 2 responses and UCP1 expression were not observed even during Hp infection. These results suggested that the suppression of obesity by Hp is dependent on IL‐33.
Variation in aggressiveness of Hymenoscyphus fraxineus genotypes amid the ash dieback epidemic
Authors: Kosawang Chatchai , McKinney Lea V. , Nielsen Lene R. , Kjær Erik D.
Published: February 2020

The ascomycete Hymenoscyphus fraxineus causes devastating damage to the European common ash (Fraxinus excelsior). The fungus originates from Asia, where it coexists with native ash species and completes its life cycle by sporulating on degrading ash leaf litter on the forest floor. Given this life cycle of the fungus, genotypes of H. fraxineus with varying degrees of aggressiveness may coexist in infected European ash forests. To test this hypothesis, we cultured 19 single‐spore isolates from apothecia collected in a trial of heavily infected ash in Denmark and carried out stem inoculations on young ash seedlings. Microsatellite markers revealed that the 19 isolates were all genetically unique and did not show any genetic structure. High variation was observed among the 19 isolates in pathogenicity on young seedlings. The variation (assessed as necrosis development) was highly significant, but not correlated with the vigour of the fungal isolates when grown on culture media. The results support the hypothesis that aggressiveness of H. fraxineus may not be crucial for its fitness. In this sense, ash dieback disease may differ from other recent emerging infectious diseases on trees. We discuss the variation in aggressiveness of H. fraxineus in relation to durability of resistance and future management of the ash dieback epidemic. The findings of this study call for more research into natural variation in endophytic versus pathogenic behaviour of H. fraxineus on European ash.
Cohort study of respiratory hospital admissions, air quality and sociodemographic factors in preterm infants born in California
Authors: Steurer Martina A. , Costello Jean , Baer Rebecca J. , Oltman Scott P. , Feuer Sky K. , Pacheco‐Werner Tania , Rogers Elizabeth , Jankowska Marta M. , Block Jessica , McCarthy Molly , Pantell Matthew S. , Chambers Christina , Ryckman Kelli K. , Jelliffe‐Pawlowski Laura L.
Published: February 2020

Background

Preterm infants suffer from respiratory morbidity especially during the first year of life.

Objective

To investigate the association of air quality and sociodemographic indicators on hospital admission rates for respiratory causes.

Methods

This is a retrospective cohort study. We identified all live‐born preterm infants in California from 2007 to 2012 in a population‐based administrative data set and linked them to a data set measuring several air quality and sociodemographic indicators at the census tract level. All sociodemographic and air quality predictors were divided into quartiles (first quartile most favourable to the fourth quartile least favourable). Mixed effect logistic models to account for clustering at the census tract level were used to investigate associations between chronic air quality and sociodemographic indicators respiratory hospital admission during the first year of life.

Results

Of 205 178 preterm infants, 5.9% (n = 12 033) were admitted to the hospital for respiratory causes during the first year. In the univariate analysis, comparing the first to the fourth quartile of chronic ozone (risk ratio [RR] 1.29, 95% confidence interval [CI] 1.21, 1.37), diesel (RR 1.10, 95% CI 1.02, 1.17) and particulate matter 2.5 (RR 1.07, 95% CI 1.01, 1.14) exposure were associated with hospital admission during the first year. Following adjustment for confounders, the risk ratios for hospital admission during the first year were 1.53 (95% CI 1.37, 1.72) in relation to educational attainment (per cent of the population over age 25 with less than a high school education) and 1.23 (95% CI 1.09, 1.38) for poverty (per cent of the population living below two times the federal poverty level).

Conclusions

Among preterm infants, respiratory hospital admissions in the first year in California are associated with socioeconomic characteristics of the neighbourhood an individual is living in.
Factors associated with health‐related quality of life among family caregivers of people with Alzheimer's disease
Authors: Liao Xiangping , Huang Ying , Zhang Ziliang , Zhong Shanquan , Xie Gaosheng , Wang Linghong , Xiao Hai
Published: February 2020

Aim

Based on the ageing population and the inadequate healthcare system in China, the majority of care for patients with Alzheimerʼs disease (AD) is provided by family caregivers. Caregivers suffer a long‐term heavy care burden and pressure, which affects their physical and mental health. The present study aims at investigating health‐related quality of life (HRQOL) among family caregivers of AD patients and exploring its influencing factors.

Methods

This study included 206 family caregivers (76 male, 130 female) of AD patients recruited from one Tier 3 hospital, one psychiatric hospital, two gerocomiums and three communities in Ganzhou city, Jiangxi Province, China. Measures included the World Health Organization (WHO) Quality of Life (WHO/ QOL‐BREF) questionnaire, Zarit burden of care scale (ZBI), and social support rating scale (SSRS).We performed face‐to‐face or telephone interviews with patients and caregivers. The association between possible factors and changes in HRQOL was examined through stepwise multiple regression analysis.

Results

The majority of family caregivers felt moderate to severe level of burden. The average HRQOL score was 54.24 ± 10.36. The mean SSRS score was 30.4 ± 10.9. The average ZBI score was 41.2 ± 12.8. The HRQOL of family caregivers of AD patients was negatively correlated with the neuropsychiatric questionnaire score, ZBI score, and chronic diseases of caregivers (P < 0.05), and positively correlated with the SSRS score (P < 0.05).

Conclusion

Reduced QOL was highly prevalent among AD patient family caregivers, and the level of burden, neuropsychiatric symptoms of patients, social support, and chronic diseases of caregivers were factors associated with HRQOL, and the effect of care burden is greatest. Interventions aimed at reducing the level of burden should focus not only on the patient but also on the caregiver.
Investigating behavior inhibition in obsessive‐compulsive disorder: Evidence from eye movements
Authors: Hu Yixin , Liao Rui , Chen Weiling , Kong Xiangwei , Liu Jingyi , Liu Dongxu , Maguire Phil , Zhou Shengqi , Wang Dawei
Published: February 2020

We investigated the role of inhibition failure in Obsessive Compulsive Disorder (OCD) through an eye tracking experiment. Twenty‐five subjects with OCD were recruited, as well as 25 with Generalized Anxiety Disorder (GAD) and 25 healthy controls. A 3 (group: OCD group, GAD group and control group) × 2 (target eccentricity: far and near) × 2 (saccade task: prosaccade and antisaccade) mixed design was used, with all participants completing two sets of tasks involving both prosaccade (eye movement towards a target) and antisaccade (eye movement away from a target). The main outcome was the eye movement index, including the saccade latency (the time interval from the onset of the target screen to the first saccade) and the error rate of saccade direction. The antisaccade latency and antisaccade error rates for OCDs were much higher than those for GADs and healthy controls. OCDs had longer latency and error rates for antisaccades than for prosaccades, and for far‐eccentricity rather than near‐eccentricity stimuli. These results suggest that OCDs experience difficulty with behavior inhibition, and that they have higher visual sensitivity to peripheral stimuli. In particular, they show greatest difficulty in inhibiting behavior directed towards peripheral stimuli.
Double‐Object Constructions in Romance: The Common Denominator
Authors: Pineda Anna
Published: February 2020

This article presents empirical and theoretical arguments that challenge several received ideas regarding double‐object constructions in Romance languages. First, I argue that the syntactic and semantic differences that, according to much prior literature, hold between Spanish ditransitives with and without dative clitic doubling do not hold, at least for many speakers. Specifically, there are nondoubled Spanish ditransitives that are to be analyzed as double‐object constructions, not as prepositional constructions; the optional presence of dative clitic doubling in double‐object constructions reduces to a mere surface difference of spellout of the Low Applicative head that relates the indirect object and the direct object and is responsible for the transfer‐of‐possession interpretation. Next, I explore some theoretical consequences of these novel empirical observations regarding dative clitic doubling, showing that arguments for a base structure for Spanish/Romance double‐object constructions in which the direct object is higher than the indirect object are not viable, since in the absence of dative clitic doubling it is not possible to account for the c‐command facts. Lastly, I show that my analysis of double‐object constructions extends to other languages in the Romance family where dative clitic doubling in ditransitives is optional, such as Catalan, as well as to Romance languages that do not have dative clitic doubling but arguably do have double‐object constructions, such as French and Italian.
Characterization of the novel HLA‐DQA1*04:08 allele by sequencing‐based typing
Authors: Cargou Marine , Andreani Marco , Testa Giuseppe , Guidicelli Gwendaline , Visentin Jonathan
Published: February 2020

HLA‐DQA1*04:08 differs from HLA‐DQA1*04:01:01:01 by one nucleotide substitution in codon 217 in exon 4.
Characterization of the novel HLA‐B*27:13:02 allele by sequencing‐based typing
Authors: Cargou Marine , Elsermans Vincent , Top Isabelle , Guidicelli Gwendaline , Visentin Jonathan
Published: February 2020

HLA‐B*27:13:02 differs from HLA‐B*27:13:01 by one nucleotide substitution in codon 273 in exon 4.
Identification of the novel allele, HLA‐C*15:02:32, in a Chinese individual
Authors: Dong Lina , Fu Rui , Wang Li , He Ji , Zhu Faming
Published: February 2020

HLA‐C*15:02:32 differs from HLA‐C*15:02:01:01 by one nucleotide substitution at position 516 (G>A).
Characterization of the novel HLA‐DQB1*06:361 allele by sequencing‐based typing
Authors: Cargou Marine , Elsermans Vincent , Top Isabelle , Ralazamahaleo Mamy , Visentin Jonathan
Published: February 2020

HLA‐DQB1*06:361 differs from HLA‐DQB1*06:04:01:01 by one nucleotide substitution in codon 15 in exon 2.
Detection of an HLA‐DQB1*06 variant, HLA‐DQB1*06:364, in a Russian individual
Authors: Loginova Maria , Paramonov Igor , Belyaev Andrey
Published: February 2020

One nucleotide change in position 216 of HLA‐DQB1*06:02 result in a novel allele, HLA‐DQB1*06:364.
A simple introduction to programming and statistics with decision trees in R
Authors: Tang Marc
Published: February 2020

University students in other disciplines without prior knowledge in statistics and/or programming language are introduced to the statistical method of decision trees in the programming language R during a 45‐minute teaching and practice session. Statistics and programming skills are now frequently required within a wide variety of research fields and private industries. However, students unfamiliar with these subjects may be reluctant to join a full course because of time or student workloads or other commitments or a belief it is not for them. The proposed session is short and can be used as an ice‐breaker to let students have a basic understanding of running statistical models in programming language.
How do you… decide which platelet bacterial risk mitigation strategy to select for your hospital‐based transfusion service?
Authors: Lu Wen , Delaney Meghan , Flegel Willy A. , Ness Paul , Ratcliffe Nora , Triulzi Darrell J. , Yazer Mark H. , Ziman Alyssa , Dunbar Nancy M.
Published: February 2020

The United States Food and Drug Administration Final Guidance for Industry titled, “Bacterial Risk Control Strategies for Blood Collection Establishments and Transfusion Services to Enhance the Safety and Availability of Platelets for Transfusion” provides nine strategies for platelet bacterial risk mitigation. Even if it is assumed all strategies are comparable in terms of safety and efficacy, the decision of which to implement remains challenging. Some additional factors that warrant evaluation before selecting a strategy include the financial impact, process for implementation, logistics upon implementation, institutional acceptance by blood bank staff, administration and clinicians, and effect on platelet availability. To assist with this difficult choice, a panel of transfusion service physicians who have expertise on the topic and have already selected strategies for their transfusion services were recruited to provide varied perspectives. In addition, the use of a decision‐making tool that objectively evaluates defined criteria for assessment of the nine strategies is described.
Antimicrobial activity of topical dyes used in clinical veterinary ophthalmology
Authors: Ferreira Thiago Alegre Coelho , Warth José Francisco Ghignatti , dos Santos Lucianne Leigue , Moore Bret A. , Montiani‐Ferreira Fabiano
Published: February 2020

Objective

To evaluate in vitro the antibacterial effects of fluorescein, rose bengal, and lissamine green topical ophthalmic dyes against selected Gram‐positive and Gram‐negative bacteria, and to evaluate whether preserved or preservative‐free fluorescein solutions are able to inhibit or potentiate bacterial growth.

Procedures

Susceptibility testing was performed using the Kirby‐Bauer disk diffusion method plated with clinical ocular isolates of Staphylococcus aureus, Staphylococcus pseudintermedius, Streptococcus spp., Escherichia coli, and Pseudomonas aeruginosa. Bacterial growth inhibition was evaluated 24 hours following the addition of commercially available fluorescein, rose bengal, and lissamine green sterile strips. Antimicrobial effectiveness testing was performed by inoculation of compounded 1% dye solutions, both with and without preservatives (fluorescein and lissamine contained thiomersal, and rose bengal contained nipagin and nepazol), with the five previously mentioned bacteria. Growth was evaluated at days 7, 14, and 28.

Results

All dyes showed antibacterial activity against Gram‐positive organisms. Preservative‐free compounded 1% fluorescein solution inhibited growth of Gram‐positive organisms but not of Gram‐negative organisms. Preservative‐free rose bengal and lissamine green inhibited growth of both types of organisms.

Conclusions

Preferably, ocular surface samples for antimicrobial culture should be taken prior to the administration of topical dyes, due to their potential antibacterial activity, particularly if undiluted strips are applied directly or commercial fluorescein solutions are used and not immediately rinsed. Ophthalmic dye solutions containing preservative are safe from bacterial growth for up to 28 days if properly handled and stored. The use of preservative‐free fluorescein solutions should be avoided and preservative‐free rose bengal and lissamine green should be handled carefully.
Neuronal HIF‐1α in the nucleus tractus solitarius contributes to ventilatory acclimatization to hypoxia
Authors: Moya Esteban A. , Go Ariel , Kim Cindy B. , Fu Zhenxing , Simonson Tatum S. , Powell Frank L.
Published: February 2020

Key points

We hypothesized that hypoxia inducible factor 1α (HIF‐1α) in CNS respiratory centres is necessary for ventilatory acclimatization to hypoxia (VAH); VAH is a time‐dependent increase in baseline ventilation and the hypoxic ventilatory response (HVR) occurring over days to weeks of chronic sustained hypoxia (CH).

Constitutive deletion of HIF‐1α in CNS neurons in transgenic mice tended to blunt the increase in HVR that occurs in wild‐type mice with CH.

Conditional deletion of HIF‐1α in glutamatergic neurons of the nucleus tractus solitarius during CH significantly decreased ventilation in acute hypoxia but not normoxia in CH mice.

These effects are not explained by changes in metabolic rate, nor CO2, and there were no changes in the HVR in normoxic mice.

HIF‐1α mediated changes in gene expression in CNS respiratory centres are necessary in addition to plasticity of arterial chemoreceptors for normal VAH.

Chronic hypoxia (CH) produces a time‐dependent increase of resting ventilation and the hypoxic ventilatory response (HVR) that is called ventilatory acclimatization to hypoxia (VAH). VAH involves plasticity in arterial chemoreceptors and the CNS [e.g. nucleus tractus solitarius (NTS)], although the signals for this plasticity are not known. We hypothesized that hypoxia inducible factor 1α (HIF‐1α), an O2‐sensitive transcription factor, is necessary in the NTS for normal VAH. We tested this in two mouse models using loxP‐Cre gene deletion. First, HIF‐1α was constitutively deleted in CNS neurons (CNS‐HIF‐1α−/−) by breeding HIF‐1α floxed mice with mice expressing Cre‐recombinase driven by the calcium/calmodulin‐dependent protein kinase IIα promoter. Second, HIF‐1α was deleted in NTS neurons in adult mice (NTS‐HIF‐1α−/−) by microinjecting adeno‐associated virus that expressed Cre‐recombinase in HIF‐1α floxed mice. In normoxic control mice, HIF‐1α deletion in the CNS or NTS did not affect ventilation, nor the acute HVR (10–15 min hypoxic exposure). In mice acclimatized to CH for 1 week, ventilation in hypoxia was blunted in CNS‐HIF‐1α−/− and significantly decreased in NTS‐HIF‐1α−/− compared to control mice (P < 0.0001). These changes were not explained by differences in metabolic rate or CO2. Immunofluorescence showed that HIF‐1α deletion in NTS‐HIF‐1α−/− was restricted to glutamatergic neurons. The results indicate that HIF‐1α is a necessary signal for VAH and the previously described plasticity in glutamatergic neurotransmission in the NTS with CH. HIF‐1α deletion had no effect on the increase in normoxic ventilation with acclimatization to CH, indicating this is a distinct mechanism from the increased HVR with VAH.
Consistency and reproducibility in atomic layer deposition
Authors: Sønsteby Henrik H. , Yanguas-Gil Angel , Elam Jeffrey W.
Published: February 2020

Atomic layer deposition (ALD) is a thin film synthesis technique that can provide exquisite accuracy and precision in film thickness and composition even on complex, large area substrates. Based on self-limiting surface chemistry, ALD can be insensitive to process conditions and reactor designs, allowing an ALD process developed in one lab to be easily reproduced in other labs. In practice, however, ALD is sometimes difficult to reproduce or replicate, and the results can vary substantially between ALD reactors and between labs. This is exemplified by large deviations in reports on the growth of, e.g., Al2O3, FeOx, and TiO2 given the same precursors under similar conditions. Furthermore, the problem of irreproducibility seems to be growing as ALD is adopted by more researchers and integrated into new applications. In this article, the authors highlight some of the major sources of variations and errors and common misconceptions related to ALD. In particular, the authors focus on issues related to precursors, substrates, and deposition tools. The authors illustrate these problems through examples from the literature, and they present results from numerical simulations that describe how nonidealities would manifest in thickness profiles in a typical cross-flow reactor. They also describe how reproducibility in ALD is linked to consistent experimental practice and reporting between labs. The authors’ hope is that by educating newcomers to ALD and advocating for consistent reporting of deposition conditions, they can minimize irreproducibility and enable ALD practitioners to realize the full potential afforded by self-limiting surface chemistry.
Direct inference of first-year sea ice thickness using broadband acoustic backscattering
Authors: Bassett Christopher , Lavery Andone C. , Lyons Anthony P. , Wilkinson Jeremy P. , Maksym Ted
Published: February 2020

Accurate measurements of sea ice thickness are critical to better understand climate change, to provide situational awareness in ice-covered waters, and to reduce risks for communities that rely on sea ice. Nonetheless, remotely measuring the thickness of sea ice is difficult. The only regularly employed technique that accurately measures the full ice thickness involves drilling a hole through the ice. Other presently used methods are either embedded in or through the ice (e.g., ice mass balance buoys) or calculate thickness from indirect measurements (e.g., ice freeboard from altimetry; ice draft using sonars; total snow and ice thickness using electromagnetic techniques). Acoustic techniques, however, may provide an alternative approach to measure the total ice thickness. Here laboratory-grown sea ice thicknesses, estimated by inverting the time delay between echoes from the water-ice and ice-air interfaces, are compared to those measured using ice cores. A time-domain model capturing the dominant scattering mechanisms is developed to explore the viability of broadband acoustic techniques for measuring sea ice thickness, to compare with experimental measurements, and to investigate optimal frequencies for in situ applications. This approach decouples ice thickness estimates from water column properties and does not preclude ice draft measurements using the same data.
Predicting Lower Quarter Y-Balance Test Performance From Foot Characteristics
Authors: Chimera Nicole J. , Larson Mallorie
Published: February 2020

Context: The lower quarter Y-Balance Test (YBT-LQ) is associated with injury risk; however, ankle range of motion impacts YBT-LQ. Arch height and foot sensation impact static balance, but these characteristics have not yet been evaluated relative to YBT-LQ. Objective: Determine if arch height index (AHI), forefoot sensation (SEN), and ankle dorsiflexion predict YBT-LQ composite score (CS). Design: Descriptive cohort. Setting: Athletic training laboratory. Participants: Twenty general population (14 females and 6 males; mean [SD]: age 35 [18] y, weight 70.02 [16.76] kg, height 1.68 [0.12] m) participated in this study. Interventions: AHI measurement system assessed arch height in 10% (AHI10) and 90% (AHI90) weight-bearing. Two-point discrim-a-gon discs assessed sensation (SEN) at the plantar great toe, third and fifth metatarsal heads. Biplane goniometer and weight-bearing lunge tests were used to measure static and weight-bearing dorsiflexion, respectively. The YBT-LQ assessed dynamic single-leg balance. Results: For right-limb dynamic single-leg balance, AHI90 and SEN were included in the final sequential prediction equation; however, neither model significantly (P = .052 and .074) predicted variance in YBT-LQ CS. For left-limb dynamic single-leg balance, both SEN and weight-bearing lunge test were included in the final sequential prediction equation. The regression model (SEN and weight-bearing lunge test) significantly (P = .047) predicted 22% of the variance in YBT-LQ CS. Conclusions: This study demonstrates that foot characteristics may play a role in YBT-LQ CS. The authors did not assess limb dominance in this study; therefore, the authors are unable to determine which limb would be the stance versus kicking limb. However, altered SEN and weight-bearing dorsiflexion appear to be contributing factors to YBT-LQ CS.