bluuebunny/crossref_metadata_2025 huggingface dataset:
PERSEPSI KLIEN TENTANG PERAWAT
Authors: Kurniati Amelia
Published: May 2019

AbstrakKesesuaian antara pengetahuan perawat tentang perawat yang kompeten dengan persepsi klien akan perawat adalah sangat penting. Kesesuaian ini menimbulkan rasa saling memahami yang merupakan kunci hubungan terapeutik perawat klien. Metode penelitian fenomenologi dipilih untuk mengidentifikasi persepsi klien akan perawat, karena metode ini dapat mengeksplor pemikiran klien dengan mendalam. Data didapat dari 8 orang partisipan di rumah sakit di Jakarta selama 2 bulan, dengan cara interview dan observasi. Hasil dideskripsikan dalam tiga katagori, yaitu: 1. Berespon positif terhadap kebutuhan klien dengan sub katagori: tanggap akan kebutuhan klien, dan menghargai klien; 2. Terampil dan  berpengetahuan; serta 3. Berkomunikasi dan mendidik. Ketiga katagori ini menjadi satu kesatuan yang saling berhubungan dalam bentuk lingkaran, dan tidak dapat dipecah menjadi katagori yang berdiri sendiri. Ketiga katagori ini saling mengisi agar perawat dapat bertindak sigap, terampil, sesuai dengan kebutuhan dan karakter klien sehingga dapat meningkatkan kemampuan klien untuk menjadi sehat. AbstractThe appropriateness between the knowledge of a nurse on nurse’s competency and perception of client about nurse is very important. Such appropriateness will produce a sense of understanding which is the key of therapeutic relation between a nurse and the client. This research chooses the phenomenology research in order to identify the perception of client on nurse in order to explore the client judgment in detail. The data and information are obtained from 8 participants from various hospitals in Jakarta within 2 months through interview and direct observation. The results are described in three categories: 1. Positive responsive to the client’s need with one sub category: response to the client’s need and respect to the clients; 2. Skillful and knowledgeable, and 3. Communicative and educative. These three categories will be integrated and interacting with each other in a circle form and cannot be disintegrated into one single category. The three category will assist each other to enable a nurse to act responsive and skillful based on the need and character on client. This is hoped to enhance the client ability to be more healthy.
KONSTRUKTIVISME DALAM KEPERAWATAN: SUATU TELAAH PENGANTAR
Authors: Rustina Yeni
Published: May 2019

AbstrakKeperawatan merupakan suatu disiplin yang menekankan pada partisipasi aktif klien dalam asuhan keperawatan. Hal ini selaras dengan paradigma faham konstruktivisme. Mereka menekankan pada proses pembelajaran aktif pembelajar dalam meningkatkan pengetahuan dan keterampilannya. AbstractNursing is a discipline which emphasizes on the client’s active participation in nursing care. This is congruent with the constructivist paradigm. They emphasize on the active learning of learners in enhancing their knowledge and skills.
Human pancreatic cancer cell exosomes, but not human normal cell exosomes, act as an initiator in cell transformation
Authors: Stefanius Karoliina , Servage Kelly , de Souza Santos Marcela , Gray Hillery Fields , Toombs Jason E , Chimalapati Suneeta , Kim Min S , Malladi Venkat S , Brekken Rolf , Orth Kim
Published: May 2019

Cancer evolves through a multistep process that occurs by the temporal accumulation of genetic mutations. Tumor-derived exosomes are emerging contributors to tumorigenesis. To understand how exosomes might contribute to cell transformation, we utilized the classic two-step NIH/3T3 cell transformation assay and observed that exosomes isolated from pancreatic cancer cells, but not normal human cells, can initiate malignant cell transformation and these transformed cells formed tumors in vivo. However, cancer cell exosomes are unable to transform cells alone or to act as a promoter of cell transformation. Utilizing proteomics and exome sequencing, we discovered cancer cell exosomes act as an initiator by inducing random mutations in recipient cells. Cells from the pool of randomly mutated cells are driven to transformation by a classic promoter resulting in foci, each of which encode a unique genetic profile. Our studies describe a novel molecular understanding of how cancer cell exosomes contribute to cell transformation.

Editorial note: This article has been through an editorial process in which the authors decide how to respond to the issues raised during peer review. The Reviewing Editor's assessment is that major issues remain unresolved (see decision letter).
Evaluation of the Use of a Force Diagram in the Management of Temporomandibular Joint Sounds: A Prospective Cross-sectional Study
Authors: Saueressig Nilton Sodi , Saueressig Hickert Aline Cristina , Keller de Andrade Gilberto , Bittencourt Hélio Radke , Basso Délcio , Saueressig Nilton Gustavo
Published: May 2019

Context

Occlusal splints are widely used in clinical practice as a noninvasive treatment for patients with temporomandibular disorders (TMDs) and for reduction of TMD-related symptoms. A force diagram allows a health care professional to evaluate the interactions of loads caused by muscular effort, which are sensed by the teeth and the temporomandibular joint during the protrusive movement of the mandible.

Objective

To evaluate the efficacy of occlusal splints combined with occlusal adjustment (OA) based on a force diagram in the management of joint sounds (clicking and crepitation).

Methods

Patients were examined clinically and administered a questionnaire for the diagnosis of TMD and orofacial pain. Patients were then assigned to 1 of 2 splint therapies: (1) an anterior bite plane of the front-plateau type (FP) or (2) a maxillary muscle relaxation appliance (MRA), both combined with OA based on a force diagram performed at 6 visits, with an interval of 24 to 48 hours between each visit. To measure the effects of treatment, at each of the 6 visits, patients also rated the severity of their TMD-related symptoms on a visual analog scale. Data were dichotomized into presence and absence of symptoms and compared using the McNemar test.

Results

A total of 199 patients were included in the study. At baseline, 38 patients (19.1%) had crepitation and 161 (80.9%) had clicking. A total of 150 patients were treated with FP+OA, with a statistically significant reduction in the number of patients reporting clicking (42.6%, P<.001) and crepitation (42.9%, P<.001). Among patients treated with MRA+OA (n=49), there was a statistically significant reduction in the number of patients reporting clicking (50%, P<.001). All 3 patients with crepitation in the MRA+OA group reported total remission (P>.05).

Conclusion

The 2 treatment strategies, FP+OA and MRA+OA, improved both clicking and crepitation. Both strategies prioritize the concept of mutually protected occlusion, in which all jaw and temporomandibular joint movements must synchronize, which may be conveniently done using the force diagram.
Storying Diffractive Pedagogy
Authors: Moxnes Anna R , Osgood Jayne
Published: May 2019

This paper aims to investigate the affective flows and material intra-actions that unfold in micro-moments in Early Childhood Teacher Education (ECTE) within observations of student teachers’ cooperative work. Putting to work Haraway’s SF philosophy (1997, 2004 and 2016) we work towards reconfiguring the primacy of critical reflection, and the cultivation of reflexive practitioners by troubling pedagogical practices such as groupwork that claim to generate critical reflexivity. We ask what else gets produced during groupwork and argue that diffractive pedagogy might open up possibilities for student-teachers to move beyond a narrow concern with critical reflection. By playing with rhythm and plasticity we stretch established ideas about ECTE and offer diffractive pedagogy as a slippery, contingent, relational, emergent, speculative and ultimately less certain concept than critical reflection. Introducing diffractive pedagogy into debates about ECTE offers a generative rupture; an opportunity to extend conceptualisations and practices.
Assessment of Knowledge and Practice about Self Expressed Breast Milk among Saudi Mothers in Jazan Region, KSA, 2016
Authors: Qutah Karimah Mohammad , Alsaleem Safar A. , Najmi Abdullah Ahmed , Zabbani Muteb Bawwah
Published: May 2019

Aim: To assess mother's knowledge and attitude regarding self-expressed milk in Jazan, Saudi Arabia.

Methodology: Study Area: An observational and cross sectional study done in Obstetric Department (Well Baby and immunization Clinics) in King Fahd Central Hospital (KFCH), Jazan, Saudi Arabia and in six PHCCs in Jazan (randomly selected) from  December 2016 - March 2017.  Pregnant women who delivered babies before and post-partum women in Obstetric departments, Obstetric outpatient clinic, mother’s in well baby, and immunization clinics in mentioned areas were included in the study. Stratified multistage sampling techniques were used.  N = 499 Saudi mothers calculated according to survey system with confidence level % 95.  The questionnaire was self-administering questionnaire (in Arabic language).  All data processed via Statistical Package for the Social Sciences (SPSS) version 19. Shapiro-Wilk test. Kruskal-Wallis test used to see the association between level of knowledge and practice with demographic variables that contains more than 2 variables. Mann-Whitney test and Spearman correlation were used.

Results: Total of 499 mothers was participating aged 30±7 years with mean number of kids 2.98 ± 2. Mothers heard about self-expressed breast milks accounts 73.5% and 236 mothers of them were practice it. Both level of knowledge and practice accuracy were inadequate. Around one third of mothers heard about it from social media. More than third of the women practice it because of work related issues. The higher the educational level was the higher knowledge (p<0.001). Age and number of kids, has no statistically significant effect on the knowledge level (P = 0.417, 0.285).  Working mothers have higher knowledge level than house wife and students (p<0.001), nurses especially who toke breast feeding teaching have higher knowledge level than physicians then teachers (p<0.001). Mothers who toke their knowledge from breast feeding courses have the highest knowledge level followed by medical stuffs other than physicians followed by social media and internet websites then physicians then mothers and last are friends (p<0.001). Mothers with more accurate practice were more knowledgeable than mothers with less accurate practices (p<0.001).

Conclusion: Mothers knowledge and practice regarding self-expressed breast milk needed to be improved in order to give the babies better chance for exclusive breast feeding. Breast feeding courses for mothers give better results in term of accuracy of mother’s knowledge and practice of expressed breast milk.
Perceived eWOM and Students’ University Enrolment Intentions: The Corporate Image as a Mediator
Authors: Balroo Shuaib Ahmed , Saleh Mahmoud Abdel Hamid
Published: May 2019

The advancement of internet technologies and the emergence of social media platforms have made the influence of electronic word of mouth (eWOM) more pronounced than ever before on consumers’ purchase decisions, especially young consumers who are more engaged with new technologies and social networks. Through social media platforms, young consumers nowadays are always connected to friends, families and organizations on smartphones, tablets or computers and actively look for eWOM before making purchase decisions. This study is aimed at examining the effect of perceived eWOM on the university enrolment intentions by the Saudi high school students mediated by the corporate image of the university. The sample comprised of 133 high school students studying in Saudi high secondary schools. The findings revealed that electronic word of mouth (eWOM) had a significant and positive association with the students’ enrolment intentions, and the corporate image mediates this relationship. This research’s findings and recommendations can largely help who are in charge of the private and public universities in Saudi Arabia to understand how eWOM shapes the university choices of students.
Relationship between Observed Seismicity and Water Level Fluctuations in Polyphyto Dam Area (North Greece)
Authors: Pavlou Kyriaki
Published: May 2019

The spatial-temporal seismicity in Aliakmona river area is presented for the period 1974-2010 (NW Greece). This study area, which was classified as low seismicity, presents a particular interest due to the unexpected strong earthquake of Ms=6.6 which occurred between the cities of Kozani–Grevena, at a distance of 18 km from the southern edge of Polyphyto lake in 1995. According to [1], seismic hazard changes have been identified SE of the Polyphyto dam after the impoundment of the lakes. In this study, we examined the possible correlation between the impoundment and the water level fluctuations due to the three artificial lakes which are established in the region and the observed seismicity using data from the catalogues of the National Observatory of Athens (NOA) (see details for seismological data on Mc, RMS, etc. in [2,3]). For the latter purpose, spatial and temporal distribution maps were developed as  well  as  correlation  diagrams  between  water  level  variations  in  respect  to  monthly seismicity for distances 10 Km, 20 Km, 30 Km, 40 Km and 50 Km around the artificial lakes using the ESRI ArcMap 10 software.  A remarkable change is observed in seismic activity in the vicinity of reservoirs for the period commencing 10 years prior to the first filling in comparison with the period 10 years after. This increased seismicity is correlated to the daily rate of water level fluctuations (dh/dt) for the period 1984-2010 reveals the presence of mainly shallow seismic activity with focal depths of 0-5 km in a high percentage (67%). This protracted seismicity which is mainly located in the SW area of Polyphyto lake, has characteristics of the second type of induced seismicity according to Talwani [4], and seems to be controlled by the water level fluctuations of Polyphyto reservoir due to the mechanism of pore pressure diffusion.
Ethnicity Effects
Authors: Cruz Rick A. , Mechammil Molly , Carrera Kenia
Published: May 2019

Developmental processes are culturally situated and, as such, ethnicity and race are key influences on child development. These social groupings have effects on children's experiences through social, economic, and other broader cultural structures, as well as more proximal influences including on the family environment. This entry describes scholarship on ethnicity and race as related to child development, including research on ethnic/racial differences and similarities, and argues for the importance of addressing within‐group variability. In light of an increasingly global society, scholars have called for greater attention to cultural diversity as an influence on development. Emerging directions for theory and research on ethnicity and race effects are discussed.
Reputation Management
Authors: Watling Dawn
Published: May 2019

Through social interactions with others, individuals develop their reputations; others form opinions about who an individual is based on their perceptions of our behavior, values, attitudes, and so on. Adolescence is an important time for adolescents to engage in reputation management. Reputations are influenced by the social norms and expectations of one's peer group. To successfully manage the impressions that others will form of the self, it is important for adolescents to understand how their behavior will be received and what is expected of them. This entry introduces how adolescents may use impression management techniques to manage their reputation; it also explores the role of friendships and peer groups and the role of social identity in shaping reputation, highlights reputation management in those with social anxiety, and discusses the fact that reputation management now takes place online as well as face to face. Future research directions are proposed.
Association of Lupus Nephritis With Coronary Artery Disease by ISN/RPS Classification: Results From a Large Real‐world Lupus Population
Authors: Sun Enid Y. , Alvarez Carolina , Sheikh Saira Z.
Published: May 2019

Objective

Patients with systemic lupus erythematosus (SLE) are at an increased risk for developing coronary artery disease (CAD). Several studies suggest that the presence of lupus nephritis (LN) is independently associated with CAD. The purpose of our study was to assess whether the presence of LN is independently associated with CAD in our patient population and whether this association varies by class of LN.

Methods

A retrospective cross‐sectional analysis was performed using medical records of patients 18 years and older with SLE at University of North Carolina Hospitals from April 4, 2014, to December 31, 2017. Subjects were identified using International Classification of Diseases, Ninth Revision (ICD‐9) and International Classification of Diseases, 10th Revision (ICD‐10) codes specific for SLE. LN class was defined by International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification. CAD was the outcome of interest. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Our sample consisted of 3732 patients with SLE, of whom 598 (16%) had LN and 537 (14%) had CAD. When adjusting for demographics and factors associated with CAD and LN, the odds of having CAD were significantly higher for patients with SLE and LN compared with patients without LN (OR 1.47; 95% CI 1.07‐2.02; P = 0.017). Controlling for these factors, class III LN (OR 1.98; 95% CI 0.95‐4.12; P = 0.069) and class III/V LN (OR 2.23; 95% CI 1.09‐4.62; P = 0.028) were very strongly associated with CAD in subjects with LN compared with subjects without LN.

Conclusion

We confirm the observations of previous studies that LN is significantly associated with CAD. Our study is the first to show the association between CAD and specific classes of LN.
One‐Step Synthesis of W2C@N,P‐C Nanocatalysts for Efficient Hydrogen Electrooxidation across the Whole pH Range
Authors: Xiong Bingyan , Zhao Wenbin , Chen Lisong , Shi Jianlin
Published: May 2019

Highly active and low‐cost non‐noble metal electrocatalysts for hydrogen oxidation reaction (HOR) are crucial for the large‐scale applications of fuel cells, which, unfortunately, are rarely documented up to now. Here, a facile one‐step strategy to fabricate W2C nanoparticles (≈3 nm) encased in N, P‐doped few layer carbon materials (W2C@N,P‐C, WNPC) as an efficient non‐noble metal HOR electrocatalyst simply by calcining the mixture of recrystallized phosphotungstic acid and dicyandiamide is reported. The obtained WNPC catalyst shows extraordinarily high HOR activities (1.03/0.91/0.84 mA cm−2 at 0.05 V vs reversible hydrogen electrode in 0.1 m HClO4/0.1 m KOH/0.1 m neutral phosphate buffered saline electrolytes, respectively), excellent durability during accelerated degradation tests for 10 000 cycles, and outstanding CO tolerance. These high performances are attributed to the uniform structure of WNPC, and more essentially, the synergistic effect among N, P, and C species which elevates the reducibility of WNPC, favoring the generation of abundant HOR active sites.
Base Metal Catalysis in Directed C(sp3)−H Functionalisation
Authors: St John‐Campbell Sahra , Bull James A.
Published: May 2019

Directed C(sp3)−H functionalisation has made enormous progress in recent years, but has largely been restricted to catalysis using noble metals, particularly palladium. However, since 2013, there have been prominent advances that exploit the reactivity of abundant first row transition metals for a multitude of new bond formations. The use of base metal catalysis for C−H functionalisation can provide huge advantages in terms of cost and sustainability compared to methods using noble metals. This review covers all examples, to the end 2018, of auxiliary‐assisted, base metal‐catalysed C(sp3)−H functionalisation reactions. Successful examples are reported for Fe, Co, Ni and Cu catalysis with monodentate or bidentate directing groups for C−N, C−O, C−S and C−C bond forming reactions. This review aims to highlight the current state of this field and potential for expansion and so scope and limitations are highlighted. Notably, examples to date have required sterically activated α‐disubstituted substrates, particularly propanamide derivatives with bidentate directing groups, such as 8‐aminoquinoline amides. Monodentate quinoline and thioamide directing groups have also been used with Co catalysis for C−N and C−C bond formations. Mechanistic details are provided to outline the nature of the proposed organometallic intermediates and potential reaction pathways. We hope this review will stimulate further developments in this growing and important field.

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Multisystem afflictions in former National Football League players
Authors: Morris Timothy P. , McCracken Caitlin , Baggish Aaron , Weisskopf Marc , Zafonte Ross , Taylor Herman A. , Nadler Lee M. , Speizer Frank E. , Pascual‐Leone Alvaro
Published: May 2019

Background

The long‐term health consequences of participation in American style football (ASF) are not well understood.

Methods

We conducted a retrospective cohort study of men who had played in the NFL after 1960. Participants were studied using a standardized self‐administered questionnaire designed to determine both the exposure history to ASF and the prevalence of chronic pain, sleep apnea, cardiometabolic disease, and neurocognitive impairment. Logistic regression and negative binomial regression models were used to assess associations between age, ethnicity, body‐mass index during professional football career, field position, and football career duration with individual and multiple afflictions.

Results

In this cohort of former NFL players (n = 3745), approximately one quarter of the eligible former players (27%) reported two or more medical afflictions (chronic pain, cardiometabolic disease, sleep apnea, or neurocognitive impairment). Career duration was significantly associated with an increase in the number of comorbidities. Age, race, and body‐mass index were associated with all affliction categories, other than neurocognitive impairment, which was similarly prevalent in middle‐aged players and older players. Earlier age when first playing the sport was protective against cardiometabolic affliction.

Conclusions

Former NFL players report significant combinations of cross‐system afflictions. Future work will be required to determine mechanistic underpinnings. However, attention to the whole player, rather than specific organ systems seems critical to improve long‐term health outcomes in former ASF professional athletes.
Induction of brain‐infiltrating T‐bet–expressing B cells in multiple sclerosis
Authors: van Langelaar Jamie , Rijvers Liza , Janssen Malou , Wierenga‐Wolf Annet F. , Melief Marie‐José , Siepman Theodora A. , de Vries Helga E. , Unger Peter‐Paul A. , van Ham S. Marieke , Hintzen Rogier Q. , van Luijn Marvin M.
Published: May 2019

Objective

Results from anti‐CD20 therapies demonstrate that B‐ and T‐cell interaction is a major driver of multiple sclerosis (MS). The local presence of B‐cell follicle‐like structures and oligoclonal bands in MS patients indicates that certain B cells infiltrate the central nervous system (CNS) to mediate pathology. Which peripheral triggers underlie the development of CNS‐infiltrating B cells is not fully understood.

Methods

Ex vivo flow cytometry was used to assess chemokine receptor profiles of B cells in blood, cerebrospinal fluid, meningeal, and brain tissues of MS patients (n = 10). Similar analyses were performed for distinct memory subsets in the blood of untreated and natalizumab‐treated MS patients (n = 38). To assess T‐bet(CXCR3)+ B‐cell differentiation, we cultured B cells from MS patients (n = 21) and healthy individuals (n = 34) under T helper 1‐ and TLR9‐inducing conditions. Their CNS transmigration capacity was confirmed using brain endothelial monolayers.

Results

CXC chemokine receptor 3 (CXCR3)‐expressing B cells were enriched in different CNS compartments of MS patients. Treatment with the clinically effective drug natalizumab prevented the recruitment of CXCR3high IgG1+ subsets, corresponding to their increased ability to cross CNS barriers in vitro. Blocking of interferon‐γ (IFNγ) reduced the transmigration potential and antigen‐presenting function of these cells. IFNγ‐induced B cells from MS patients showed increased T‐bet expression and plasmablast development. Additional TLR9 triggering further upregulated T‐bet and CXCR3, and was essential for IgG1 switching.

Interpretation

This study demonstrates that T‐bethigh IgG1+ B cells are triggered by IFNγ and TLR9 signals, likely contributing to enhanced CXCR3‐mediated recruitment and local reactivity in the CNS of MS patients. ANN NEUROL 2019;86:264–278
Production of Conjugated Linoleic Acid by Microwave‐Assisted and Ultrasound‐Assisted Alkali Isomerization: Effects of Microwave Power and Ultrasound Amplitude
Authors: Alaşalvar Hamza , Erinç Hakan , Salur Fatma , Özbey Ayşe
Published: May 2019

Conjugated linoleic acid (CLA) is commercially produced by alkali isomerization of linoleic acid (LNA). However, this method constitutes a relatively high content of undesirable CLA isomers. In present study, microwave‐assisted and ultrasound‐assisted alkali isomerization techniques were applied for production of CLA as an alternative to traditional alkali isomerization. This study was aimed to evaluate the isomerization degree of LNA, by using various process conditions such as microwave power, ultrasound amplitude, and their reaction times. The best conditions for LNA isomerization were a microwave power of 700 W and a reaction time of 6 h for microwave‐assisted alkali isomerization and an ultrasound amplitude of 100% and a reaction time of 6 h for ultrasound‐assisted alkali isomerization. Under determined conditions, microwave‐assisted alkali isomerization (97.21%) resulted in a higher isomerization degree compared to ultrasound‐assisted alkali isomerization (76.98%) while the content of undesirable CLA isomers in ultrasound‐assisted alkali isomerization (0.62%) was lower than that of microwave‐assisted alkali isomerization (1.87%). This study showed that application of the both techniques resulted in equal amounts of desirable CLA isomers. The content of desirable CLA isomers was 47.09% cis‐9, trans‐11 and 48.25% trans‐10, cis‐12 for microwave‐assisted alkali isomerization and 36.34% cis‐9, trans‐11 and 40.02% trans‐10, cis‐12 for ultrasound‐assisted alkali isomerization.
Guideline Implementation: Sterilization
Authors: Link Terri
Published: May 2019

Ensuring that reusable surgical instruments and medical devices have been sterilized is an important factor in preventing surgical site infections. The sterilization method for a particular device is based on the device design, material, packaging, compatibility with the sterilant, load limitations, and safety requirements. Perioperative team members must review the manufacturer's instructions for cleaning, packaging, and sterilizing the device to determine the correct sterilization process. The AORN “Guideline for sterilization” provides guidance for processing reusable medical devices for use in perioperative and procedural settings. This article elaborates on key takeaways from the guideline, including processing a device based on the intended use of the item, protecting sterile items during transport, reprocessing by immediate‐use steam sterilization when certain conditions can be met, and educating personnel who perform sterile processing activities. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.
Inadvertent Perioperative Hypothermia Risks and Postoperative Complications: A Retrospective Study
Authors: Akers J. Luke , Dupnick Amanda C. , Hillman Elisa L. , Bauer Andrew G. , Kinker Lauren M. , Hagedorn Wonder Amy
Published: May 2019

Inadvertent perioperative hypothermia is a widely known patient condition that is associated with postoperative complications. This retrospective comparative study of 298 surgical patients was conducted at a single hospital site in the midwestern United States. Our aims were to describe risk factors and outcomes associated with perioperative hypothermia. We compared the type and frequency of patient factors, clinical factors, and postoperative complications during the inpatient stay of the sample patients to determine whether there were factors or complications associated with perioperative hypothermia. Significant factors associated with the occurrence of perioperative hypothermia included older age and type of surgery. Hypothermia in patients was associated with a higher rate of postoperative complications when compared with normothermic patients. Nurses and perioperative leaders should understand the risk factors and complications associated with perioperative hypothermia to collaboratively develop and test evidence‐based initiatives, improve care, and promote optimal patient outcomes.
The Effect of Radiofrequency Technology on Time Spent Searching for Surgical Sponges and Associated Costs
Authors: Steelman Victoria M. , Schaapveld Ann G. , Storm Hillary E. , Perkhounkova Yelena , Shane Dan M.
Published: May 2019

Retained surgical items (eg, sponges, instruments) remain the most frequently reported sentinel events. The primary strategy for preventing retained sponges is the sponge count. Reconciling sponge counts is time consuming and can extend the duration of operative and other invasive procedures. The primary objective of this observational study was to evaluate the effect of a radiofrequency (RF) surgical‐sponge detection system on time spent searching for surgical sponges. The study included 27,637 procedures during nine months before and after implementing an RF surgical‐sponge detection system. After implementation of the system, time spent searching for sponges was reduced by 79.58%, the percentage of unreconciled counts was reduced by 71.28%, and time spent using radiography to rule out a retained sponge was reduced by 46.31%. This resulted in a reduction of costs. These findings should be used as part of a comprehensive cost analysis of alternative methods when evaluating RF sponge detection technology.
Extracellular Vesicles and Cell–Cell Communication in the Cornea
Authors: Zieske James D. , Hutcheon Audrey E. K. , Guo Xiaoqing
Published: May 2019

One question that has intrigued cell biologists for many years is, “How do cells interact to influence one another's activity?” The discovery of extracellular vesicles (EVs) and the fact that they carry cargo, which directs cells to undergo changes in morphology and gene expression, has revolutionized this field of research. Little is known regarding the role of EVs in the cornea; however, we have demonstrated that EVs isolated from corneal epithelial cells direct corneal keratocytes to initiate fibrosis. Intriguingly, our data suggest that EVs do not penetrate epithelial basement membrane (BM), perhaps providing a mechanism explaining the importance of BM in the lack of scarring in scrape wounds. Since over 100‐million people worldwide suffer from visual impairment as a result of corneal scarring, the role of EVs may be vital to understanding the mechanisms of wound repair. Therefore, we investigated EVs in ex vivo and in vivo‐like three‐dimensional cultures of human corneal cells using transmission electron microscopy. Some of the major findings were all three major cell types (epithelial, fibroblast, and endothelial cells) appear to release EVs, EVs can be identified using TEM, and EVs appeared to be involved in cell–cell communication. Interestingly, while our previous publication suggests that EVs do not penetrate the epithelial BM, it appears that EVs penetrate the much thicker endothelial BM (Descemet's membrane). These findings indicate the huge potential of EV research in the cornea and wound healing, and suggest that during homeostasis the endothelium and stromal cells are in communication. Anat Rec, 2019. © 2019 The Authors. The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists.
Design, synthesis, biological evaluation, and molecular dynamics of novel cholinesterase inhibitors as anti‐Alzheimer's agents
Authors: Shamsimeymandi Reza , Pourshojaei Yaghoub , Eskandari Khalil , Mohammadi‐Khanaposhtani Maryam , Abiri Ardavan , Khodadadi Arash , Langarizadeh Amin , Sharififar Fariba , Amirheidari Bagher , Akbarzadeh Tahmineh , Lotfian Hania , Foroumadi Alireza , Asadipour Ali
Published: May 2019

A series of novel chroman‐4‐one derivatives were designed and synthesized successfully with good to excellent yield (3a–l). In addition, the obtained products were evaluated for their cholinesterase (ChE) inhibitory activities. The results show that among the various synthesized compounds, analogs bearing the piperidinyl ethoxy side chain with 4‐hydroxybenzylidene on the 3‐positions of chroman‐4‐one (3l) showed the most potent activity with respect to acetylcholinesterase (anti‐AChE activity; IC50 = 1.18 μM). In addition, the structure–activity relationship was studied and the results revealed that the electron‐donating groups on the aryl ring of the 3‐benzylidene fragment (3k,3l) resulted in the designed compounds to be more potent ChE inhibitors in comparison with those having electron‐withdrawing groups (3h). In this category, the strongest ChE inhibition was found for the compound containing piperidine as cyclic amine, and a hydroxyl group (for AChE, compound3l) and fluoro group (for butyrylcholinesterase (BuChE, compound3i) on thepara‐position of the aryl ring of the benzylidene group. The molecular docking and dynamics studies of the most potent compounds (3iand3lagainst BuChE and AChE, respectively) demonstrated remarkable interactions with the binding pockets of the ChE enzymes and confirmed the results obtained through in vitro experiments.
The relationship between symptoms of autism spectrum disorder and visual impairment among adults with intellectual disability
Authors: Kiani Reza , Bhaumik Sabyasachy , Tyrer Freya , Bankart John , Miller Helen , Cooper Sally Ann , Brugha Traolach Sean
Published: May 2019

The higher prevalence of autism reported in blind children has been commonly attributed to the confounding effects of an underlying intellectual disability. The aim of this study was to explore the relationship between symptoms of autism and blindness in adults with intellectual disability. We hypothesized that blindness can increase the probability of the autism phenotype, independent of known risk factors, that is, severity of intellectual disability and gender. A general population case register (population size of 0.7 million) was used to conduct two studies. The first study was on 3,138 adults with intellectual disability, using a validated autism risk indicator to study adults with visual impairment. This identified 386 adults with partial and complete visual impairment, both of which were associated with presence of high number of autistic traits (P < 0.001). The second study was only on those with congenital blindness using a standardized assessment tool, the Pervasive Developmental Disorder—Mental Retardation Scale. Those with hearing impairment or unilateral, partial, and acquired visual impairment were excluded. Control groups were randomly selected from those with normal hearing and vision. Prevalence of the autism phenotype was higher among those with congenital blindness (n = 46/60; 76.7%) than their controls (n = 36/67; 53.7%) and this association was statistically significant (adjusted odds ratio = 3.03; 95% confidence interval: 1.34–6.89; P = 0.008). Our results support the hypothesis that a congenital blindness independently affects psychosocial development and increases the probability of the autism phenotype. Early identification of autism could facilitate appropriate psychosocial interventions and educational opportunities to improve quality of life of people with blindness. Autism Res 2019, 12: 1411–1422. © 2019 International Society for Autism Research, Wiley Periodicals, Inc.

Lay Summary

Although autism has been commonly reported in those with blindness, it is generally attributed to an accompanying intellectual disability. Current study, however, revealed that congenital blindness is independently associated with symptoms of autism. In spite of its high prevalence, autism can be overlooked in those with intellectual disability and blindness. Improving diagnosis in this population should, therefore, be advocated through raising awareness of this association to facilitate early access to services.
Economic evaluation and comparison of succinic acid and electricity co‐production from sugarcane bagasse and trash lignocelluloses in a biorefinery, using different pretreatment methods: dilute acid (H2SO4), alkaline (NaOH), organosolv, ammonia fibre expansion (AFEX™), steam explosion (STEX), and wet oxidation
Authors: Nieder‐Heitmann Mieke , Haigh Kathleen , Louw Janus , Görgens Johann F.
Published: May 2019

The sugar yield achieved during pretreatment of lignocelluloses has an impact on the economic outcome of biorefineries. Chemical and physiochemical pretreatment methods were evaluated and compared to determine the most favorable pretreatment method for the commercial co‐production of succinic acid and electricity in a sugarcane lignocellulosic biorefinery. Nine methods were identified and simulated in Aspen Plus®. All the pretreatment methods were profitable except organosolv and wet oxidation. Steam explosion (STEX), sulfur dioxide (SO2), catalyzed STEX, and ammonia fibre expansion (AFEX™) resulted in the highest succinic acid yields, with 45.7, 43.5 and 33.4 kg succinic acid per 100 tonnes of dry feedstock, respectively, and they are recommended for commercial application. However, due to the high cost of enzymatic hydrolysis (46.23 million US$), the AFEX™ pretreatment method was the most expensive scenario at 385.7 million US$ total capital cost with an internal rate of return (IRR) of 22.81%. This may be compared with 384.2 million US$ for STEX pretreatment, which resulted in the most profitable biorefinery scenario with an IRR of 28.04%. © 2019 Society of Chemical Industry and John Wiley & Sons, Ltd
State of the States: A survey of statutory law, regulations and court rules pertaining to guilty pleas across the United States
Authors: Zottoli Tina M. , Daftary‐Kapur Tarika , Edkins Vanessa A. , Redlich Allison D. , King Christopher M. , Dervan Lucian E. , Tahan Elizabeth
Published: May 2019

A psycholegal research agenda on guilty pleas is in its nascent stage. Multijurisdictional surveys of related law and policy may advance this research agenda by focusing investigators on the specifics of existing policies and motivating cross‐jurisdictional comparisons of diverse policies. We thus conducted a systematic, national survey of statutes, regulations and court rules across the United States pertaining to nine aspects of the guilty plea process, including sentencing differentials, collateral consequences and waiver of rights, which have been identified in existing legal and psycholegal research and commentary. Following a discussion of these issues, including legal concerns and existing research findings, we present the results of our systematic survey. We supplement this review with a non‐systematic sampling of appellate case law. Broadly, there was notable diversity in whether and how jurisdictions approached these issues. We discuss general and specific implications of our findings for future research, emphasizing the importance of data on actual policies and procedures to the design of studies that may contribute to evidence‐based criminal justice policy.
Detection of mutations in circulating cell‐free DNA in relation to disease stage in colorectal cancer
Authors: Liebs Sandra , Keilholz Ulrich , Kehler Inge , Schweiger Caroline , Haybäck Johannes , Nonnenmacher Anika
Published: May 2019

Enthusiasm has emerged for the potential of liquid biopsies to provide easily accessible genetic biomarkers for early diagnosis and mutational cancer characterization. We here systematically investigated the suitability of circulating cell‐free DNA (cfDNA) analysis for mutation detection in colorectal cancer (CRC) patients with respect to clinicopathological disease stage. Droplet Digital PCR (ddPCR) was performed to detect common point mutations in the KRAS and BRAF oncogenes in cfDNA from 65 patients and compared to mutations in tumor tissue. Stage of disease was classified according to UICC (Union for International Cancer Control) criteria. In tumor tissue, KRAS or BRAF mutations were present in 35 of 65 cases (44% UICC stage I, 50% stage II, 47% stage III, and 62% stage IV). Although cfDNA was detected in 100% of patients, ddPCR displayed the tumor tissue mutation in only 1 of 6 (17%) stage II patients, whereas 10 of 18 (56%) reported variants were verified in cfDNA samples of the stage IV cohort. No BRAF or KRAS mutation was detected in cfDNA from patients with wild‐type tumor tissue. In one case of mutant stage II colon cancer (KRAS‐G12C), the G12D variant was detected in cfDNA instead. Further workup revealed that circulating tumor‐derived DNA and liver metastases originated from a synchronous KRAS‐mutated cancer of the pancreas. Our results demonstrate that ddPCR‐based analysis is highly specific and useful for mutation monitoring, but the sensitivity limits its usefulness for early cancer detection.
Chemical Strategies for Visualizing and Analyzing Endogenous Nonribosomal Peptide Synthetase (NRPS) Megasynthetases
Authors: Ishikawa Fumihiro , Tanabe Genzoh
Published: May 2019

Nonribosomal peptide (NRP) natural products are among the most promising resources for drug discovery and development, owing to their wide range of biological activities and therapeutic applications. These peptide metabolites are biosynthesized by large multienzyme machinery known as NRP synthetases (NRPSs). The structural complexity of a number of NRPs poses an enormous challenge in their synthesis. A major issue in this field is reprogramming NRPS machineries to allow the biosynthetic production of artificial peptides. NRPS adenylation (A) domains are responsible for the incorporation of a wide variety of amino acids and can be considered as reprogramming sites; therefore, advanced methods to accelerate the functional prediction and assessment of A‐domains are required. This Concept article demonstrates that activity‐based protein profiling of NRPSs offers a simple, rapid, and robust analytical platform for A‐domains and provides insights into enzyme–substrate candidates and active‐site microenvironments. It also describes the background associated with the development and application of a method to analyze endogenous NRPS machinery in its natural environment.
Hyperglycemia induces NF‐κB activation and MCP‐1 expression via downregulating GLP‐1R expression in rat mesangial cells: inhibition by metformin
Authors: Kang Zhanfang , Zeng Jianwen , Zhang Tian , Lin Shuyun , Gao Jun , Jiang Chonghe , Fan Rongrong , Yin Dazhong
Published: May 2019

Hyperglycemia impairs glucagon‐like peptide‐1 receptor (GLP‐1R) signaling in multiple cell types and thereby potentially attenuates the therapeutic effects of GLP‐1R agonists. We hypothesized that the downregulation of GLP‐1R by hyperglycemia might reduce the renal‐protective effects of GLP‐1R agonists in diabetic nephropathy (DN). In this study, we examined the effects of high glucose on the expression of GLP‐1R and its signaling pathways in the HBZY‐1 rat mesangial cell line. We found that high glucose reduced GLP‐1R messenger RNA (mRNA) levels in HBZY‐1 cells and in the renal cortex in db/db mice comparing with control groups. In consistence, GLP‐1R agonist exendin‐4 induced CREB phosphorylation was attenuated by high glucose but not low glucose treatment, which is paralleled with abrogated anti‐inflammatory functions in HBZY‐1 cells linked with nuclear factor‐κB (NF‐κB) activation. In consistence, GLP‐1R inhibition aggravated the high glucose‐induced activation of NF‐κB and MCP‐1 protein levels in cultured HBZY‐1 cells while overexpression of GLP‐1R opposite effects. We further proved that metformin restored high glucose‐inhibited GLP‐1R mRNA expression and decreased high glucose evoked inflammation in HBZY‐1 cells. On the basis of these findings, we conclude that high glucose lowers GLP‐1R expression and leads to inflammatory responses in mesangial cells, which can be reversed by metformin. These data support the rationale of combinative therapy of metformin with GLP‐1R agonists in DN.
A case of neck xanthogranulomatous inflammation‐suspected malignant tumor
Authors: Nomura Tsutomu , Momose Syuji , Takashima Masatoshi , Kikuchi Shigeru
Published: May 2019

Xanthogranulomatous inflammation (XGI) is an uncommon chronic inflammatory disease. A 59‐year‐old male presented with a neck mass which had been diagnosed as an undifferentiated carcinoma. From CD68 staining, XGI was confirmed. It is important to consider the possibility of XGI for a neck mass mimicking a malignant tumor.
Hydrochlorination of Acetylene Over the Activated‐Carbon‐Supported Au Catalysts Modified by N−P−O‐Containing Ligand
Authors: Zhang Chuanming , Zhang Haiyang , Li Yanqin , Xu Liang , Li Jian , Li Linfeng , Cai Ming , Zhang Jinli
Published: May 2019

Etidronic acid (HEDP) and Nitrilotri(methylphosphonic acid) (ATMP) were selected as heteroatoms‐containing ligands to modify Au catalysts for acetylene hydrochlorination. Results from several analytical methods reveal an optimal mole ratio of Au/ligand (L) of 1 : 1, with obvious increments over the Au1‐L1/AC catalyst. The coordination between the Au and the heteroatoms, especially the collocative presence of N, P, and O promoted electron transfer from the heteroatoms to the Aun+ and increased the density of the electron cloud around active centers. This stabilized the Aun+ and increased the difficulty in the reduction of Au species, and re‐oxidized the Au0 to active Aun+ species. Moreover, the coordination inhibited the migration of active components. The increased density of the electron cloud around active centers also weakens the adsorption capacity for C2H2 and strengthens the adsorption ability for HCl of the catalysts, which is conductive for constructing the micro‐environment favorable to the reaction. DFT calculations proved the stabilization effect of the heteroatoms‐containing ligands, and the energy sequence of the transition states supported the experimental results.