bluuebunny/crossref_metadata_2025 huggingface dataset:
Thyroid nodules in childhood‐onset Hashimoto's thyroiditis: Frequency, risk factors, follow‐up course and genetic alterations of thyroid cancer
Authors: Lee Yun Jeong , Cho Yeon Jin , Heo You Joung , Chung Eun‐Jae , Choi Young Hun , Kim Jong‐Il , Park Young Joo , Shin Choong Ho , Lee Young Ah
Published: April 2021

Objective

We evaluated the frequency, risk factors and the follow‐up outcomes of thyroid nodules, and genetic alterations in thyroid cancer, in youth with childhood‐onset Hashimoto thyroiditis (HT) residing in an iodine‐sufficient country.

Design

A retrospective cohort study.

Patients and measurements

A total of 213 patients (194 females, mean age 10.6 years at the time of HT diagnosis) were ultrasonographically evaluated. Thyroid nodules were categorized using the Korean Thyroid Imaging Reporting and Data System (K‐TIRADS) and the American College of Radiology Thyroid Imaging Reporting and Data System (ACR‐TI‐RADS).

Results

Thyroid nodules were detected in 40 (18.8%) patients over a median follow‐up period of 3.4 years, usually after the onset of puberty. A family history of thyroid disease (hazard ratio 2.1, p = .031) was predictive of thyroid nodule detection. Papillary thyroid carcinoma (PTC) was diagnosed in 9 (4.2% of all and 22.5% of nodule‐positive patients). The malignant nodules had a higher K‐TIRADS or ACR‐TI‐RADS risk level compared with benign nodules (p < .01 for both). Genetic alterations were revealed in 7 (BRAFV600E in 6 and RET‐ERC1 fusion in 1) of the eight available tumour tissue samples. None showed evidence of disease over a median follow‐up period of 3.4 years.

Conclusions

The nodule detection rate was 18.8%, with a 22.5% risk of malignancy among the detected nodules in childhood‐onset HT patients, showing increased risk in those with a family history. Additional large‐scale studies are required to evaluate the usefulness of K‐TIRADS or ACR‐TI‐RADS risk level for the differentiation of paediatric thyroid nodules.
Anogenital syringocystadenocarcinoma papilliferum in situ or anaplastic extramammary Paget disease? A unifying concept and review of the literature
Authors: Sheldon Jesse D. , Buckley Kaila , Ulman Catherine , Chung Catherine G.
Published: April 2021

Extramammary Paget disease (EMPD) is a rare cutaneous malignancy that typically involves the genital skin and can be primary or associated with an underlying internal malignancy. The typical histopathological appearance of EMPD consists of single or small aggregates of cells with abundant pale cytoplasm and large pleomorphic nuclei, known as Paget cells, scattered throughout the epidermis. We report a case of anogenital EMPD occurring in a 53‐year‐old man with unusual histopathologic findings of marked epidermal acanthosis, acantholysis, intraepidermal glandular differentiation, and prominent plasma cell‐rich fibrovascular cores. These features were entirely confined to the epidermis and adnexa with no evidence of dermal invasion or underlying systemic disease. We review and summarize the literature for atypical features noted in EMPD and summarize similar findings previously described under a variety of descriptions including anaplastic EMPD, anogenital syringocystadenocarcinoma papilliferum in situ (SCACPIS), SCACPIS‐like changes in EMPD, and EMPD mimicking acantholytic squamous cell carcinoma in situ. We propose that these features represent a single entity and be considered under a unifying diagnosis to facilitate recognition of this entity.
Altered precipitation dynamics lead to a shift in herbivore dynamical regime
Authors: Pepi Adam , Holyoak Marcel , Karban Richard
Published: April 2021

The interaction between endogenous dynamics and exogenous environmental variation is central to population dynamics. Although investigations into the effects of changing mean climate are widespread, changing patterns of variation in environmental forcing also affect dynamics in complex ways. Using wavelet and time series analyses, we identify a regime shift in the dynamics of a moth species in California from shorter to longer period oscillations over a 34‐year census, and contemporaneous changes in regional precipitation dynamics. Simulations support the hypothesis that shifting precipitation dynamics drove changes in moth dynamics, possibly due to stochastic resonance with delayed density‐dependence. The observed shift in climate dynamics and the interaction with endogenous dynamics mean that predicting future population dynamics will require information on both climatic shifts and their interaction with endogenous density‐dependence, a combination that is rarely available. Consequently, models based on historical data may be unable to predict future population dynamics.
Latitudinal patterns of terrestrial phosphorus limitation over the globe
Authors: Hou Enqing , Wen Dazhi , Jiang Lifen , Luo Xianzhen , Kuang Yuanwen , Lu Xiankai , Chen Chengrong , Allen Keanan T. , He Xianjin , Huang Xingzhao , Luo Yiqi
Published: April 2021

Phosphorus limitation on terrestrial plant growth is being incorporated into Earth system models. The global pattern of terrestrial phosphorus limitation, however, remains unstudied. Here, we examined the global‐scale latitudinal pattern of terrestrial phosphorus limitation by analysing a total of 1068 observations of aboveground plant production response to phosphorus additions at 351 forest, grassland or tundra sites that are distributed globally. The observed phosphorus‐addition effect varied greatly (either positive or negative), depending significantly upon fertilisation regime and production measure, but did not change significantly with latitude. In contrast, phosphorus‐addition effect standardised by fertilisation regime and production measure was consistently positive and decreased significantly with latitude. Latitudinal gradient in the standardised phosphorus‐addition effect was explained by several mechanisms involving substrate age, climate, vegetation type, edaphic properties and biochemical machinery. This study suggests that latitudinal pattern of terrestrial phosphorus limitation is jointly shaped by macro‐scale driving forces and the fundamental structure of life.
Causal associations of serum matrix metalloproteinase‐8 level with ischaemic stroke and ischaemic stroke subtypes: a Mendelian randomization study
Authors: Jia Yiming , Guo Daoxia , Zhang Kaixin , Yang Pinni , Zang Yuhan , Sun Lulu , Wang Yu , Liu Fanghua , Shi Mengyao , Zhang Yonghong , Zhu Zhengbao
Published: April 2021

Background and purpose

Elevated serum matrix metalloproteinase‐8 (MMP‐8) concentrations are associated with high risk of vascular disease, but the causality remains unclear. A two‐sample Mendelian randomization (MR) study was performed to examine the causal effect of serum MMP‐8 concentrations on the risk of ischaemic stroke, ischaemic stroke subtypes and coronary artery disease.

Methods

Ten independent single‐nucleotide polymorphisms related to serum MMP‐8 concentrations were identified as instrumental variables from a genome‐wide association study of 6049 European subjects. Genetic association estimates for ischaemic stroke were obtained from the Multiancestry Genome‐wide Association Study of Stroke consortium with 446,696 European individuals. The inverse‐variance weighted method was applied to assess the causal associations of serum MMP‐8 with ischaemic stroke and its subtypes in the main analysis.

Results

No significant causal association was observed for MMP‐8 levels with total ischaemic stroke, large artery stroke or cardioembolic stroke. Genetically determined 1 – unit higher log‐transformed serum MMP‐8 concentration was associated with an increased risk of small vessel stroke (odds ratio 1.25; 95% confidence interval 1.12–1.39; p < 0.001). In secondary analysis, a similar adverse impact was reported for MMP‐8 on coronary artery disease (odds ratio 1.05; 95% confidence interval 1.01–1.10; p = 0.017). Sensitivity analyses further confirmed the relationship between serum MMP‐8 level and small vessel stroke and coronary artery disease. Mendelian randomization Egger regression showed no evidence of pleiotropic bias.

Conclusions

High serum MMP‐8 concentrations were causally associated with increased risks of small vessel stroke and coronary artery disease. The mechanism underlying the effect of serum MMP‐8 on the vascular system requires further investigation.
Prior On–Off Relationship Instability and Distress in the Separation and Divorce Transition
Authors: Monk James Kale , Kanter Jeremy B. , Ogan Matthew A.
Published: April 2021

Divorce is considered distressing for many individuals (Sbarra et al., Current Directions in Psychological Science, 2015, 24, 109); however, individuals in poor‐quality relationships may experience certain benefits of leaving an unstable union (Amato & Hohmann‐Marriott, Journal of Marriage and Family, 2007, 69, 621). On–off relationship cycling, or the breakup and reconciliation of a relationship, is a salient indicator of poor relationship quality and a common form of relationship instability (Dailey et al., Personal Relationships, 2009, 16, 23) that is associated with distress (Monk et al., Family Relations, 2018, 67, 523). In line with divorce–stress–adjustment and relational turbulence theory perspectives, we hypothesized that those whose relationships were characterized by on–off instability would experience less distress during the separation and divorce process. Given gender inequality in marriage (e.g., Dempsey, Journal of Sociology, 2002, 38, 91; Monin & Clark, Sex Roles, 2011, 65, 320), we also hypothesized that this association would be more pronounced for women. Using data from 98 divorced or separating couples, we found that relationship cycling prior to the separation and divorce process was associated with fewer distress symptoms for women. Conversely, a history of relationship cycling was associated with more distress symptoms for men. Our study provides support and extends prior investigations illustrating that, for some, those in unions characterized by more turmoil, may experience relief following a termination.
Corruption perceptions: Confidence in elections and evaluations of clientelism
Authors: Bacchus Emily Beaulieu , Boulding Carew
Published: April 2021

How does the fairness of the democratic process influence public perceptions of corruption? This article demonstrates the ways that elections can influence broader confidence in democracy. Corruption is often described as one of the most serious problems facing democracy today, and citizen confidence in democracy has implications for system support and legitimacy. What constitutes corruption, however, is not always obvious. We focus on the importance of citizens' feelings about electoral integrity for shaping their attitudes about corruption more broadly. Using survey data from Latin America and an experimental survey in the United States, we show that when asked to evaluate political practices as corrupt or not, people who are more confident in the fairness of their electoral process are generally less concerned about corruption, compared with people who are less confident in elections. These effects hold across a range of practices, experiences, and electoral contexts.
The structure of POMGNT2 provides new insights into the mechanism to determine the functional O‐mannosylation site on α‐dystroglycan
Authors: Imae Rieko , Kuwabara Naoyuki , Manya Hiroshi , Tanaka Tomohiro , Tsuyuguchi Masato , Mizuno Mamoru , Endo Tamao , Kato Ryuichi
Published: April 2021

Defects in the O‐mannosyl glycan of α‐dystroglycan (α‐DG) are associated with α‐dystroglycanopathy, a group of congenital muscular dystrophies. While α‐DG has many O‐mannosylation sites, only the specific positions can be modified with the functional O‐mannosyl glycan, namely, core M3‐type glycan. POMGNT2 is a glycosyltransferase which adds β1,4‐linked GlcNAc to the O‐mannose (Man) residue to acquire core M3‐type glycan. Although it is assumed that POMGNT2 extends the specific O‐Man residues around particular amino acid sequences, the details are not well understood. Here, we determined a series of crystal structures of POMGNT2 with and without the acceptor O‐mannosyl peptides and identified the critical interactions between POMGNT2 and the acceptor peptide. POMGNT2 has an N‐terminal catalytic domain and a C‐terminal fibronectin type III (FnIII) domain and forms a dimer. The acceptor peptide is sandwiched between the two protomers. The catalytic domain of one protomer recognizes the O‐mannosylation site (TPT motif), and the FnIII domain of the other protomer recognizes the C‐terminal region of the peptide. Structure‐based mutational studies confirmed that amino acid residues of the catalytic domain interacting with mannose or the TPT motif are essential for POMGNT2 enzymatic activity. In addition, the FnIII domain is also essential for the activity and it interacts with the peptide mainly by hydrophobic interaction. Our study provides the first atomic‐resolution insights into specific acceptor recognition by the FnIII domain of POMGNT2. The catalytic mechanism of POMGNT2 is proposed based on the structure.
Treatment outcomes of stereotactic body radiation therapy using a real‐time tumor‐tracking radiotherapy system for hepatocellular carcinomas
Authors: Uchinami Yusuke , Katoh Norio , Abo Daisuke , Taguchi Hiroshi , Yasuda Koichi , Nishioka Kentaro , Soyama Takeshi , Morita Ryo , Miyamoto Naoki , Suzuki Ryusuke , Sho Takuya , Nakai Masato , Ogawa Koji , Kakisaka Tatsuhiko , Orimo Tatsuya , Kamiyama Toshiya , Shimizu Shinichi , Aoyama Hidefumi
Published: April 2021

Aim

To report the outcomes of stereotactic body radiotherapy using a real‐time tumor‐tracking radiotherapy system for hepatocellular carcinoma patients.

Methods

From January 2005 to July 2018, 63 patients with 74 lesions with a maximum diameter ≤52 mm were treated by stereotactic body radiotherapy using a real‐time tumor‐tracking radiotherapy system. No patient with a Child–Pugh Score ≥9 was included, and 85.6% had a score of 5 or 6. Using the biological effective dose (BED) with an α/β ratio of 10 (BED10), the median dose in BED10 at the reference point was 76.8 Gy (range 60–122.5 Gy). Overall survival (OS) and local control rates were assessed using the Kaplan–Meier method.

Results

With a median follow‐up period of 24.6 months (range 0.9–118.4 months), the 1‐year and 2‐year OS rates were 86.8% (95% confidence interval [95% CI] 75.8–93.3) and 71.1% (57.8–81.6), respectively. The 2‐year OS was 89.6% in patients with the baseline modified albumin‐bilirubin (mALBI) grade =1, and 61.7% in patients with grade ≥2a. In the multivariate analysis, the mALBI grade (=1 vs. ≥2a) was a significant factor for OS (p = 0.028, 95% CI 1.11–6.18). The 1‐year and 2‐year local control rates were 100% (100–100%) and 92.0% (77.5–97.5%). The local control rates were significantly higher in the BED10 ≥100 Gy group than in the BED10 <100 Gy group (2‐year 100% vs. 86.5%, p = 0.049) at the reference point.

Conclusion

This retrospective study of stereotactic body radiotherapy using real‐time tumor‐tracking radiotherapy for hepatocellular carcinoma showed favorable outcomes with lower incidence of toxicities, especially in patients treated with BED10 ≥100 Gy to the reference point.
Alkali‐free processing of advanced open‐celled sinter‐crystallized glass‐ceramics
Authors: Elsayed Hamada , Rabelo Monich Patricia , Savio Gianpaolo , Hartmann Malte , Boccaccini Aldo R. , Galusek Dusan , Kraxner Jozef , Bernardo Enrico
Published: April 2021

The cooling of a melt corresponding to the eutectic between wollastonite (CaSiO3) and diopside (CaMgSi2O6) determines the synthesis of an interesting example of alkali‐free bioactive glass, easily converted into glass‐ceramics featuring two silicate phases, coupled also with åkermanite (Ca2MgSi2O7), by sinter‐crystallization of fine glass powders at 1000°C. The fabrication of scaffolds by digital light processing of glass powders suspended in a photo‐curable, sacrificial binder, is a well‐established technique; the present paper aims at disclosing novel approaches, concerning the topology of scaffolds, offering components with remarkable strength, especially in bending conditions. As an alternative, glass‐ceramic foams were fabricated by the firing of porous precursors derived from the gelation of suspensions of glass powders in alkali‐free basic aqueous solution.
Dynamic roles of neutrophils in post‐stroke neuroinflammation
Authors: Wanrooy Brooke J , Wen Shu Wen , Wong Connie HY
Published: April 2021

Clinical trials involving the blockage of peripheral inflammatory leukocyte recruitment into the brain have puzzlingly led to either no significant improvement in stroke outcome, or even worsened outcomes and increased mortality, prompting a re‐evaluation of our understanding into the neuroinflammatory processes after stroke. Whilst traditionally understood as simple effectors of the innate immune system, emerging research in vascular disease biology has redefined the neutrophil as a specialized and highly specific cell type with dynamic functional capacity. Indeed, emerging experimental evidence indicates that neutrophils display diverse roles in the acute stages of ischemic stroke with the ability to elicit both pro‐inflammatory and anti‐inflammatory effects. Currently, there is some uncertainty as to whether neutrophil diversity is beneficial or harmful in stroke as their interactions with the resident cells of the brain, such as microglia and neurons, would potentially elicit heterogeneous outcomes. Current treatments for patients with stroke aim to remove the vascular blockage and to restore blood flow, but there are currently no drug treatments for managing the loss of functional brain tissue nor restoration of microglial and neuronal damage. If these hypothesized wound‐healing functions of neutrophils can be validated in a stroke setting, promoting the recruitment of this type of neutrophils into the injured brain tissue may form a promising therapeutic target for the majority of stroke patients currently without treatment. In this review, we will provide an update on recent research that has explored neutrophil heterogeneity in the neuroinflammatory cascade after ischemic stroke.
Association between resilience and burnout of front‐line nurses at the peak of the COVID‐19 pandemic: Positive and negative affect as mediators in Wuhan
Authors: Zhang Xiaoning , Jiang Xue , Ni Pingping , Li Haiyang , Li Chong , Zhou Qiong , Ou Zhengyan , Guo Yuqing , Cao Junli
Published: April 2021

The outbreak of coronavirus disease 2019 (COVID‐19) is having a dramatic effect on the mental health of healthcare workers (HCWs). Upon the emergence of the COVID‐19 pandemic, the Chinese government dispatched about 42 000 HCWs to Wuhan City and Hubei Province to fight this pandemic. This study briefly examines front‐line nurses who experienced burnout, with the main objective of investigating the mediating roles of positive and negative affect in the relationship between resilience and burnout in Wuhan hospitals at the peak of the COVID‐19 pandemic. A total of 180 front‐line nurses voluntarily participated via a social media group. They completed the online questionnaires, including the Maslach Burnout Inventory‐General Survey (MBI‐GS), the Positive and Negative Affect Schedule (PANAS), the Connor–Davidson Resilience Scale (CD‐RISC), demographics, and work‐related characteristics. Structural equation modelling (SEM) analysis was used to examine the mediating effect of positive and negative affect on the relationship between resilience and burnout. The total prevalence of burnout was 51.7%, of which 15.0% were severe burnout. These preliminary results revealed that positive and negative affect fully mediated the effects of resilience on burnout, emotional exhaustion, depersonalization, and reduced personal accomplishment of front‐line nurses. It is necessary to know the impact of resilience on HCWs with burnout through the positive and negative affect of individual backgrounds and situations, and how policymakers can deploy resilience interventions to support front‐line HCWs.
Nurses’ experiences in response to COVID‐19 in a psychiatric ward in Singapore
Authors: Gao Z. , Tan F. P. L.
Published: April 2021

Aim

To understand nurses’ responses to COVID‐19 and identify their uptake of changes in the procedure required for the management of COVID‐19 in an inpatient psychiatric ward.

Background

The infection risk for COVID‐19 in an enclosed inpatient psychiatric ward is high due to living arrangements in the ward and the nature of the infectious disease.

Introduction

This paper describes inpatient nurses’ experiences, challenges and strategies deployed at the institutional and national levels to contain the spread of infection.

Methods

Written feedback was collected to understand nurses’ responses and identify their uptake of changes in procedure following the COVID‐19 outbreak in the ward.

Findings

Nurses felt shocked, worried, isolated, expressed a lack of confidence, and experienced physical exhaustion. COVID‐19 specific challenges were highlighted in the delivery of safe and quality nursing care. Nurses were satisfied with the hospital policy and strategies implemented during the outbreak, acknowledging the importance of support from nursing leaders.

Discussion

Practical support and strong nursing leadership have been imperative in the battle against the COVID‐19 outbreak in the psychiatric hospital. Psychiatric nursing care was maintained with a modified management and treatment approach.

Implications for Nursing practice

Nurses' willingness to adjust to the reconfiguration of operations to accommodate changes has been crucial for the healthcare system to run effectively. Good practices and policies established during this crisis should be developed and established permanently in nursing practice.

Implications for Health Policy

Prompt and effective contingency planning and policymaking at the national and institutional level, targeting human resource management and infection control, can introduce changes and alternative options for nursing care in a pandemic.

Conclusion

With support from influential nursing leaders, strategies and policies are imperative in ensuring the successful management of COVID situations in an inpatient psychiatric setting.
Should Shareholders Have a Say on Acquisitions?
Authors: Becht Marco , Polo Andrea , Rossi Stefano
Published: April 2021

Shareholders of U.S. corporations have lost billions of dollars in acquisitions they never approved. In the United Kingdom, the listing rules give shareholders a binding say when targets are large relative to their acquirers.

A transatlantic comparison of M&A activity suggests that if U.S. shareholders had a say on acquisitions, U.S. acquirers would do fewer value‐destroying acquisitions and their own shareholders would experience smaller losses. The authors also report finding a significant difference in the performance of the large U.K. deals that are subject to a mandatory vote and those that are not. The United States has given shareholders a mandatory say on pay. Is it time for U.S. shareholders to have a binding say on corporate acquisitions?
The Relationship between Shareholder Return and CEO Pay over a CEO's Full Period of Service
Authors: Schmidt Ron
Published: April 2021

The author reports the findings of his examination of the relationship between CEO pay and performance, as measured by shareholder returns, using measures of compensation and returns that span a CEO's full period of service. Unlike studies that look at annual measures of CEO pay and stock returns—which are distorted by the widespread use of options and the arbitrary effects of when CEOs choose to exercise their options—the author finds a statistically significant connection between total compensation and shareholder return measured over full periods of service for 521 S&P 500 CEOs. Indeed, after one adjusts for differences in the length of a CEO's service, shareholder return is arguably the most important determinant of variation in the amount paid CEOs over their complete tenures.

Besides answering the legion of critics of CEO pay, the author's analysis refutes the claim that bull markets are the main force driving executive pay by demonstrating that the increases in career pay attributable to increases in shareholder returns are almost exactly offset by reductions in pay when the Value‐Weighted (S&P 500) Index increases by the same amount. In other words, CEOs’ cumulative career pay is effectively driven by the extent to which their stock returns outperform the broad market. The analysis also casts doubt on the popular claim that the link between CEO pay and corporate size provides incentives to undertake even value‐reducing acquisitions to boost size. As the author's analysis shows, the estimated losses in career CEO pay associated with even small declines in shareholder returns are likely to be offset by the pay increases attributable to size.
Implications of Short Selling for Corporate Finance
Authors: Deshmukh Sanjay , Howe Keith M. , Gamble Keith Jacks
Published: April 2021

Corporate managers often view short sellers as market manipulators whose actions drive their company's stock price below intrinsic value. But recent academic research suggests that some short sellers are effective in processing publicly available information and that their short selling may provide useful information to market participants. This article summarizes the authors’ own published research, which provides evidence of informed short selling by linking it to changes in corporate fundamentals.

More specifically, the authors’ findings indicate that increases in short interest are reliable indicators of an economically (as well as statistically) significant decline in a company's operating performance over the following three years. And when examining changes in short interest around announcements of seasoned equity offerings, the authors also find a negative relation between an increase in short interest and future operating performance. In addition, they find that the greater the increase in short interest in the period leading up to the SEO announcement, the more negative is the stock‐price response to the announcement itself.

The authors’ findings suggest that corporate managers can benefit from monitoring the short‐selling activity in their company's stock. Short‐selling data can be used to reassess corporate strategy or rethink major corporate decisions that have been announced but not carried out, and take preemptive actions to forestall impending future declines in performance and so preserve value.
Investigation of 60Co gamma irradiation on dehydration kinetics: A case study of apple slices
Authors: Mohammad‐Razdari Ayat , Ebrahimi Rahim , Zarein Mohammad , Mahfeli Mandana , Yoosefian Seyedeh Hoda
Published: April 2021

Little research has been done on the effects of irradiation on dehydration kinetics of dried fruit in recent decades. Hot air drying is a convenience method frequently used for dehydration and moisture removal in products, such as fruits and vegetables. However, there are some disadvantages to using hot air dryers that often lead to the production of dried products with inferior quality due to its low drying efficiency. The present research aims to investigate the hot air dryer performance and presents a new strategy to improve dried bio‐products quality using gamma irradiation as a drying pretreatment. The effects of irradiation dosage (control, 0.5, 2, and 5 kGy) and air temperature (50, 65, and 80°C) on the dehydration rate, moisture ratio, activation energy, and diffusion coefficient of dried apple slices were investigated. The results showed that different dose 0.5, 2, and 5 kg decreased moisture content average 35, 21, and 11%, respectively. Also, by decreasing dehydration temperature, moisture content decreased to 42, 31, and 25%, respectively. The effective diffusivity values at different temperatures increased by increasing the irradiation dosage (control, 0.5, 2, and 5 kg increased to 12, 17, 29, and 43% respectively), and vice versa for the activation energy.

Practical Applications

Irradiation is one of the few food technologies that can maintain food quality and address food safety and security problems without significantly affecting a food's sensory or nutritional attributes. The destructive effect of 60Co γ‐ray irradiation on interior tissue of some fruit and vegetables may change product structure to some extent. These kinds of structural changes can affect the drying kinetics, dehydration rate, moisture ratio, activation energy, and diffusion coefficient. Therefore, the investigation of hot‐air drying kinetics of apple slices pretreated by 60Co γ‐ray was required to improve the product quality. Additionally, it can cause a reduction in drying quality and improve the product characteristics during the drying process.
Palliative care for persons with dementia
Authors: Blackstone Karen A. , Cobbs Elizabeth L.
Published: April 2021

This editorial comments on the article by Mo et al. in this issue.
Successful outcomes in childrens specialist weight management: Impact assessment of a novel early years weight management programme
Authors: Tee Louise P. , Brandreth Rachael A. , Sauven Natasha , Clarke Lia , Frampton Ian
Published: April 2021

Background

In the UK, more than one in five children are overweight on starting school. An elevated body mass index (BMI) in childhood increases the likelihood of developing many health and social issues. The Lifestyles, Eating and Activity for Families (LEAF) programme is a weight management service for clinically obese children under the age of 7 years and their families. This study evaluates the effectiveness of the LEAF programme by measuring BMI z‐score change, the reduction in calorific beverage consumption and user satisfaction.

Methods

Data were collected over 6 years from 2012 and children who met the local weight management pathway criteria were recruited. Contact time was typically 20 h over 12 months and included home and clinic‐based assessment by the multidisciplinary team and community‐based intervention through six group sessions. This study compared baseline and post‐intervention BMI z‐scores (zBMI) for 65 children, as well as daily total calorific intakes from beverages for 41 children, and, in addition, 20 parents completed user satisfaction questionnaires.

Results

There was a highly significant reduction in both mean zBMI (0.5; p < 0.001) and mean total calories from beverages (199; p < 0.001) across the intervention period. There was no significant correlation between zBMI and beverage calorific trends. Families who completed user satisfaction questionnaires reported that they had changed their dietary habits and 90% would recommend the programme to others.

Conclusions

This initial evaluation indicates that the LEAF programme was effective in reducing the zBMI of a group of clinically obese young children.

Keywords obesity epidemic, young children, intervention, multidisciplinary
Monazite petrochronology of polymetamorphic granulite‐facies rocks of the Larsemann Hills, Prydz Bay, East Antarctica
Authors: Spreitzer Steven K. , Walters Jesse B. , Cruz‐Uribe Alicia , Williams Michael L. , Yates Martin G. , Jercinovic Michael J. , Grew Edward S. , Carson Christopher J.
Published: April 2021

The Prydz Bay coast, including the Larsemann Hills, features relatively extensive bedrock exposures of interest because of the proximity to a hypothesized suture associated with Gondwana assembly. Critical units are the basement Søstrene Orthogneiss (1,126 ± 11 Ma protolith) and cover Brattstrand Paragneiss (maximum depositional age 1,023 ± 19 Ma). The two units share a polymetamorphic history with events at ~900 Ma (D1) and ~530 Ma (D2‐4). Here we present electron microprobe dates of monazite growth zones and Perple_X pseudosection models of granulite‐facies rocks from the Søstrene Orthogneiss, Brattstrand Paragneiss, and D2‐4 pegmatites of the Larsemann Hills. We propose a scenario for Cambrian metamorphism involving a peak stage at 6–7.5 kbar and 800–860°C (D2 convergence), melt crystallization and garnet breakdown during decompression to early retrograde conditions of 3–4.5 kbar and 700–750°C (D2 convergence, D3 extension), and a late retrograde stage with decompression and cooling to 3–3.5 kbar and 550–650°C (D4). We combine monazite chemistry with phase assemblages predicted by pseudosection modelling to link specific monazite growth domains to individual tectonic stages. Monazite domains containing moderate Th and low to moderate Y are interpreted to be preserved from the prograde path when garnet was stable, and constrain the timing of prograde metamorphism at 536 ± 4 Ma. High‐Th, low‐Y domains, dated at 527 ± 2 Ma, represent the earliest stages of post‐peak melt crystallization. Monazite domains with elevated Y and low‐moderate Th are interpreted to represent monazite growth during garnet breakdown at 514 ± 2 Ma. Our monazite ages, combined with published biotite Ar–Ar cooling ages, yield a two‐stage history of cooling at 3–8°C/Myr from ~530 Ma to ~510 Ma followed by cooling at 18–25°C/Myr from ~510 Ma to ~490 Ma, corresponding to 0.2–0.6 mm/yr of exhumation. This duration of granulite‐facies metamorphism in the Larsemann Hills is consistent with estimates for Precambrian granulite facies metamorphic complexes elsewhere.
Differential abnormalities of cerebrospinal fluid dopaminergic versus noradrenergic indices in synucleinopathies
Authors: Goldstein David S. , Sullivan Patti , Holmes Courtney , Lamotte Guillaume , Lenka Abhishek , Sharabi Yehonatan
Published: April 2021

The synucleinopathies Parkinson's disease (PD), multiple system atrophy (MSA), and pure autonomic failure (PAF) are characterized by intra‐cytoplasmic deposition of the protein alpha‐synuclein and by catecholamine depletion. PAF, which manifests with neurogenic orthostatic hypotension (nOH) and no motor signs of central neurodegeneration, can evolve into PD+nOH. The cerebrospinal fluid (CSF) levels of catecholamine metabolites may indicate central catecholamine deficiency in these synucleinopathies, but the literature is inconsistent and incomplete. In this retrospective cohort study we reviewed data about CSF catecholamines, the dopamine metabolites 3,4‐dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), and the norepinephrine metabolites 3,4‐dihydroxyphenylglycol (DHPG) and 3‐methoxy‐4‐hydroxyphenylglycol (MHPG). The compounds were measured in 36 patients with PD, 37 patients with MSA, and 19 patients with PAF and in 38 controls. Compared to the control group, the PD, MSA, and PAF groups had decreased CSF MHPG (p < .0001 each by Dunnett's post hoc test), DHPG (p = .004; p < .0001; p < .0001) and norepinephrine (p = .017; p = .0003; p = .044). CSF HVA and DOPAC were decreased in PD (p < .0001 each) and MSA (p < .0001 each) but not in PAF. The three synucleinopathies therefore have in common in vivo evidence of central noradrenergic deficiency but differ in the extents of central dopaminergic deficiency—prominent in PD and MSA, less apparent in PAF. Data from putamen 18F‐DOPA and cardiac 18F‐dopamine neuroimaging in the same patients, post‐mortem tissue catecholamines in largely separate cohorts, and review of the neuropathology literature fit with these distinctions. The results suggest a ‘norepinephrine first’ ascending pathogenetic sequence in synucleinopathies, with degeneration of pontine locus ceruleus noradrenergic neurons preceding the loss of midbrain substantia nigra dopaminergic neurons.

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Do oxidative stress and melanin accumulation contribute to the pathogenesis of idiopathic guttate hypomelanosis: A prospective case‐control study
Authors: Zeeshan Md , Sonthalia Sidharth , Yadav Priyanka , Gupta Pooja , Agrawal Mahima , Bhatia Jushya , Jha Abhijeet Kumar , Roy Prasoon Kumar
Published: April 2021

Background

Oxidative stress parameters have been reported to be significantly higher than controls in diverse disorders of pigmentation but no such data seem to be extant for IGH.

Objectives

To verify whether heightened oxidative stress levels are seen in patients with IGH (compared with matched controls) and quantify the same in blood using appropriate biochemical markers. Further, an attempt to determine if there might be any correlation between the amount of oxidative stress and the severity of the disease.

Methodology

This prospective case‐control study was conducted in Northern India. Thirty Indian patients (Fitzpatrick skin phototype (SPT) IV‐V) were included. The diagnosis of IGH lesions was confirmed based on characteristic clinical, and dermoscopic characteristics and confirmed on histopathological examination (H & E) of one of the lesions.

Results

The oxidative stress enzyme level was significantly higher among the cases compared to controls which were statistically significant (p < 0.05). A positive correlation was also observed between the levels of these markers and number of lesions, but this finding was statistically not significant [p > 0.05]. Assessment of melanin level by Dopa staining method in the IGH lesions revealed irregularly distributed melanin with areas of high and low melanin content and greater accumulation in the basement layer.

Conclusion

The results of this probably the first study evaluating oxidative stress in IGH show that the oxidative stress is increased in patients with IGH. Level of oxidative stress seems to be correlated with both age of the patient (more in the elderly) and number of lesions.
Astragaloside prevents UV‐induced keratinocyte injury by regulating TLR4/NF‐κB pathway
Authors: Wang Jie , Ke Jin , Wu Xing , Yan Yuehua
Published: April 2021

Background

Ultraviolet (UV) radiation is a key risk factor of environment to contribute photoaging and skin cancer through production of reactive oxygen species (ROS) and inflammatory responses. Astragaloside IV (AS‐IV) is an active component from Astragalus membranaceus, and shows various pharmacological effects on inflammation, oxidative stress and apoptosis. However, whether AS‐IV shows protective effect on UVB‐induced injury in epidermal keratinocytes remain unknown.

Aims

To explored the effects of AS‐IV on UVB‐induced oxidative injury and inflammatory response in human epidermal keratinocytes.

Methods

HaCaT keratinocytes were exposed to UVB irradiation, followed by AS‐IV incubation. The cell viability, intracellular ROS level, oxidative stress, and apoptosis were determined. The regulatory effects of AS‐IV on toll‐like receptor 4 (TLR4) pathway in UVB‐exposed HaCaT cells were also investigated.

Results

Astragaloside IV pretreatment (10, 25, 50, 100 and 150 μM) increased cell viability in UVB‐exposed HaCaT cells. AS‐IV (50 μM) significantly reduced intracellular ROS level and lipid oxidation product malondialdehyde (MDA) content, and increased a ROS‐scavenging enzyme superoxide dismutase (SOD) in HaCaT cells with UVB irradiation. In addition, AS‐IV pretreatment suppressed apoptosis, increased Bax protein, caspase‐3 and 9, and decreased BCL‐2 protein in contrast to HaCaT cells with UVB‐irradiation. AS‐IV suppressed proinflammatory cytokine production, inhibited TLR4 and its downstream signaling molecules NF‐κB, iNOS and cyclooxygenase‐2 (COX‐2) protein expression. We also found that the effects of AS‐IV on cell viability and TLR4 expression was reversed by NAC. The protective of AS‐IV on UVB‐induced damage and TLR4 expression was dependent on ROS, as the increase in viability and decrease in TLR4 protein by AS‐IV was significantly attenuated by ROS scavenger NAC (1 mM).

Conclusion

Astragaloside IV prevent UVB‐induced oxidative damage and inflammation by inhibiting TLR4 expression.
Association of Nursing Practice Environment on reported adverse events in private management hospitals: A cross‐sectional study
Authors: Granados‐Plaza Montse , Gea‐Caballero Vicente , Martí‐Ejarque Maria del Mar , Ferré‐Grau Carme
Published: April 2021

Aims and objectives

To examine the relationships between nurses’ perceptions of their practice environment, other working conditions and reported adverse events in two private management hospitals.

Background

Patient safety is influenced by knowledge, available resources and the context in which nursing care is provided. In this sense, it has been found that certain work environments (e.g., workload, nurse turnover level, patient‐to‐nurse ratio, nurse staffing, nurse manager ability) influence patient outcomes. The association between nursing practice environment and reported adverse events has not been explored in private management hospitals.

Design

A cross‐sectional study. The STROBE was selected as the checklist in this study.

Methods

A total of 219 nurses were included in the study. This study was conducted from June 2018–June 2019 in Spain. Data were collected through questionnaires focusing on work conditions, reported adverse events (falls, medication errors, catheter‐related sepsis and pressure ulcer) and Practice Environment Scale of the Nursing Work Index. Binary logistic regression analysis was performed to determine the factors influencing the occurrence of errors.

Results

Nurses reported poor perception of the professional environment, and 62.1% reported having made at least one error in the previous year. Manager support and leadership and nurse–physician relations were the most favourable aspects of work environment. Medical–surgical units, rotating in the same shift and favourable work environment, were associated with more reporting of adverse events.

Conclusion

The factors of nursing practice (hospital area workload, staff rotating and perception of work environment) associated with reporting adverse events can be worked upon from the organisation and provided an opportunity for safety culture improvement and safer healthcare services.

Relevance to clinical practice

Improving the nurse work environment may reduce adverse patient events in private management hospitals.
Affirmation on the go: A proof‐of‐concept for text message delivery of values affirmation in education
Authors: Manke Kody J. , Brady Shannon T. , Baker Mckenzie D. , Cohen Geoffrey L.
Published: April 2021

The present study offers a proof‐of‐concept for the delivery of values affirmation via text message. In two studies, we tested whether we could distill the typical 15‐minute pen‐and‐paper values affirmation exercise into a brief (∼4 minute) text‐message based exercise. In Study 1 (N = 42), we asked students to identify an upcoming academic stressor. In Study 2, we targeted students (N = 121) who reported that they would be starting a summer internship they expected to be stressful. In both studies, students completed a brief exercise (affirmation or control) via text message the night before their stressor. Across the studies, we found consistent benefits of this mobile affirmation on students’ belonging, inconsistent effects on their perceptions of stress, and no effects on their evaluations of their stressor when measured shortly after (Study 1) or during (Study 2) the stressor. Together, these studies offer initial evidence for a novel, promising, and scalable method of delivering values affirmation at the “right time and place” using mobile technology. We also discuss lessons we learned and offer recommendations to researchers interested in administering affirmation via text message.
Dementia care from behind the mask? Maintaining well‐being during COVID‐19 pandemic restrictions: Observations from Dementia Care Mapping on NHS mental health hospital wards in Wales
Authors: Page Sean , Davies‐Abbott Ian , Jones Adrian
Published: April 2021

Accessible summary

What is known on the subject?

Coronavirus disease 2019 (COVID‐19) is a new infectious disease that has spread across the world and infected a large number of people many of whom have died.

People with moderate to severe dementia are at very high risk of becoming infected as the disease mainly impacts on older people with other health problems and once infected the person with dementia is more likely to become seriously ill than other people.

To prevent infection, people are required to wear masks and isolate from contact with others. It is believed that these measures can reduce the quality of life and general well‐being of people with moderate to severe dementia in hospital or social care. This belief has not yet been demonstrated by research.

What does this paper add to the existing knowledge?

We show that people with moderate to severe dementia receiving care on mental health hospital wards and subject to strict infection prevention measures can still achieve high levels of well‐being.

We show that mental health nurses alter the focus of their care to deliberately overcome the challenges and particularly the restrictions on visiting by families.

What are the implications for practice?

We believe that the changes in practice we observed can occur in other healthcare and social care settings and that whilst restrictions remain in place care staff can protect and possibly enhance well‐being for people with moderate to severe dementia.

Introduction

The effect of coronavirus (COVID‐19) on people living with dementia is potentially severe in its clinical impacts. More widely, for this vulnerable group, the social restrictions to limit the spread of infection may be emotionally and psychologically damaging.

Aim

To explore the impact of restrictions on well‐being for people with moderate to severe dementia in acute mental health hospital care.

Method

“Dementia Care Mapping” was the observational tool used to determine well‐ or ill‐being. Observations were undertaken in two mental health hospital wards during a time of restrictions and the use of personal protective equipment.

Results

We report levels of well‐being that are higher than might be expected alongside a change in the focus of psychological care delivered through mental health nursing interventions aimed at enhancing well‐being. Discussion—We postulate that mental health nurses faced with an unprecedented challenge respond by changing practice to mitigate for infection prevention measures and to compensate for family absence.

Implications for practice

We suggest that the desirable enhancing actions by nursing staff which raise well‐being in these hospital settings are readily transferable to other settings that are aiming to maintain well‐being but also practising under COVID‐19 restrictions.
In vivo exposure of Albendazole sulphoxide by Haemonchuscontortus and correlation between plasma and target tissue or gastrointestinal content dispositions in goats
Authors: Gokbulut Cengiz , Cirak Veli Y. , Aypak Suleyman , Avci Hamdi , Sekkin Selim , Yalinkilinc Hande S. , Boga Buket , Ayaz Erol
Published: April 2021

Sheep and goats are sharing different helminth parasites including Haemonchus contortus. Control of these helminths is based mainly on the use of anthelmintics. However, in goats, the application of anthelmintics is often carried out mainly at dosages determined for sheep without knowing the real effects and metabolism features. One of the several anthelmintic classes used against these parasites is (pro) benzimidazoles which are still widely in use in small ruminants in many countries. The objective of this study was to determine (i) the correlation between plasma and tissue or gastrointestinal content dispositions of ricobendazole (RBZ) in goats and (ii) the in vivo exposure of ricobendazole by H. contortus. Ten goats were experimentally infected with 10,000 larvae of H. contortus. Four weeks of post‐infection, the animals received RBZ subcutaneously at 5 mg/kg body weight. Two goats were sacrificed per time at 1, 2, 4, 6 and 12 h after drug administration and, blood, bile, urine, liver, lung, muscle and kidney gastrointestinal tissues/fluids were collected. Adult H. contortus were collected from abomasum, and all samples were analysed by HPLC system. Ricobendazole (RBZ) and its sulphone metabolite were extensively excreted by urine and distributed to all tissues and digestive tract, mainly into the abomasum fluid. RBZ concentration in the lung and ABZSO2 in the kidney were relatively higher than those of other tissues, respectively. The parent drug and its metabolite were recovered in both male and female H. contortus. This study indicates that in goats the plasma concentration profiles of RBZ are strongly correlated with those achieved in different target tissues or fluids, which in turn, reflect the amount of drug taken up by parasites.